MEDICAL AND SURGICAL TECHNIQUES

Controlled Hypotension/Hypotensive anesthesia:

Intentional and controlled lowering of blood pressure reduces bleeding by decreasing pressure on injured blood vessels and causing less disruption of newly formed clots.

Arterial Embolization:

Therapeutic introduction of either mechanical or chemical agents into blood vessels to occlude them. In emergencies, embolization can control active bleeding from a lacerated artery. This intervention may avoid general anesthesia and major surgery (postpartum hemorrhage, uterine fibroids, gastro-intestinal bleeding).

Hemodilution:

At the start of the surgical procedure some of the patient’s own blood is diverted through a closed circuit while intravenous fluids are given to replace blood volume. This technique dilutes the patient’s blood and reduces the amounts of blood cells and clotting factors lost during surgery.

Oximetry:

This is a non-invasive monitoring of the oxygen level of blood.

Laboratory sampling:

Minimal volumes of blood samples are obtained for laboratory analysis.

BLOOD CONSERVATION DEVICES AND EQUIPMENT

(Devices which promote clotting)

Electrosurgery:

A probe heated used to cut and coagulate capillary vessels and small arteries during surgical procedures.

Harmonic Scalpel:

A scalpel that uses sound waves to seal tissue as it cuts, used during surgery on vascular organs, such as the spleen or liver.

Argon Beam Coagulator:

A device which uses argon gas to coagulate blood vessels to lessen bleeding.

Intraoperative blood salvage (Cell Saver):

The patient’s own blood is recovered, filtered, and returned during surgery.

MINIMALLY INVASIVE SURGERY

(Performed with specialized devices designed to use small incisions, minimizing blood loss; bleeding or other problems can be located, diagnosed, and treated without conventional open surgery).

Laparoscopy:

Using a tube-like device, abdominal structures can be visualized through a small “keyhole” incision.

Endoscopy:

Using a flexible tube-like device a visual examination of the interior of the stomach, intestines, and other body cavities is possible.

HEMATOLOGICAL AGENTS

(Stimulate blood cell growth and development)

Synthetic Erythropoietin:

Also known as PROCRIT, EPOGEN, or “EPO”; this medication stimulates the patient’s own bone marrow to produce red blood cells.

Synthetic Granulocyte-Colony Stimulating Factor:

Also known as Neupogen, Filgastrim, or G-CSF; this medication stimulates the bone marrow to produce neutrophils, a specific infection-fighting white blood.

Medical Thrombopoietic agents:

Drugs that stimulate the bone marrow to produce blood platelets that are needed for normal clotting.

HEMOSTATIC AGENTS

(Promote clotting; can be given intravenously or applied topically)

Aminocaproic Acid and Tranexamic Acid:

Medications given intravenously which slow or stop the breakdown of blood clots.

Volume Expanders:

Intravenous fluids enhance the circulation of the patient’s own blood by maintaining adequate volume.