{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:24:58Z","timestamp":1790731498566,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T00:00:00Z","timestamp":1678579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T00:00:00Z","timestamp":1678579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Backgrounds<\/jats:title>\n                    <jats:p>This study aims to identify the objective findings of haemoglobin (Hb) drift in patients that had a Whipple's procedure in the last 10\u2009years, their transfusion status intraoperatively and post\u2010operatively, the potential factors affecting Hb drift, and the outcomes following Hb drift.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted at Northern Health, Melbourne. All adult patients who were admitted for a Whipple's procedure from 2010 to 2020 were included and information collected retrospectively for demographics, pre\u2010operative, operative and post\u2010operative details.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 103 patients were identified. The median Hb drift calculated from a Hb level at the end of operation was 27.0\u00a0g\/L (IQR 18.0\u201334.0), and 21.4% of patients received a packed red blood cell (PRBC) transfusion during the post\u2010operative period. Patients received a large amount of intraoperative fluid with a median of 4500\u2009mL (IQR 3400\u20105600). Hb drift was statistically associated with intraoperative and post\u2010operative fluid infusion leading to concurrent issues with electrolyte imbalance and diuresis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hb drift is a phenomenon that does happen in major operations such as a Whipple's procedure, likely secondary to fluid over\u2010resuscitation. Considering the risk of fluid overload and blood transfusion, Hb drift in the setting of fluid over\u2010resuscitation needs to be kept in mind prior to blood transfusion to avoid unnecessary complications and wasting of other precious resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.18363","type":"journal-article","created":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T14:59:46Z","timestamp":1678633186000},"page":"1833-1838","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Haemoglobin drift in patients following Whipple's procedure"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9269-9001","authenticated-orcid":false,"given":"Yuchen","family":"Luo","sequence":"first","affiliation":[{"name":"Division of Surgery Northern Health  Epping Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Tacey","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Melbourne  Epping Victoria Australia"},{"name":"Melbourne School of Population and Global Health University of Melbourne  Carlton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4772-516X","authenticated-orcid":false,"given":"Russell","family":"Hodgson","sequence":"additional","affiliation":[{"name":"Division of Surgery Northern Health  Epping Victoria Australia"},{"name":"Department of Surgery University of Melbourne  Epping Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nezor","family":"Houli","sequence":"additional","affiliation":[{"name":"Division of Surgery Northern Health  Epping Victoria Australia"},{"name":"Department of Surgery Western Health  Footscray Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6881-7699","authenticated-orcid":false,"given":"Tuck","family":"Yong","sequence":"additional","affiliation":[{"name":"Division of Surgery Northern Health  Epping Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.03.038"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2020.12.042"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12491"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2009.02029.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012452"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1446"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2008.10.015"},{"key":"e_1_2_9_9_1","first-page":"2544","article-title":"Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery","volume":"116","author":"Murphy GJ","year":"2007","journal-title":"Cardiovasc. 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