Make Your Surgery Safer, Avoid Blood Transfusion

Donated blood may be safer than ever, but that doesn’t mean the same for blood transfusion. Transfusions, even with “safe” blood or blood you donated yourself, expose you to a higher risk of complications and even death. However, bloodless surgery for elective procedures such as total joint replacements and spinal surgeries may be considered as an alternative.

Blood Transfusion Risks: 

• One life-threatening risk is bacterial infection from blood contaminated during storage.
• Another is Transfusion-Related Acute Lung Injury (TRALI), where fluid fills lungs and can cause respiratory failure.
• Transfusion-Associated Circulatory Overload (TACO), when a large volume of blood is transfused too quickly, is another life-threatening syndrome marked by shortness of breath and rapidly increased blood pressure.
• The most common complication is Febrile Non-Hemolytic Transfusion Reaction (FNHTR). While not life threatening or long lasting, the associated fever, chills and shakes can be uncomfortable.

For decades, blood transfusion has been a widely used practice. But today we know that transfusion is often not as beneficial as avoiding it altogether.

Reducing bleeding before, during and after surgery
That’s why blood management is becoming a bigger focus for health care institutions, including Fairview, Lakewood and Lutheran Hospitals. Each of these Cleveland Clinic hospitals now offers bloodless surgery for elective procedures such as total joint replacements and spinal surgeries.

Blood management is the effort to use blood supplies wisely.

Bloodless surgery, where steps are taken before, during and after surgery to reduce the need for blood transfusion, is one blood management tactic.

Bloodless surgery does not mean the procedure involves no blood. It means that steps are taken before, during and after surgery to reduce the need for blood transfusion.

Weeks before surgery, doctors try to increase a patient’s hemoglobin and red blood cells with medication and extra doses of iron. Doing so “strengthens” the patient’s blood so they may not need a transfusion, even if they lose blood during surgery.

During surgery, anesthesiologists may use a type of anesthesia that lowers blood pressure and lightens blood flow. Surgeons may use minimally invasive techniques to limit bleeding. Or they may use special devices to cauterize tissues or temporarily stitch closed large blood vessels.

Another technique is spraying a gel-like coating into the open wound at the end of surgery. The coating closes off small blood vessels and stops them from oozing and bleeding.

After surgery, patients may continue blood-strengthening medications. Surgeons may try to limit the amount of blood drawn for post-operative tests.

All of this adds up to a significantly reduced need for blood transfusion. And that means a significantly reduced risk of transfusion-related complications.

Save blood, save money, go home sooner
Plus, without transfusions, patients have shorter hospital stays and lower hospitalization costs. Those benefits far outweigh the extra time and effort spent preparing for bloodless surgery with pre-op medication.

For the medical community, benefits are just as great. In addition to providing better treatment, bloodless surgery conserves donated blood for situations where transfusion is dire.

After all, blood transfusion is like an organ transplant. It is necessary for some patients, but certainly not all.

By choosing bloodless surgery, you may be able to avoid blood transfusion and all the risks and costs that come with it.

Transfusions down 80% at Cleveland Clinic hospitals
Since using bloodless surgery, Fairview, Lakewood and Lutheran Hospitals have decreased the number of patients requiring blood transfusion* by more than 80 percent.

*After total joint replacement

To learn more about bloodless medicine, call 216-476-0076.