Marjorie Montemayor-Quellenberg, MA
Bloodless surgery and medicine avoids using donor
blood transfusions. Goals of bloodless surgery include:
Lost blood during surgery is usually replaced by blood transfusions of donated blood. However, a patient may not want to receive donated blood. Reasons may include:
Bloodless surgery is an option for those who do not want or cannot have a donor blood transfusion.
There are also benefits of bloodless surgery:
Complications from bloodless surgery may include having a poor reaction to the medications, fluids, and other methods used to prepare your body for the procedure. If you plan to use the bloodless approach, your doctor will review a list of possible complications specific to your situation, focusing on the type of surgery you will be having and your overall health.
may increase the risk of complications. If you smoke, talk to your doctor about how you can
Your doctor will:
If available, the doctor will use your own blood if a blood transfusion is needed. To prepare, a nurse will collect and store your blood. You may be given fluids through a needle in your vein (IV) to replace any blood taken. To make sure that there is enough blood to use, your doctor will create a plan to help your body make more blood. This plan may involve:
Your doctor may give you medications to boost blood production (erythropoiesis-stimulating agents) before surgery. Medications to improve clotting may be given during and after surgery. You may also asked to stop taking certain medications, herbs, or supplements. Your doctor will discuss medications you need to stop taking in advance of your surgery.
An important role of blood is to store and deliver oxygen to your body’s cells. Blood loss during surgery means less oxygen for your body to function properly. To prevent oxygen levels from dropping even if blood is lost, your doctor will “pump” your blood with extra oxygen. So even if blood is lost, remaining blood will have an extra supply of oxygen to keep your body functioning.
To “pump” the extra oxygen into your blood, you may be placed in a
hyperbaric oxygen chamber. This is a sealed chamber with air that has a very high oxygen concentration. You will lie on a padded table and breathe normally. This is a painless process.
may be used to block pain and keep you asleep during surgery. The anesthesiologist will carefully monitor your body temperature and blood pressure. Your body temperature or blood pressure may be dropped below normal, since this is a way to slow or limit blood loss during surgery. You may be given special IV fluids that contain no blood elements, but can help your body deal with a loss of blood by increasing its circulating volume of fluids.
What will happen during the procedure depends on the type of surgery you will be having and many other factors. Your doctor may decide to do
minimally invasive surgery. This involves making small cuts and inserting small tools to do the procedure. Open surgery, on the other hand, results in more blood loss because larger cuts are made.
To further minimize blood loss, the doctor will:
The doctor may also collect your blood using a cell saver machine. This machine will suction, wash, and filter your blood during surgery so that it can be re-infused into your body if needed.
If a blood transfusion is needed after surgery, the doctor will re-infuse your blood that was collected pre-surgery. You may be infused with special fluids that contain substances found in blood. You may also be put in a hyperbaric oxygen chamber to increase the amount of oxygen in your blood. Infections and other complications will be treated to prevent additional stress and oxygen need.
Depends on the type of surgery you have.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
How long you will stay in the hospital depends on the type of surgery.
You will be taken to your recovery room where the healthcare team will monitor you. You and the hospital staff will also take measures to reduce your chance of infection.
When you leave the hospital, the doctor will give you instructions on how to care for yourself at home. This may include instructions on diet, physical activity, medications, lifestyle, and showering.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
Canadian Blood Services
Bloodless medicine and surgery. Trinitas Regional Medical Center website. Available at:
http://www.trinitashospital.org/bloodless_medicine.htm. Accessed May 29, 2014.
Bloodless Surgery Center. Division of Cardiothoracic Surgery, St. Luke’s-Roosevelt website. Available at:
http://www.slrctsurgery.com/bloodless.html. Accessed May 29, 2014.
The Center for Bloodless Medicine & Surgery at Pennsylvania Hospital. Penn Medicine website. Available at:
http://www.pennmedicine.org/bloodless. Accessed May 29, 2014.
Glossary of terms. Department of Cardiothoracic Surgery, University of Southern California website. Available at:
http://www.cts.usc.edu/zglossary-cellsaver.html. Accessed May 29, 2014.
Hyperbaric oxygen (HBO) therapy process and applications. Englewood Hospital Medical Center website. Available at:
http://www.englewoodhospital.com/pdf/HBOProcessandApplications.pdf. Accessed May 29, 2014.
Mizuno J, Ozawa Y, Arita H, Hanaoka K. Anesthetic management of a Jehovah's Witness for pancreaticoduodenectomy.
Shander A, Javidroozi M, et al.
From bloodless surgery to patient blood management.
Mt Sinai J Med. 2012;79(1):56.
Stuart A. Hyperbaric oxygen therapy. EBSCO Health Library website. Available at:
http://www.ebscohost.com/healthLibrary. Updated January 15, 2014. Accessed May 29, 2014.
What is bloodless surgery? Bloodless Surgery website. Available at:
http://bloodless-surgery.net/what-is-bloodless-surgery. Accessed May 29, 2014.
Last reviewed May 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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