Accurate determination of the amount of blood loss is very important for clinical practice and plays a crucial role in the determination of anesthesia, transfusion tactics and postoperative management period of the patient as a whole. In experimental and military field surgery for this purpose historically and to this day a large number of various methods that are considered in the review of scientific sources is used. The purpose of the study is to consider and analyze the effectiveness of existing methods of determination blood loss. Results. Existing methods for determining the amount of blood loss are divided into direct and indirect. Direct methods are divided into: colorimetric, weight, and volume. Colorimetric method is the Phillips method (1945), based on the ability of copper protein to form a shell around a drop of blood or plasma, which retains its relative density for 10-15 seconds. In 1956 G. A. Barashkov modified the Phillips method by adding hematocrit data. Colorimetric methods make it possible to measure in real time and have a high degree of correlation. Weighing method is gravimetric method, weighing blood-stained surgical material. Historically, the first methods of determining blood loss are considered to be volumetric (direct measurement of the volume of blood lost). Indirect methods are represented by the following groups: clinical, laboratory, hardware, radial, mathematical (calculated), and indicator. Among the clinical methods, the first is the Algover shock index and Buri (1967) (the ratio of heart rate to magnitude systolic blood pressure); visual methods – determination of blood loss by wound size proposed by Grant and Reeve (1951). In shock states monitoring the central hemodynamics on definition of the central venous pressure is applied. To assess capillary perfusion a test of capillary filling is used. Mandatory in clinical practice are laboratory research methods: the content of erythrocytes, hemoglobin, hematocrit, definition of relative blood density. Barashkov's method is based on these indicators. Hardware method is N. M. Shestakov method (1977), a method of determining the circulating blood volume for integral body resistance by using a rheograph. G. A. Shifrin proposed a method based on the registration of the electrical resistance of the body, which is registered when performing bipolar integral rheography. Radiation methods are iodine isotope I131 isotope of chromium Cr-chloride of chromium Cr51Cl3, which is used to determine circulating blood volume; plasma fluorometry method; radionuclide method of circulating blood volume research. Mathematical (calculation) methods involve the use of mathematical formulas to determine the degree of hypovolemia. It is a hematocrit method. F. D. Moore (1956), Nelson's formula is based on hematocrit. In 1983, V. D. Sidora proposed a mathematical calculation method based on the knowledge of circulating blood volume and hematocrit at each body weight in women and men. M. M. Abakumov et al. (2002) proposed a linear regression equation. The amount of blood loss can be calculated by the P. G. Bryusovs formula (1997). M. A. Libov (1962) proposed a formula for determining the amount of blood loss by weighing napkins that are soaked in blood. Indicator method, using Evans blue (blue azo dye T-1824), method of dilution with indocyanine green, as well as the method of determining circulating blood volume using dextar solution (polyglucin). Conclusion. Today, there is no quick enough accurate and cheap method of determining the value of circulating blood volume, despite the growth of technical equipment in medicine. It is vital for practical medicine to have an accurate, fast, cheap and affordable method of determining the amount of blood loss, which will allow timely and accurate calculation of the volume and quality of replacement therapy for blood loss. When providing assistance in areas of mass trauma and emergency surgery, modern medicine is in dire need of a specific system for objective assessment of the severity of victims with blood loss, which will meet the high requirements of practical health care

Keywords: blood loss, methods of determining circulating blood volume, the amount of blood loss

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1. Bryusov PG. Ostraya krovopoterya: klassifikatsiya, opredelenie velichiny i tyazhesti [Acute blood loss: classification, determination of magnitude and severity]. Voenno-meditsinskiy zhurnal. 1997;1:46-52. [Russian]
