Alternative Strategies

The Bloodless Medicine and Surgery program at Spartanburg Regional helps patients avoid or reduce the need for blood transfusions using a combination of the following methods:

Pre-operative planning

• Autologous blood – patient donates his own blood for use in surgery
• Hyperbaric oxygen chamber – delivers high concentrations of oxygen levels in the blood of pre/post surgical patients
• Interventional radiology – uses imaging technology, such as CT, angiography, MRI and MRA to diagnose and treat many diseases
• Minimal phlebotomy – use of smaller tubes allows for minimum blood draws
• Synthetic erythropoietin – stimulates the patient's bone marrow to produce red blood cells
• Volume expanders (bloodless alternatives) – fluids administered intravenously to increase blood volume

(In June 1988, The Consensus Conference on Preoperative Red Cell Transfusion, sponsored by the NIH, recommended a reduction in the transfusion trigger from 10 g per dL. What is the appropriate level? Transfusion is rarely indicated when the hemoglobin level exceeds 10 g per dL; it is usually indicated when the level is below 7 g per dL.)

Office of Medical Applications and Research. National Institutes of Health. Preoperative red cell transfusion. JAMA 1988; 260:2700-e

How Low can we go? Is there a way to know? Transfusion Volume 30, Jan1990 Number 1

Minimize Blood Loss - Recover Lost Blood

• Argon beam coagulator – device that helps stop bleeding during surgery
• Cell saver – continuously recirculates the patient's own blood during surgery, avoiding the need for transfusions
• Endoscopic surgery – surgery performed with tiny instruments to avoid large incisions and open procedures
• Intraoperative hemodilution – dilutes blood to reduce red blood cell loss
• Laser surgical techniques – techniques that help create a bloodless surgical field
• Thromboelastograph (TEG machine) – device that identifies problems in the body's ability to stop bleeding
• Trancutaneous oximetry – allows physicians to track oxygen levels in the skin during surgical procedures
• Platelet gel – material formed from the patients own blood to help speed healing after surgery
• Harmonic scalpel – tool that simultaneously cuts and coagulates tissue during surgery to avoid blood loss
• Quick trauma response
• Damage control surgery
• Rapid rewarming