Acta orthopaedica Scandinavica
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Clinical Trial Controlled Clinical Trial
No influence of large volume blood loss on serum vancomycin concentrations during orthopedic procedures.
We prospectively studied orthopedic patients with either large or small blood loss who also received vancomycin prophylaxis to determine the effect of intraoperative volume shifts on serum vancomycin concentrations. There were 6 index patients in the large blood loss group (greater than 2 L), and 7 in the control group (less than 2 L). Mean estimated blood loss for index and controls was 4.4 L and 1.0 L, respectively. ⋯ This was a morbidly obese patient with massive blood loss. Thus, blood loss during orthopedic procedures has minimal effects on intraoperative kinetics of vancomycin. Redosing is rarely indicated, although a preoperative 1.5 gram-dose should be considered for patients weighing more than 90 kg.