At CVTSA, we are always working to ensure the safest and most effective techniques are used to care for our patients. In 2008, we implemented new protocols for blood transfusions based upon national and international research which demonstrated that long-term survival rates for those who have received a transfusion were not as good as those who had not been transfused. In addition, patients who received blood reported poorer quality of life indicators than those who did not receive blood.

 

Based on this evidence, our cardiac surgeons, in coordination with the perfusionists and other members of the cardiovascular operating room team implemented a new, multidisciplinary protocol to reduce the use of blood products. Immediately after the patient is anesthetized and before the chest incision is made, a central line is placed in the patients. Two units of the patient’s own blood are withdrawn. During the surgery, the patient’s blood is kept at normal body temperature and moves in a rocker to prevent it from clotting. This blood is never run through the bypass machine nor is it exposed to air or any drugs/chemicals. After the surgery, the patient is re-perfused with their own blood in a process called Acute Normovolemic Hemodilution.

 

In 2008, we reduced the number of patients receiving blood products from 66 to 25 percent.  Watch Dr. Alan Speir talk about blood conservation on NewsChannel 8

 

It is safer/healthier for patients to receive back their own blood because both loss of blood during surgery and transfusions from donated blood can weaken patients’ immune systems and make them more susceptible to allergic reactions and post-operative infections. Additionally, those patients who do not require blood products (from someone else) tend to recover faster and stay a shorter amount of time in the hospital.

 

Many people ask why they cannot donate their own blood before surgery instead of having blood removed during surgery, or risk needing a transfusion from donated blood. While this is an option for some patients, cardiac surgery is usually scheduled within a week or two from the time a patient sees a surgeon. Once someone gives blood it takes several weeks for their blood volume to return to its normal level and a normal level is required for surgery. Therefore, someone who gives their own blood will not be able to have cardiac surgery as scheduled.

 

In addition to providing a safer environment for patients, conserving patients’ blood in the operating room helps minimize the constant blood shortage across the nation and in this area. Only 5 percent of Americans donate blood and donated blood only lasts a few weeks. When a patient needs blood, there is no substitute. When there is a shortage of blood, elective surgery often has to be postponed or cancelled until enough blood becomes available.

 

To read about our work conserving blood in during pediatric heart surgery, click here.