2. Phillips R, Friberg M, Lantz Cronqvist M, Jonson CO, Prytz E. Visual estimates of blood loss by medical laypeople: Effects of blood loss volume, victim gender, and perspective. PLoS One. 2020 Nov 12;15(11):e0242096. PMID: 33180812. PMCID: PMC7660581. https://doi.org/10.1371/journal.pone.0242096
3. Potapov OO, Rubanets MM, Kmyta OP. Klinichni aspekty transfuziolohiyi [Clinical aspects of transfusiology]. Navch posib. Sumy: Sumskyi derzhavnyi universytet; 2019. 397 s. [Ukrainian]
4. Kursov SV, Nikonov VV, Skoroplet NN. Krovopoterya (lektsiya) [Blood loss (lecture)]. Meditsina nevidkladnikh staniv. 2019;1(96):7-21. [Russian]
5. Ashburn JC, Harrison T, Ham JJ, Strote J. Emergency physician estimation of blood loss. West J Emerg Med. 2012;13(4):376-379. PMID: 22942938. PMCID: PMC3421978. https://doi.org/10.5811/westjem.2011.9.6669
6. Budair B, Ahmed U, Hodson J, David M, Ashraf M, McBride T. Are we all guilty of under-estimating intra-operative blood loss during hip fracture surgery? J Orthop. 2017;14(1):81-84. PMID: 27829730. PMCID: PMC5094288. https://doi.org/10.1016/j.jor.2016.10.019
7. Kochanov DA. Metodika flyuorimetrii plazmy dlya izmereniya obema tsirkuliruyushchey krovi [Plasma fluorimetry technique for measuring the volume of circulating blood]. Abstr. PhDr. (Med.). M; 2008. 130 s. [Russian]
8. Kligulenko EN, Kravets OV. Intensivnaya terapiya krovopoteri [Intensive care of blood loss]. M: MEDpress-inform; 2005. 112 s. [Russian]
9. Mutschler M, Nienaber U, Münzberg M, Wölfl C, Schoechl H, Paffrath T, et al. The Shock Index revisited - a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the Trauma Register DGU. Critical Care. 2013;17(4):172. PMID: 23938104. PMCID: PMC4057268. https://doi.org/10.1186/cc12851
10. Usenko LV, Znoskova IA. Metody opredeleniya krovopoteri [Methods for determining blood loss]. Bіl, znebolyuvannya і іntensivna terapіya. 1998;(4):8-17. [Russian]
11. Bogdan NV, Gain YuM. Problema ostroy krovopoteri v khirurgii. Sposoby opredeleniya obema i stepeni tyazhesti krovopoteri [The problem of acute blood loss in surgery. Methods for determining the volume and severity of blood loss]. Voennaya meditsina. 2007;2:46-50. [Russian]
12. Struthers David. Blood and plasma specific gravities and plasma formol reactions in general medical conditions. Thesis submitted to the University of Glasgow; 1949 Dec. ProQuest LLC; 2019. 256 p.
13. Phillips RA, Van Slyke LA, Dole VP, Emerson KJr, Hamilton PB, Archibald RM. Copper sulphate method for measuring specific gravities of blood and plasma. Army Medical Bulletin. 1943 Dec;71:66-83. (OCoLC) 01778648
14. Osnovi intensivnoi terapiyi [Basics of intensive care]. Navchalniy posibnik. Za red LV Usenko. Ternopil: Ukrmedkniha; 2002 332 s. [Ukrainian]
15. Barashkov GA. Diagnostika vnutrennikh krovotecheniy s pomoshchyu opredeleniya nekotorykh fizicheskikh pokazateley krovi [Diagnosis of internal bleeding by determining some physical indicators of blood]. Vestnik khirurgii. 1956;3:48-53. [Russian]
16. Gerdessen L, Meybohm P, Choorapoikayil S, Herrmann E, Taeuber I, Neef V, et al. Comparison of common perioperative blood loss estimation techniques: a systematic review and meta-analysis. J Clin Monit Comput. 2021;35(2):245-258. PMID: 32815042. PMCID: PMC7943515. https://doi.org/10.1007/s10877-020-00579-8
17. Chernov AM. Optimizatsiya protsesu viznachennya ta otsinki ob'yemu krovovtrati v poslidovomu ta pislyapolohovomu periodakh [Optimization of the process of determining and estimating the amount of blood loss in the consecutive and postpartum periods]. Abstr. PhDr. (Med.). K; 2016. 167 s. [Ukrainian]
18. Allgöwer M, Burri C. [Schock index]. Dtsch Med Wochenschr. 1967 Oct 27;92(43):1947-50. [German]. PMID: 5299769. https://doi.org/10.1055/s-0028-1106070
19. Davies WL. Methods of assessment of blood loss in the shocked and injured patient. Br J Anaesth. 1966 Apr;38(4):250-4. PMID: 5939807. https://doi.org/10.1093/bja/38.4.250
20. He YL, Tanigami H, Ueyama H, Mashimo T, Yoshiya I. Measurement of blood volume using indocyaninc green measured with pulsespectrophotometry: The reproductivity and reliability. Crit Care Med. 1998 Aug;26(8):1446-51. PMID: 9710108. https://doi.org/10.1097/00003246-199808000-00036
21. Usenko LV, Shifrin GA. Intensivnaya terapiya pri krovopotere. [Intensive care for blood loss]. 3-e izd, kontseptualnoe i innovatsionnoe. Dnepropetrovsk: Izd-vo «Novaya ideologya»; 2007. 290 s. [Russian]
22. Zhiznevskiy YaA. Osnovy infuzionnoy terapii [Fundamentals of infusion therapy]. Mn: Vyssh shk; 1994. 288 s. [Russian]
