Age/sex category
adult female
Weight
lb
Initial hemoglobin of the patient
g/dL
Lowest acceptable hemoglobin
g/dL
Allowable blood loss
ml

The allowable blood loss calculation is an essential part of the pre-surgery routine. It estimates how much blood can a patient lose before reaching a dangerously low level of hemoglobin. In this article, you can find information on what's the maximum allowable blood loss and what formula we use.

How to use the allowable blood loss calculator?

  1. Choose the sex/age category of the patient - the calculator uses several different coordinates, whether they're a newborn baby or an adolescent male.
  2. Enter their weight in the preferred unit - our calculator converts it to kilograms by itself.
  3. Enter their hemoglobin (Hgb) level in g/dL.
  4. Enter the lowest allowable hemoglobin level - depending on the patient, it's usually between 7 and 10 g/dL.
  5. The allowable blood loss is calculated in mL, but you can switch to other units just by clicking on the unit.

What is the allowable blood loss formula?

Here, the blood volume is already included in the equation:

ABL = weight (kg) * age_sex_factor * ( initial_hemoglobin (g/dL) - final_hemoglobin (g/dL) ) / initial_hemoglobin (g/dL)

The age_sex_factor is the amount of blood per kilogram of body weight for the chosen category. It equals:

  • 100 mL/kg for premature infants;
  • 85 mL/kg for babies younger than 3 months;
  • 75 mL/kg for children over the age of 3 months;
  • 70 mL/kg for male adolescents;
  • 65 mL/kg for female adolescents and adults;
  • 75 mL/kg for male adults.

What is the maximum allowable blood loss volume?

The allowable blood loss depends on the total blood volume. You can estimate it using our calculators for adults and for pediatric use.

For example, for a relatively healthy adult male, with a hemoglobin level 15 g/dL and 80 kg of weight, the allowable blood loss would be around 2,400 ml, whereas for a teenager, with a hemoglobin level of 12 g/dL and 60 kg of weight, it would only be 1,050 ml.

According to Morgan and Mikhail's Clinical Anesthesiology:

“Ideally, blood loss should be replaced with crystalloid or colloid solutions to maintain intravascular volume (normovolemia) until the danger of anemia outweighs the risks of transfusion. At that point, further blood loss is replaced with transfusions of red blood cells to maintain hemoglobin concentration (or hematocrit) at that level. For most patients, that point corresponds to a hemoglobin between 7 and 10 g/dL or a hematocrit of 21-30%.”

For information about blood transfer, check out our blood donor calculator.

Małgorzata Koperska, MD

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Allowable Blood Loss Formula