Blood conservation techniques
Blood conservation in the surgical patient is a team effort that requires careful planning throughout the patient’s entire hospital stay.
Many blood conservation devices and techniques have been developed to decrease and/or eliminate the need for blood transfusion in the surgical patient.
- Laboratory screening and identification of high-risk patients
- Pre-Operative identification of anemia
- Treatment of anemia may include: Iron, Folate, B12, EPO
- Consider delaying elective surgical procedures to allow for optimization of hemoglobin.
- Treat coagulation abnormalities
- Refferal to specialist may be needed to optimize cardiopulmonary, renal, and hepatic condition of patient.
- Ensure availability of equipment and personnel
- Informed Consent.
- Meticulous surgical hemostasis
- Cell saver
- Post op salvage
- Acute Normovolemic Hemodilution
- RAP – Retrograde Autologous Prime
- Enhanced coagulation testing (TEG, PT, aPTT, Plt, Fib)
- Utilization of a coagulation algorithm
- DDAVP – Desmopressin acetate, which is used in specific patients with demonstratable and specific platelet dysfunction
- Amicar/Tranexamic acid
- Controlled hypotension
- Limited blood draws and sample size for laboratory analysis
- Post-op cell salvage
- Avoid hypotension
- Monitor patient and blood loss
- Prompt intervention in case of post-op bleeding.