{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T06:10:46Z","timestamp":1778134246853,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The bleeding in cardiac surgery remains a significant clinical problem. There is no \u201cgold standard\u201d method to quantify blood loss. Traditional measurement of drainage volume often underestimates or overestimates, as it does not consider the type of fluid. We hypothesized that blood loss could be more accurately calculated using the Hb\/kg index in terms of haemoglobin (Hb) mass loss per kilogram of the patient\u2019s body mass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>This study aimed to Objective<\/jats:title>\n                    <jats:p>To develop a novel approach for calculating actual blood loss using the Hb\/kg index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center prospective study included 195 patients who underwent cardiac surgery between October 2023 and November 2024. The Hb\/kg index was calculated based on intraoperative Hb loss, Hb loss via chest tubes, packed red blood cell transfusions and patient weight. Eighty-six additional clinical predictors were analyzed using conventional statistics and machine learning algorithms. Predictors with statistically significant Spearman correlations were included for further analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Lasso regression achieved the best overall performance in predicting Hb\/kg index. It yielded the lowest mean squared error (0.08 \u00b1 0.04), mean absolute percentage error (0.18 \u00b1 0.10), with the highest correlation (0.92 \u00b1 0.06) and R\u00b2 score (0.82 \u00b1 0.13). BMI showed a significant negative relationship (\u22120.018,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Postoperative Hb and haematocrit values had negative correlation (\u22120.69,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001 and \u22120.07,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.015), while initial Hb was positively correlated (0.85,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This method provides a more reliable and clinically relevant tool to calculate actual blood loss and allows for a more precise assessment and treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591251370110","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T10:56:32Z","timestamp":1755687392000},"page":"470-477","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Calculation of blood loss in cardiac surgery: How should we monitor?"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0844-7268","authenticated-orcid":false,"given":"Yerlan","family":"Orazymbetov","sequence":"first","affiliation":[{"name":"Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Medical Academy, Lithuanian University of Health Sciences"},{"name":"National Scientific Medical Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serik","family":"Aitaliyev","sequence":"additional","affiliation":[{"name":"Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Medical Academy, Lithuanian University of Health Sciences"},{"name":"Al-Farabi Kazakh National University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Povilas","family":"Jaku\u0161ka","sequence":"additional","affiliation":[{"name":"Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Medical Academy, Lithuanian University of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audron\u0117","family":"Veikutien\u0117","sequence":"additional","affiliation":[{"name":"Lithuanian University of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadas","family":"Lenkutis","sequence":"additional","affiliation":[{"name":"Lithuanian University of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rassul","family":"Zhumagaliyev","sequence":"additional","affiliation":[{"name":"Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Medical Academy, Lithuanian University of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Au\u0161ra","family":"Saudargien\u0117","sequence":"additional","affiliation":[{"name":"Lithuanian University of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rimantas","family":"Benetis","sequence":"additional","affiliation":[{"name":"Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Medical Academy, Lithuanian University of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"crossref","unstructured":"Al-Attar N Johnston S Jamous N et al. 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