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Authors
Advisor(s)
Abstract(s)
Atualmente, uma das preocupações médicas está relacionada com as perdas sanguíneas em
Bloco Operatório. Este facto deve-se à atenção cada vez maior para com o paciente e para
com a melhoria dos cuidados de saúde prestados. Já em contexto cirúrgico, tem que ver com a
preparação do médico anestesista para que seja dada uma resposta rápida e adequada ao
paciente, sendo que esta depende da tipologia e do nível de sangramento da cirurgia.
Uma das cirurgias com maior nível de sangramento em Ortopedia trata-se da cirurgia de
escoliose idiopática. Este é o motivo do presente trabalho, devido ao facto de ser uma cirurgia
muito comum, ser bastante invasiva e por ser realizada em crianças e adolescentes. Nestes
casos há uma preocupação acrescida, pelo que o conhecimento das perdas sanguíneas seria
uma grande ajuda na prevenção e preparação destes casos.
No sentido de dar resposta às preocupações emergentes em contexto hospitalar,
nomeadamente às demonstradas pelo Serviço de Anestesiologia do Centro Hospitalar do
Porto, E.P.E. – Hospital de Santo António, este trabalho foca-se na procura de um método
prático, fiável e reprodutível de determinação de perdas sanguíneas que possa ser utilizado no
Bloco Operatório. Para isso, foram comparadas três metodologias diferentes de recolha de
dados: (1) método empírico; (2) método gravimétrico; (3) método espectrofotométrico. Estas
metodologias foram aplicadas em dois tipos de compressas, de acordo com a sua utilização
durante a cirurgia: compressas de gaze e compressas de contraste.
Através da comparação das três metodologias utilizadas foi possível obter um modelo de
previsão para as três variáveis em estudo, Peso de Sangue Aproximado, VisNIR e Opinião da
enfermeira instrumentista, baseado no modelo de regressão quadrática. Apesar de ter ficado
aquém das espectativas, os erros médios associados a este modelo não foram muito elevados,
o que pode indicar que possivelmente com um número mais elevado de dados os resultados
poderão melhorar e os erros médios associados poderão diminuir. Foi também possível
estimar um valor médio para o volume de sangue perdido por cirurgia.
Currently, one of the medical concerns is related to blood loss in the operating theater. This is due to the increasing attention to the patient and to the improvement of health care provided. Already in the surgical setting, it has to do with the preparation of the anesthetist to be given a fast and appropriate response to the patient, and this depends on the surgery type and the type of surgery bleeding. One of the surgeries with higher bleeding in Orthopedics comes from surgery for idiopathic scoliosis. This is the motive of the present work, due to being a very common surgery, quite invasive and to be performed in children and adolescents. In such cases there is a greater concern, so knowledge of blood loss would be a great help in preventing and preparation of these cases. In order to respond to emerging concerns in the hospital setting, particularly to those shown by the Anesthesiology Service of the Porto Hospital Center, E.P.E. - Hospital de Santo António, this work focuses on the search for a practical, reliable and reproducible method for determining blood loss that can be used in the Operating Room. For this purpose, three different methods of data collection were compared: (1) empirical method; (2) gravimetric method; (3) spectrophotometric method. These approaches were applied to two types of swabs, according to their use during surgery: gauze and contrast. By comparing the three methodologies was possible to obtain a prediction model for the three variables under study, Blood Approximate Weight, VisNIR and instrumentalist nurse Opinion, based on the polynomial model. Despite having fallen short of expectations, the average error associated with this model were not very high, which may possibly indicate that a higher number of data could improve the results and average errors associated may decrease. It was also possible to estimate an average value of the volume of blood lost through surgery.
Currently, one of the medical concerns is related to blood loss in the operating theater. This is due to the increasing attention to the patient and to the improvement of health care provided. Already in the surgical setting, it has to do with the preparation of the anesthetist to be given a fast and appropriate response to the patient, and this depends on the surgery type and the type of surgery bleeding. One of the surgeries with higher bleeding in Orthopedics comes from surgery for idiopathic scoliosis. This is the motive of the present work, due to being a very common surgery, quite invasive and to be performed in children and adolescents. In such cases there is a greater concern, so knowledge of blood loss would be a great help in preventing and preparation of these cases. In order to respond to emerging concerns in the hospital setting, particularly to those shown by the Anesthesiology Service of the Porto Hospital Center, E.P.E. - Hospital de Santo António, this work focuses on the search for a practical, reliable and reproducible method for determining blood loss that can be used in the Operating Room. For this purpose, three different methods of data collection were compared: (1) empirical method; (2) gravimetric method; (3) spectrophotometric method. These approaches were applied to two types of swabs, according to their use during surgery: gauze and contrast. By comparing the three methodologies was possible to obtain a prediction model for the three variables under study, Blood Approximate Weight, VisNIR and instrumentalist nurse Opinion, based on the polynomial model. Despite having fallen short of expectations, the average error associated with this model were not very high, which may possibly indicate that a higher number of data could improve the results and average errors associated may decrease. It was also possible to estimate an average value of the volume of blood lost through surgery.