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Bleeding after delivery

Main and The Obgyn Clinic of Hvidovre (danish)

Blood loss% of volume (100 % = 5 l for 60 kg woman)	Replacement	Volume	Total
0-20 % --> 1 l	Nacl isotonic 1000 ml x 3	3000	.	.
20 - 50 % --> 2,5 l	RBC suspension x 2	600	2	.
.	Synthetic plasma substitutes	1000	.	.
50 - 90 % --> 4,5 l	RBC suspension x 4	1200	+4	.
.	FFP x 2	600	.	.
90 - 100 % --> 5 l	RBC suspension x 2	600	+2	Prepare for Novoseven *
.	FFP x 3	600	.	.
> 100 % --> 5 l	RBC suspension x 4	1200	+4	.
.	Thrombocytes x 2 pools	.	.	.
.	Fibrinogen 2 g or FFP 10-20 ml/kg x5	.	.	.
.	*	.	.	Novoseven 50 mg/kg i.v. over 2-3 minutes (can be repeated af 20 minutes)
* Eventual repetition of above mentioned before Novoseven	.	.	.	.
.	Thrombocytes x 2 pools	.	.	.
.	.	1200	4	.
.	Fibrinogen 2 g or FFP 10-20 ml/kg	.	.	.
.	Cyklocapron 1 g	.	.	.

Suggestion for blood replacement and preparation for the use of Novoseven (Sandbjerg 2005, guideline in Danish)