The VIBe SCALE classifies bleeding into five severity levels that allow surgical teams to use an efficient, common language when working in the operating room.
The VIBe SCALE grades are based on the appearance in the visual field and correlate to the rate of blood loss and potential tissue damage
Grade 0: No Bleeding
Grade 0 is depicted in this abrasion of the kidney. Grade 0 are the clinically insignificant and unremarkable bleeds. There is no bleeding with blood loss less than 1.0 ml/min.
Grade 1: Mild
Grade 1 is depicted in this capsular abrasion of the liver. Grade 1 are the nuisance bleeds. They appear not to be bleeding after blotting them, but then well up over 1-2 mins. There is a general ooze with an appearance of mild capillary bleeding at 1-5 ml/min.
Grade 2: Moderate
Grade 2 is depicted in this vascular rupture of the left anterior descending (LAD) marginal vessels. Grade 2 are distracting to the surgical procedure. They visibly well up after being blotted. There is a continuous flow with an appearance of moderate small vessel bleeding at 5-10 ml/min.
Grade 3: Severe
Grade 3 is depicted in this rupture of a venous plexus during a dorsal laminectomy. Grade 3 are disruptive to the surgical procedure. They well up immediately after being blotted and must be treated to continue the procedure. There is a controllable spurting or overwhelming flow with an appearance of a severe noncentral vessel bleeding at 10-50 ml/min
Grade 4: Life Threatening
Grade 4 is depicted in this aortic tear. Grade 4 are catastrophic. They demand the immediate attention of the surgical and anesthetic teams. There is a unidentified or inaccessible spurting or gush with an appearance of life-threatening central vessel bleeding at greater than 50 ml/min.
The VIBe SCALE makes the assessment of bleeding more reliable and may foster appropriate hemostatic product selection
First Scale of Its Kind
Over 140 surgeons contributed to the development and validation of the VIBe SCALE. It is the first and only scale to fulfill all FDA criteria for clinician-reported outcome assessments of intraoperative bleeding.
Validated Across Multiple Specialties
Use of the VIBe SCALE had excellent repeatability and reproducibility across 102 surgeons from 11 different surgical specialties. It achieved a Kendall’s coefficient of correlation of 0.98 for intraobserver and 0.91 for interobserver agreement—a value of 1.0 is perfect.
FDA Accepted for Clinical Studies
The VIBe SCALE fulfills FDA criteria for a clinician-reported scale: Its valid content and construct is clear, relevant, and usable to surgeons.
Access the VIBe SCALE Paper
Development and validation of an intraoperative bleeding severity scale for use in clinical studies of hemostatic agents.
The VIBe SCALE was published in Surgery, a leading surgical journal that publishes practical, authoritative information about procedures, clinical advances, and major trends.