Ivan Zamorano

Acupunture Treatment

Bloodless Medicine and Surgery: What You Need to Know | Steven Frank, M.D.


[MUSIC] Providing bloodless care
to patients is simply providing medical care
without giving patients blood donated by another person. The way we do this is to
conserve blood by reducing or eliminating bleeding,
by stimulating the body to make its own blood cells
at an accelerated rate. And also by recycling blood that
patients lose during surgery, and giving them back
their own blood. [MUSIC] Well, there are several reasons
why patients may choose a bloodless approach
to their surgery. Historically, patients have
elected to avoid transfusion because of religious reasons,
but also, some patients just simply wish to avoid the risk or
the side effects of transfusion. For example, we know that
patients treated with the bloodless methods have
a shorter length of stay, decreased incidence of hospital
acquired infections, and also a less chance of
an allergic reaction, or even receiving the wrong unit
of blood, which still occurs. [MUSIC] The first thing we do is we
diagnose or treat anemia prior to surgery, so patients come
to the operating room with enough red blood cells so they
can tolerate any blood loss. During surgery,
we can avoid hypothermia or hypertension, both of which
can increase bleeding. And then we can collect and recycle the blood they lose,
using the cell saver, and give them back their own
blood during surgery. We can also use
what we call ANH, Acute Normovolemic Hemodilution,
which is where we bank the patient’s own blood at
the beginning of the case, and give it back to them at
the end of the case. There’s one more technique. There’s new versions of
electrocautery that have come out recently that can
dramatically decrease bleeding during orthopedic cases and
during spine surgery, for example. [MUSIC] Virtually, 99% of all
the procedures we do can be performed without transfusion. For example, we’ve done
some really big surgeries, like a Whipple for
pancreatic cancer, we’ve done many of those
without transfusions. We’ve done open heart surgeries, even revision open
heart surgeries, for valve replacements and
bypass surgery without blood. And recently,
we even did a six kilogram baby. That’s about a 14 pound baby, who had open heart surgery for
tetralogy of fallot, requiring cardiopulmonary
bypass without a transfusion. [MUSIC] We believe that we offer more
different types of specialty care than any other hospital in
the country that has a bloodless program. Plus, our program blends
seamlessly into the care plan that’s offered by all varieties
of specialties within the hospital. [MUSIC] Surgery itself is becoming
less and less invasive. For example,
the laparoscopic and robotic approach to different
surgeries have dramatically decreased the amount of
blood that patients lose and the amount of transfusions
they require. Also, we’re giving new,
intravenous medications, like iron, or we’re even
giving erythropoietin, which is one of the medications
that the professional cyclists use to blood dope. Only now, we’re giving it
legally to our patients to build their blood counts
prior to surgery. So they don’t require
a transfusion. [MUSIC]

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