Optimizing transfusion in vascular surgery: is bloodless surgery an option?

Area of Science:

• Anesthesiology
• Transfusion Medicine
• Surgical Patient Management

Background:

• Surgery often involves significant blood loss, necessitating transfusions.
• Allogeneic blood transfusions carry risks and costs, driving the need for alternatives.
• Blood conservation strategies are increasingly recognized as essential for patient care.

Purpose of the Study:

• To present decision-making processes for blood transfusions.
• To evaluate transfusion risks and discuss blood conservation strategies.
• To highlight the evolving field of blood conservation and its future potential.

Main Methods:

• Review of blood conservation modalities: restricted phlebotomy, restrictive transfusion triggers, acute normovolemic hemodilution, blood salvage, meticulous hemostasis.
• Use of erythropoiesis-stimulating agents prior to surgery.
• Evaluation of transfusion risks and costs.

Main Results:

• Blood conservation strategies are practical and increasingly adopted in hospitals.
• Various techniques can reduce the number of transfused blood units.
• Research is expanding understanding of hematopoiesis, coagulation, and anemia impact.

Conclusions:

• Blood conservation is vital due to allogeneic transfusion risks and costs.
• Active research in hematopoiesis, artificial oxygen carriers, and anemia offers future transfusion alternatives.
• The goal is to replace or eliminate allogeneic blood transfusions in diverse clinical settings.