Evidence in favor of bloodless surgery mounts

A recent study conducted at the Maritime Heart Center in Halifax, Nova Scotia showed that blood transfusions for stable cardiac-surgery patients increased their risk of death, renal failure, and sepsis or infection. The results were released at the Canadian Cardiovascular Congress show, and was presented by Robert Riddell, a medical student at Dalhousie University in Halifax, Nova Scotia. The study looked at 3842 consecutive patients, who were all undergoing different types of cardiac surgery. According to theheart.org,

the patients were sorted into four groups: the first received no blood product transfusions; the second received blood products during their surgery; the third group received blood products within the first 48 hours; and the fourth received blood products 48 hours or later after surgery.

After making adjustments for age, sex and other factors the study concluded that blood transfusions dramatically increased morbidity and mortality rates compared with those who received bloodless surgery. The study also suggests that the later the blood transfusion the worse off the patient is. There are realistic alternatives to blood transfusions today. According to AllSands, since the tragedy of AIDS people have become all too aware that our blood supply can never be completely safe and that in a recent poll 89 per cent of Canadians would rather have an alternative to donated blood. Most people associate the refusal of blood transfusions to the stand taken by Jehovah's Witnesses who look upon the procedure as against Bible teachings. However, according to AllSands, that stand has led to bloodless medicine and surgery reaching "an advanced level of development and is the preferred treatment of many informed people." The avoidance of blood during surgery means that post-operative infections and complications are avoided, and blood types would not have to be matched, erasing any complications from matching errors. Bloodless surgeries typically cost 25 per cent less than those that use donated blood with extra savings from a 50 per cent increase in recovery times, translating into shorter hospital stays. In the event of a large blood loss, in most cases the volume of blood can be maintained by alternative fluids such as Ringer’s lactate solution, dextran, hydroxyethel starch and others that will prevent hypovolemic shock. Drugs are now being used before surgery to stimulate the production of red blood cells, blood platelets and various white blood cells to increase the volume of blood as well as other medications to reduce blood loss. Surgeons are now able to manage bleeding better by the use of biological hemostats. New glues and sealants can block puncture wounds or cover larger areas of exposed bleeding tissue. Patients can now have blood that is lost in surgery or trauma to be salvaged by the use of machines that cleanse the blood and return it to the patient without storing it. According to the Encyclopedia of Surgery, new instruments and surgical techniques now allow surgeons to perform procedures with minimal blood loss. All of the above procedures have been performed successfully on thousands of patients worldwide, who seek safer medical care, whether it be for religious reasons or not. By the end of 2002, 30 per cent of all requests for bloodless surgeries came from people who were not Jehovah's Witnesses.