There is a broad and growing range of effective techniques and technologies that allow physicians to avoid the need for donated blood and blood products. Some of these techniques play a major role in surgical procedures. Some are used as alternatives in preoperative and postoperative treatments or in treating specific medical conditions such as anemia. Blood management alternatives used as part of the Blood Management and Bloodless Medicine and Surgery Program at Mount Sinai Beth Israel include:

Pharmaceuticals, such as:
-A synthetic hormone (erythropoetin or EPO) used to stimulate bone marrow to produce more red blood cells.
-Drugs that can stimulate the creation of white blood cells and platelets.
-Hemostatic agents to reduce blood loss during surgery or to help to reduce acute bleeding.
-Intravenous iron infusions to treat iron-deficiency anemia.

Lab technologies that use low-volume tubes, which draw minimal amounts of blood.

Anesthesia techniques, such as:
-Hypotensive anesthesia, which induces low blood pressure to decrease operative blood loss.
-Normovolemic hemodilution, in which blood is slowly drained inside a closed system immediately prior to surgery. This blood volume is simultaneously replaced with fluid to keep vital signs stable and the blood is thinned. When some blood is lost in surgery, the anesthesiologist returns the previously drained whole blood to the patient.
-Volume expanders, which help to maintain fluid volume so that patients can tolerate some loss of blood.

Surgical techniques and equipment, such as:
-Blood salvage technology, including the Cell Saver, which recovers and recycles blood that is lost during surgery. Shed blood is collected and the red blood cells are concentrated and washed prior to reinfusion. Postoperative blood salvage can also minimize the total blood loss from surgical procedures.
-Minimally and less invasive laparoscopic, laser and robotic surgery.
-Embolization, which strategically blocks blood vessels.
-Retrograde autologous priming of the heart-lung machine, which allows a heart surgery patient's arterial blood to replace some of the priming fluid in the heart-lung machine that circulates blood during surgery.
-Electrocautery, which uses heat to stop vessels from bleeding.
-The harmonic scalpel, which uses vibration and friction to cut and simultaneously cause blood clotting, stemming the loss of blood.
-The argon beam coagulator, which clots blood during surgery to minimize blood loss.

Biological products, such as:
-Collagen and cellulose woven pads that stop bleeding by direct application.
-Fibrin glues and sealants that cover large areas of bleeding tissue.

Supplemental approaches, such as an iron-rich diet in preparation for surgery to avoid the incidence of anemia.

Contact Us

For more information, you or your physician can call the program coordinator of the Blood Management and Bloodless Medicine and Surgery Program at Mount Sinai Beth Israel at (212) 420-2430.