Not sure if you are aware of this. But there is a calculation error. I did do a quick search but didn’t find anything.
Item says it removes 20% of you life per second, and gives 20% missing health gained as ward.
Just equipped it and lost 204 HP and gained 123 ward 
Presumably that was from full life?
Yes from full life. Character just turned level 23!
I don’t believe there’s any calculation error here. Exsanguinous grants you 20% of your missing health as ward each second, but your ward is also decaying every second. The ward you lose each second is based on this formula: (0.4 x current ward) / (1 + 0.5 x ward retention).
By the very wording on the item. If it is removing 20% hp per second and returning it as 20% hp as ward per second, it should give you 100% ward for the HP it removes. So with a base HP of 264 it removes 204 HP, leaving me with 60hp it should give 204 Ward, not 123.
So what you are saying is the item is basically useless at level 23, because I don’t have 200% ward retention, and no way to get that kind of retention at such a low level! Then surely in that case the level of the item needs changing, to reflect a level where that kind of retention is possible?!
I would have thought this item by its very wording would be separate from the basic ward calculation!
EHP = HP-(0.4xcurrent ward) \ (1+0.5xward retention) should = base ward
EHP=264 before, 73 when equipped so 191 hp removed. Retention = 44%
EHP = 264-(0.4x191) / (1+0.5x44) = 261(rounded up) overall EHP, hp+ward. Current ehp=186!
So ward should be static at 188, not 113!
Can someone please double check my calculations! Thanks.
Just logged back in again from this morning now I am down to 113 ward which is 10 less than when I logged out! Also when I logged out hp was at 60, now its 73!
So there is something amiss!
It doesn’t work like that. The chest removes 20% of current health & gives you 20% of missing health as ward, per second. So if your max hp = 100 & your current hp = 100 in the first second you would loose 20 hp & gain (up to) 4 ward per second. After that first second, you’d be at 80 hp & so you’d then loose 16 hp & gain (up to) 7 ward per second, etc.
Since you have ward being generated per second, you’re also loosing ward from ward decay, though it should be relatively small on the initial tick.
If it were, it would generate an endless amount of ward (albeit slowly at low levels).
It does take a few seconds to stabilise. Also, if you have an added hp regen, that will cut the amount of ward you get from it.
Ditched the item. The build I am running has no extra ward regen, so equipping this item solely for the no bleed buff at low level leaves you to vulnerable! That loss of a 3rd of my eHP is to much!
Making a Acolyte summoner. I am trying to build it using conventional armour and protection, with GB and CSA, and block. Seeing as ward is so weak now. But it is hard as there isn’t much in the passives, so having to rely on my gear!
Would have been nice to have some ward to!
