Correspondence  |   January 2017
Complexities of Bleeding During Spine Surgery: It’ll Take Your (Mechanical) Breath Away
Author Notes
  • University of Virginia, Charlottesville, Virginia (B.I.N.). bin4n@virginia.edu
  • (Accepted for publication October 5, 2016.)
    (Accepted for publication October 5, 2016.)×
Article Information
Correspondence
Correspondence   |   January 2017
Complexities of Bleeding During Spine Surgery: It’ll Take Your (Mechanical) Breath Away
Anesthesiology 1 2017, Vol.126, 195. doi:10.1097/ALN.0000000000001411
Anesthesiology 1 2017, Vol.126, 195. doi:10.1097/ALN.0000000000001411
We read with great interest the article by Kang et al.1  wherein the authors report the effect of mechanical ventilation mode on perioperative blood loss in patients undergoing posterior lumbar interbody fusion surgery. The authors report that pressure control ventilation, by limiting peak inspiratory airway pressure, reduced median intraoperative blood by 130 ml.
We would like to highlight several limitations of this study, which may confound interpretation of the results:
In conclusion, this article suggests that the mode of mechanical ventilation, by altering airway pressure and inferior vena cava compression, will ultimately affect surgical-site bleeding. However, the authors have not provided sufficient surgical and coagulation data to demonstrate conclusively that mode of mechanical ventilation was the only factor responsible for the observed difference in blood loss.
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