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 through 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