Abstract
Despite the widespread use of allogeneic blood components in clinical practice, there
are patients in whom transfusion cannot be carried out for various reasons, including
refusal of transfusions because of religious beliefs. The refusal of transfusion is
not equivalent to refusal of medical treatment, and numerous options are available
to effectively manage care without transfusions. The strategies are collectively called
Bloodless Medicine and Surgery and share many similarities with Patient Blood Management,
that is, application of evidence-based medical and surgical concepts designed to preserve
patient's own blood to improve the outcomes of patients. The strategies involve obtaining
advance directive and consent to determine what components and procedures are acceptable
to the patient; preoptimizing the patient for early correction of treatable deficiencies
(e.g., anemia, coagulopathy); minimizing blood loss (e.g., hemostatic agents, blood
salvage); and improving physiologic responses to anemia. Using these approaches, it
is possible to effectively manage patients, with outcomes comparable to patients who
accept transfusions.
Keywords
blood transfusion - Bloodless Medicine - Patient Blood Management - anemia - hemoglobin
