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Maximum allowable blood loss (ABL) without transfusion

Maximum allowable blood loss (ABL) without transfusion
Patient category (average blood volume)
Weight
Starting hematocrit
%
Lowest acceptable hematocrit
%
Complete the fields above to see the result.

When to use

  • Anticipating, before or during surgery, how much blood loss can be tolerated before transfusion is likely needed.

Formula

EBV = weight x average blood volume per kg. ABL = EBV x (starting Hct - lowest acceptable Hct) / average Hct, where average Hct = (starting + lowest acceptable)/2.

Pearls and pitfalls

  • Corrects for the fact that hematocrit falls progressively as blood is lost and replaced with crystalloid/colloid, unlike the simpler uncorrected formula.
  • Treat the transfusion trigger (lowest acceptable Hct/Hb) as an individualized clinical decision, not a fixed number.

References

  1. Gross JB. Anesthesiology. 1983;58(3):277-280.