Blood Management Techniques

• An iron-rich diet which will build your iron stores and ensure that a supply of iron will be readily available to assist in the formation of red blood cells, when needed.
• Start or decrease your intake of Vitamin C. This will aid in the absorption of iron.
• Vitamin B12 is important in the formation of all cells in the body, especially red blood cells and the covering of nerve cells (myelin). The body needs myelin for nerves to function properly.
• Folic acid is a B-complex vitamin needed to form healthy cells, especially red blood cells.

These supplements can be purchased over-the-counter at your local pharmacy.

Medications
Certain medications have proven effective in minimizing blood loss during surgery. Below are a few that could be used, if determined by your physician to be appropriate for you:

• Tranexamic Acid
  BRAND NAME(S): Cyklokapron ®
  Tranexamic acid (marketed in the UK under the trade name "Cyclokapron") is an antifibrinolytic agent which competitively inhibits the activation of plasminogen to plasmin. The drug has affinity for the five lysine-binding sites of plasminogen. It thus promotes clot stability and is useful as adjunctive therapy in hemophilia and some other bleeding disorders. The use of tranexamic acid has superseded the use of aminocaproic acid, which not only has a shorter plasma half-life but is less potent and more toxic.
  
• Aminocaproic Acid
  BRAND NAME(S): Amicar ®
  Aminocaproic acid inhibits certain biochemical reactions that involve enzymes, incuding the activation of plasminogen, a natural enzyme that dissolves blood clots. As a result, blood becomes more prone to clotting which helps to stanch episodes of uncontrolled bleeding.
  
• Aprotinin
  BRAND NAME(S): Trasylol ®
  Aprotinin is a protein that is obtained and purified from cow's lungs. It has been used in medicine for many years as a drug in heart surgery and is available in Australia under the brand name TRASYLOL.
  
• Desmopressin
  BRAND NAME(S): DDVP ®
  Desmopressin is a chemical that is similar to a hormone found naturally in your body. It increases urine concentration and decreases urine production. Desmopressin is used to prevent and control excessive thirst, urination, and dehydration caused by injury, surgery and certain medical conditions, allowing you to sleep through the night without awakening to urinate. It is also used to treat specific types of diabetes insipidus and conditions after head injury or pituitary surgery.
  
• Vitamin K
  There are three forms of Vitamin K: phylloquinone, which is found in food, menadione, which is man-made and menaquinone, which is produced by the body. Vitamin K is used in the body to control blood clotting and is essential for synthesizing the liver protein that controls the clotting. It is involved in creating the important prothrombin, which is the precursor to thrombin, a very important factor in blood clotting. It is also involved in bone formation and repair. In the intestines it also assists in converting glucose to glycogen, this can then be stored in the liver. There are some indications that Vitamin K may decrease the incidence or severity of osteoporosis and slow bone loss.

Certain medications may be stopped several days prior to surgery (e.g. aspirin and anti-inflammatory drugs) because they may hinder the formation of blood cells or interrupt blood clotting function.

Primary Components of Blood
Download a chart with more information on what is contained in blood and how it is used.

Anesthesia Techniques
Techniques without blood and blood products that support heart rate, blood pressure and oxygen levels include:

• Volume expanders: fluids
• Hypotensive anesthesia: controlled lowering of blood pressure
• Induced hypothermia: cooling the body by reducing the body temperature to below normal
• Normovolemic hemodilution: blood conservation strategy that minimizes the loss of whole blood by exchanging blood for volume expanders during the critical blood loss period.

Surgical Methods
Instrumentation that cauterizes bleeding vessels, blood collection and recycling, embolization of bleeding arteries are methods used in the operating room that result in decreased blood loss with minimal damage to tissues:

• Electrocautery
• Ultrasonic scalpel
• Laser surgery
• Argon beam coagulator
• Autotransfusion devices
• Selective embolization

Blood Loss Through Phlebotomy
Point-of-care testing and pediatric sampling reduce the amount of blood drawn for testing and preserve critical oxygen-carrying blood cells.

Treatment Options
Treatment options include:

• Meticulous surgical technique
• Equipment to salvage and recycle patient's own blood
• Hemodilution, a blood-sparing process using patient's own blood
• Erythropoietic agents used during and after surgery to stimulate red cell production
• Other pharmaceuticals derived from primary components of blood to stimulate the growth of new cells and promote healing and control blood loss