(Surgery, Bloodless; Bloodless Medicine; Medicine, Bloodless)
Bloodless surgery and medication avoids using donor
. Goals of bloodless surgery include:
- Save and re-infuse the patient’s own blood (instead of donated blood)
- Use medications that will boost a patient’s blood production and put off elective surgery until anemia resolves
- Minimize blood loss with surgical techniques and medications to improve clotting
Reasons for Procedure
Lost blood during surgery is usually replaced by blood transfusions from donated blood. However, a patient may not want to receive donated blood. Reasons may include:
Concerns about blood-borne diseases, such as
- Complications from a blood transfusion
- Religious beliefs
Bloodless surgery is an option for those who do not want or cannot have a donor blood transfusion.
There are also benefits of bloodless surgery:
- Quicker recovery time
- Shorter hospital stay
- Faster wound-healing
- Fewer blood transfusion complications
Complications from bloodless surgery may include having a poor reaction to the medications, fluids, and other methods used to prepare your body for the procedure. If you plan to use the bloodless approach, your doctor will review a list of possible complications specific to your situation, focusing on the type of surgery you will be having and your overall health.
may increase the risk of complications. If you smoke, talk to your doctor about how you can
What to Expect
Prior to Procedure
Your doctor will:
- Do a medical history and physical exam
- Order tests
- Give you instructions to prepare for surgery
If available, the doctor will use your own blood if a blood transfusion is needed. To prepare, a healthcare team member will collect and store your blood. You may be given IV fluids to replace any blood taken. To make sure that there is enough blood to use, your doctor will create a plan to help your body make more blood. This plan may involve:
|Common IV Placement
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Eat foods high in
and/or take supplements to increase the amount of iron in your blood. Iron is an important component of blood.
Eat foods high in
, since this vitamin helps your blood absorb iron.
Your doctor may give you medications to boost blood production (erythropoiesis-stimulating agents) before surgery. Medications to improve clotting may be given during and after surgery. You may also asked to stop taking certain medications, herbs, or supplements. Your doctor will discuss medications you need to stop taking in advance of your surgery.
An important role of blood is to store and deliver oxygen to your body’s cells. Blood loss during surgery means less oxygen for your body to function properly. To prevent oxygen levels from dropping even if blood is lost, your doctor will “pump” your blood with extra oxygen. So even if blood is lost, remaining blood will have an extra supply of oxygen to keep your body functioning.
To “pump” the extra oxygen into your blood, you may be placed in a
hyperbaric oxygen chamber
. This is a sealed chamber with air that has a very high oxygen concentration. You will lie on a padded table and breathe normally. This is a painless process.
may be used to block pain and keep you asleep during surgery. The anesthesiologist will carefully monitor your body temperature and blood pressure. Your body temperature or blood pressure may be dropped below normal, since this is a way to slow or limit blood loss during surgery. You may be given special IV fluids that contain no blood elements, but can help your body deal with a loss of blood by increasing its circulating volume of fluids.
Description of the Procedure
What will happen during the procedure depends on the type of surgery you will be having and many other factors. Your doctor may decide to do
minimally invasive surgery
. This involves making small cuts and inserting small tools to do the procedure. Open surgery, on the other hand, results in more blood loss because larger cuts are made.
To further minimize blood loss, the doctor will:
- Limit the amount of blood samples taken
- Give medications to help your body increase its own blood supply or increase the amount of oxygen in your blood
- Use special surgery tools or techniques to control bleeding
The doctor may also collect your blood using a cell saver machine. This machine will suction, wash, and filter your blood during surgery so that it can be re-infused into your body if needed.
Immediately After Procedure
If a blood transfusion is needed after surgery, the doctor will re-infuse your blood that was collected pre-surgery. You may be infused with special fluids that contain substances found in blood. You may also be put in a hyperbaric oxygen chamber to increase the amount of oxygen in your blood. Infections and other complications will be treated to prevent additional stress and oxygen need.
How Long Will It Take?
Depends on the type of surgery you have.
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
How long you will stay in the hospital depends on the type of surgery.
At the Hospital
You will be taken to your recovery room where the healthcare team will monitor you. You and the hospital staff will also take measures to reduce your chance of infection.
When you leave the hospital, the doctor will give you instructions on how to care for yourself at home. This may include instructions on diet, physical activity, medications, lifestyle, and showering.
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, a lot of bleeding, or any discharge from the incision site
- Nausea or vomiting
- Pain that cannot be controlled with the medications you were given
- Cough, shortness of breath, or chest pain
- Lightheadedness or weakness
- Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
- New or unexpected symptoms
If you think you have an emergency, call for emergency medical services right away.
Canadian Blood Services
Bloodless medicine and surgery. Trinitas Regional Medical Center website. Available at:
http://www.trinitashospital.org/bloodless%5Fmedicine.htm. Accessed May 29, 2014.
Bloodless Surgery Center. Division of Cardiothoracic Surgery, St. Luke’s-Roosevelt website. Available at:
http://www.slrctsurgery.com/bloodless.html. Accessed May 29, 2014.
Center for Bloodless Medicine & Surgery at Pennsylvania Hospital. Penn Medicine website. Available at:
https://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/bloodless-medicine. Accessed May 29, 2014.
Glossary of terms. Department of Cardiothoracic Surgery, University of Southern California website. Available at:
http://www.cts.usc.edu/zglossary-cellsaver.html. Accessed May 29, 2014.
Hyperbaric oxygen (HBO) therapy process and applications. Englewood Hospital Medical Center website. Available at:
http://www.englewoodhospital.com/pdf/HBOProcessandApplications.pdf. Accessed May 29, 2014.
Mizuno J, Ozawa Y, Arita H, Hanaoka K. Anesthetic management of a Jehovah's Witness for pancreaticoduodenectomy.
Shander A, Javidroozi M, Perelman S, Puzio T, Lobel G.
From bloodless surgery to patient blood management.
Mt Sinai J Med. 2012;79(1):56.
What is bloodless surgery? Bloodless Surgery website. Available at:
http://bloodless-surgery.net/what-is-bloodless-surgery. Accessed May 29, 2014.