23. Moore FD. Metabolic care of surgical patients. Philadelphia-London: W.B. Sanders Company; 1959. 1247 p.
24. Tishhenko M.I. Biofizicheskie i metrologicheskie osnovy integral'nyh metodov opredeleniya udarnogo ob'ema krovi cheloveka [Biophysical and metrological bases of integrated methods for determining the stroke volume of human blood]. Abstr. PhDr. (Med.). M; 1971. 144 p. [Russian]
25. Tkachenko AE. Dyferentsiyne khirurhichne likuvannya postrazhdalykh z poyednanoyu kranio-abdominalnoyu travmoyu [Differential surgical treatment of victims with combined cranio-abdominal trauma]. Abstr. PhDr. (Med.). К; 2016. 168 s. [Ukrainian]
26. Grant RT, Reeve EB. Observations on the general effects of injury in man, with special reference to wound shock. Spec Rep Ser Med Res Counc (G B). 1951;277:1-313. PMID: 14881915
27. Abakumov MM, Lozhkin AV, Khvatov VB. Otsenka obema i stepeni krovopoteri pri travme grudi i zhivota [Assessment of the volume and degree of blood loss in chest and abdominal injuries]. Khirurgiya. 2002;11:4-7. [Russian]
28. Bisenkov LN. Khirurgiya ognestrelnykh raneniy grudi [Surgery of gunshot wounds to the chest]. SPb: Gippokrat; 2000. 312 s. [Russian]
29. Orth VH, Rehm M, Thiel M, Kreimeier U, Haller M, Brechtelsbauer H, et al. First clinical implications of perioperative red cell volume measurement with a nonradioactive marker (sodium fluorescein). Anesth Analg. 1998;93:82-87. https://doi.org/10.1213/00000539-199812000-00003
30. Robertson TA, Bunel F, Roberts MS. Fluorescein Derivatives in Intravital Fluorescence Imaging. Cells. 2013 Aug 2;2(3):591-606. PMID: 24709799. PMCID: PMC3972669. https://doi.org/10.3390/cells2030591
31. Kim KM, Park DY, Kang EH, Kim M, Choi BM, Noh GJ, et al. A modified method of measuring plasma volume with indocyanine green: reducing the frequency of blood sampling while maintaining accuracy. J Clin Monit Comput. 2021 Aug;35(4):779-785. PMID: 32472337. https://doi.org/10.1007/s10877-020-00536-5
32. Brecher M, Monk T, Goodnough L, A Standardized method for calculating blood loss. Transfusion. 997 Oct;37(10):1070-4. PMID: 9354828. https://doi.org/10.1046/j.1537-2995.1997.371098016448.x
33. Kocsis L, Herman P, Eke A. Mathematical model for the estimation of hemodynamic and oxygenation variables by tissue spectroscopy. J Theor Biol. 2006 Jul 21;241(2):262-75. PMID: 16413035. https://doi.org/10.1016/j.jtbi.2005.11.033
34. Belousov A, Malygon E, Yavorskiy V. Calculating the True Volume of Blood Loss. J Anesth Clin Res. 2017;8(11): 1000787. https://doi.org/10.4172/2155-6148.1000787
35. Nelson GH. Consideration of blood loss at delivery as percentage of estimated blood volume. Am J Obstet Gynecol. 1980 Dec 15;138(8):1117-9. PMID: 6969544. https://doi.org/10.1016/S0002-9378(16)32776-4
36. Sidora VD. Ekspress metod opredeleniya defitsita ili izbytka ob'ema tsirkuliruyushchey krovi i ego komponentov [Express method for determining the deficit or excess of circulating blood volume and its components]. Metodicheskie rekomendatsii dlya studentov lechebnogo fakulteta. Poltava; 1983. 20 s. [Russian]
37. Libov MA. Etapnoe opredelenie krovopoteri i tempa ee zameshcheniya pri operatsiyakh na serdtse i magistralnykh sosudakh [Staged determination of blood loss and the rate of its replacement in operations on the heart and main vessels]. Abstr. PhDr. (Med.). Novosibirsk; 1962. 14 s. [Russian]
38. Gibson JG, Evans WA. Clinical studies of the blood volume. I. Clinical application of a method employing the azo dye " Evans Blue " and the spectrophotometer. J Clin Invest. 1937 May;16(3):301-16. PMID: 16694480. PMCID: PMC424872. https://doi.org/10.1172/JCI100859
39. Heilmeyer L, ‎ Schoen R, ‎ de Rudder B, Red. Ergebnisse der Inneren Medizin und Kinderheilkunde: Neue Folge. Berlin-Gottingen-Heidelberg; 1960. 650 p.
40. Kvartovkin KK. K metodike opredeleniya obema tsirkuliruyushchey krovi s pomoshchyu poliglyukina [To the method of determining the volume of circulating blood using polyglucin]. Lab delo. 1976;6:377-378. [Russian]
41. Lekmanov AU, Goldina OA. Opredelenie obema tsirkuliruyushchey krovi s ispolzovaniem preparatov gidroksietilirovannogo krakhmala [Determination of circulating blood volume using hydroxyethylated starch preparations]. Vestnik intensivnoy terapii. 2001;3:13-16. [Russian]
42. Pozharskiy VF. Politravmy oporno-dvigatelnoy sistemy i ikh lechenie na etapakh meditsinskoy evakuatsii [Polytraumas of the musculoskeletal system and their treatment at the stages of medical evacuation]. M: Meditsina; 1989. 256 s. [Russian]