What are bloodless medicine and surgery programs?

Updated: Apr 16, 2019
  • Author: Linda L Maerz, MD, FACS, FCCM; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Clinical practice with patients who decline blood transfusion for religious reasons has led to the emergence of healthcare centers with bloodless medicine and surgery programs. These programs aim to minimize component transfusion therapy for all patients, regardless of religious beliefs. Integrated preoperative, intraoperative, and postoperative conservation approaches are used. Included are preoperative autologous donation, erythropoietic support, acute normovolemic hemodilution, individualized assessment of anemia tolerance, implementation of conservative transfusion thresholds, meticulous surgical techniques, judicious use of phlebotomy, and pharmacologic agents for limiting blood loss. Success requires a multidisciplinary team consisting of surgeons, intensivists, scrub team members, pathologists, nursing staff, administrators, anesthesiologists, hematologists, pathologists, pharmacists, phlebotomists, and transfusion medicine specialists. Progress in terms of blood use reduction and outcomes improvement should be tracked to encourage a robust and successful program. [4, 77]


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