Bloodless medicine refers to the practice of not receiving blood products or transfusions before, during or after surgery or other medical procedures. This includes donated blood, banked blood and even blood taken from the patient themselves. A wide range of surgeries from routine cosmetic procedures to complex heart and cancer surgeries can successfully use bloodless practices. Special techniques are utilized to ensure that patients undergoing bloodless procedures have a positive outcome.
Why Doctors Use Blood Products?
Traditionally, blood products or transfusions have been given to patients during surgery and other medical procedures when they have lost too much blood. The hemoglobin in blood carries oxygen throughout the body. If there is too little hemoglobin present in the body due to blood loss, the vital organs and tissues of the body may not receive enough oxygen. This may promote infection, cause organ and tissue damage or death.
Why Choose Bloodless Medicine?
There are religious, medical and ethical reasons why people may choose bloodless medicine. Most people choosing bloodless medicine do so for religious reasons. Jehovah’s Witnesses are the main religious group that practice bloodless medicine. Their religious beliefs include the conviction that blood should never be removed from the body, stored or used by another person.
Concerns about the Blood Supply
In the early 1980s, many people chose bloodless medicine because of concerns about infectious agents like HIV in the blood supply. Although this concern has died down as HIV screening procedures have improved, other infectious agents like hepatitis, STDs and malaria have caused continued concerns.
Complications from Blood Products
Some patients choose bloodless medicine because of the complications blood transfusions and other procedures involving blood products can cause. Complications can include infection, medical errors, antigen reactions, sepsis and viral infection.
Benefits of Bloodless Medicine
There are several benefits to bloodless medicine. Foremost among them is that it allows people to avoid contaminants and potential antigen reactions. Following bloodless practices also helps those with rare blood types to avoid the need for blood from an already severely limited supply.
Research is being conducted on the possibility that bloodless medicine may also help prevent infections and injuries commonly associated with blood transfusions like post-operative infections and lung injuries.
Bloodless medicine also promises to be an invaluable and lifesaving tool on the battlefield. The U.S. Army is currently funding research into its use. Bloodless medicine can be a money saver. Each unit of blood used in a hospital costs $500 per unit, including testing. Doctors can eliminate that cost if no blood is used during a procedure.
Bloodless medicine patients also experience a faster recovery rate than those who have received transfusions.
Risks of Bloodless Medicine
Any type of surgery or medical procedure contains an element of risk, and bloodless medicine is no exception. However, bloodless procedures carry added risk when compared to traditional procedures.
Healthy adults can lose up to 20% of their blood volume without experiencing lasting damage to their bodies. However major blood loss, that above 20% of total blood volume, can occur regardless of the precautions taken. Complications of severe blood loss include low blood pressure, anemia, changes in blood acidity and decreased oxygen supply. Additionally organ damage, tissue death, hemorrhaging, brain damage, heart attack, lung injuries, kidney failure or death can occur.
Medications used during bloodless procedures may cause side effects, allergic reactions, blood clots or a serious condition called disseminated intravascular coagulation.
Special Precautions for Bloodless Procedures
There are several things that need to be done to prepare a person for a bloodless procedure. First, the patient’s red blood cell count needs to be increased. These levels can be boosted by eating iron rich foods, taking certain medications and stopping smoking.
During surgery, oxygen levels are carefully monitored. Special care is taken to minimize blood loss and increase oxygen levels. Patients may opt to have their own blood collected and reused during bloodless surgery in case major blood loss occurs.
Following surgery, specialized measures and careful monitoring will continue to be followed to ensure that patients have a good and uneventful recovery.
University of Pennsylvania Health System: Penn Medicine