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With the advent of universal testing of all donor blood, the medical community embraced the idea that when in doubt, it was better to transfuse than not to transfuse. Now, with a clearer understanding of anemia and its effects on the body, this conventional wisdom is being challenged. In fact, we know that transfusions can be safely avoided in most cases with patients functioning quite safely and comfortably with only a fraction of the normal number of red blood cells. In addition, the use of pharmaceutical agents, intravenous fluids, and improved diagnostic procedures and surgical techniques can prevent or lessen the anemia associated with surgery and other medical procedures.

Planning Ahead

With careful planning, several steps can be taken to help your body compensate for blood loss during surgery without the use of donor blood. For example, a number of approved pharmaceutical agents are used to lessen or prevent anemia. These include erythropoieten and iron, which are typically used prior to surgery to stimulate the bone marrow's production of red blood cells. These same agents can be used after emergency surgery to rebuild the red blood count.

Less is Better

New technology in the laboratory allows us to use fewer samples of blood, and sometimes only one sample of blood, for multiple tests rather than the typical practice of drawing numerous different samples. Furthermore, smaller amounts of blood, or microsampling, are now just as effective in testing as larger, conventionally sized samples. By using fewer and smaller blood samples, we can significantly reduce the blood loss associated with essential diagnostic tests. University Hospital has implemented micro-sampling throughout the hospital.

Meticulous Technique

Blood loss during surgery can be minimized by using extra caution and deliberate operative techniques -- avoiding small cuts, immediate clamping or cauterizing of bleeding vessels, etc. The choice of instrumentation is also important. For example, electrocautery, surgical lasers, and argon beam coagulators cause less blood loss than traditional cutting scalpels and help in the clotting of blood during surgery. Additionally, minimally invasive surgery, such as the use of endoscopic or laparoscopic techniques, usually result in much less blood loss than traditional open forms of surgery.

Conserving Your Resources

Thanks to major advances in surgical technology, blood lost during certain types of surgeries can be salvaged and recycled. For example, blood that spills in the chest or abdominal cavity can be collected, filtered and re-infused in a continuous process. This technique is commonly referred to as a "cell saver" and is particularly important when blood loss is due to a traumatic injury. This technique is used in trauma as well as in the operating suite to ensure that as much blood is salvaged as possible.

Another method that can be used during surgery to conserve your red blood cells is hemodilution. This method involves the drawing of blood, followed by the immediate infusion of intravenous fluids to replace the missing blood. Any blood lost during the surgery will be diluted by the intravenous fluid and therefore fewer red cells are lost. At the same time, the blood that was drawn is slowly returned via a continuous circuit that is linked to your circulatory system, thereby replacing the lost red blood cells.

Respecting Your Decision

The University Center for Bloodless Surgery and Medicine is committed to providing the highest quality care to all patients who wish to avoid the use of blood transfusions. While in the hospital, bloodless surgery and medicine patients are clearly identified to all relevant hospital staff to ensure their bloodless treatment plan is maintained at all times. You and your family will be involved in every step of the diagnostic and treatment decision-making process and your wishes and beliefs will be respected. Our nurse coordinator is available to work with you and your family before, during and after hospitalization to answer your questions and to help ensure your satisfaction with our services.

For More Information

We encourage all patients to learn as much as possible about the positive benefits of bloodless surgery and medicine and to consider choosing this approach whenever possible. Our coordinator is available to answer your questions and to help guide you in your decision. Please call the toll-free number to speak with the coordinator or to receive a referral to one of our many physicians who are committed to bloodless treatment: 1-888-BLD-LESS (253-5377).

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