Virginia Commonwealth Univeristy

Practicing Excellence in Transfusion Therapy

Blood conservation techniques

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.

Preoperative

  • 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.

Intraoperative

  • 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
  • Positioning
  • Controlled hypotension

Postoperative

  • Limited blood draws and sample size for laboratory analysis
  • Normothermia
  • Positioning
  • Post-op cell salvage
  • Avoid hypotension
  • Monitor patient and blood loss
  • Prompt intervention in case of post-op bleeding.