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Anesth Analg. 2019 Jan;128(1):144-151. doi: 10.1213/ANE.0000000000003478.

Proceedings From the Society for Advancement of Blood Management Annual Meeting 2017: Management Dilemmas of the Surgical Patient-When Blood Is Not an Option.

Author information

1
From the Department of Anesthesiology, University of Colorado, School of Medicine, Aurora, Colorado.
2
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
3
Department of Anesthesiology/Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
4
Department of Anesthesiology and Critical Care Medicine, Englewood Hospital and Medical Center and TeamHealth Research Institute, Englewood, New Jersey.

Abstract

Vigilance is essential in the perioperative period. When blood is not an option for the patient, especially in a procedure/surgery that normally holds a risk for blood transfusion, complexity is added to the management. Current technology and knowledge has made avoidance of blood transfusion a realistic option but it does require a concerted patient-centered effort from the perioperative team. In this article, we provide suggestions for a successful, safe, and bloodless journey for patients. The approaches include preoperative optimization as well as intraoperative and postoperative techniques to reduce blood loss, and also introduces current innovative substitutes for transfusions. This article also assists in considering and maneuvering through the legal and ethical systems to respect patients' beliefs and ensuring their safety.

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