Bloodless medicine: current strategies and emerging treatment paradigms

Abstract

Given the emerging evidence that patients who avoid ABTs do as well if not better than patients who accept ABTs, further efforts are needed to determine whether all patients could benefit from bloodless strategies. Bloodless approaches in selected patients could reduce risks, improve outcomes, and decrease costs for all patients.

Preoperative treatment of anemia and outcomes in surgical Jehovah's Witness patients

“…[1][2][3][4] The majority of patients requesting management without transfusions (frequently denoted "bloodless") are members of the Jehovah's Witness (JW) faith, comprising over 8 million individuals worldwide with 1.2 million in the United States. 5 JW doctrines forbid transfusion of "primary" blood components (red cells, platelets, leukocytes, plasma) while individual clotting factor concentrates and albumin may be accepted at the individual's discretion. [4][5][6] Most will accept autologous blood collected from the surgical field using an instrument (cell saver) that is physically contiguous with the body, although autologous blood donated preoperatively is generally not accepted.…”

“…5 JW doctrines forbid transfusion of "primary" blood components (red cells, platelets, leukocytes, plasma) while individual clotting factor concentrates and albumin may be accepted at the individual's discretion. [4][5][6] Most will accept autologous blood collected from the surgical field using an instrument (cell saver) that is physically contiguous with the body, although autologous blood donated preoperatively is generally not accepted. 4,5 These patients present unique challenges, particularly in the setting of anemia and surgical procedures associated with significant blood loss.…”

The blood-saving effect of vasopressinergic V1 receptor agonists in urologic oncology

“…Очевидно, что у пациентов, подвергающихся он-коурологическим операциям, является обоснованным применение кровосберегающих технологий и прин-ципов так называемой бескровной медицины (blo odless medicine), которая улучшает исходы лечения при различных состояниях, сопровождающихся кровопо-терей [3,[6][7][8].…”

“…В настоящее время известны как хирургические методы кровосбережения, включающие совершенст-вование собственно оперативной техники и оснаще-ния, так и средства консервативного воздействия на объем периоперационной кровопотери, в том числе применение современных плазмозаменителей, гемо-статиков, адекватная интраоперационная миоплегия и обезболивание [7,8]. Для этой цели также могут быть использованы препараты, относящиеся к группе селективных агонистов V 1 -вазопрессиновых рецепто-ров, обеспечивающие избирательную вазоконстрик-цию артериальной сети микроциркуляторного русла органов и тканей брюшной полости.…”

The Idea of Preoperative Autologous Blood for Postpartum Fatigue

“…In recent years, based on allogeneic blood transfusion risk and resource shortage, bloodless surgery concept has been proposed, hoping to rely entirely on patients own blood transfusion and blood protection management to complete the surgical treatment [2]. There is a wide application of ABT in the operation of obstetrics and gynecology, orthopedic surgery, neurosurgery, hepatobiliary surgery, urology, rare blood group surgery and others [3].…”