Word: bloodlessness
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Medical technology has tried to answer the call. It has come up with a panoply of methods and machinery, some of them known for decades but refined and repackaged to fit today's needs and concerns. While bloodless techniques vary from hospital to hospital, they invariably begin with medicinal and nutritional approaches to increase a patient's blood count before surgery. Efforts are made to guard against unnecessary blood loss from tests, and standard blood drawings are either reduced or eliminated altogether. And since an intensive-care patient during an average stay must part with close to a liter...
Erythropoietin is usually the drug of choice for bloodless medicine because of its stimulative effect on red-blood-cell production. Hormones and vitamin B12 are also prescribed to encourage cell production. Doctors may employ a hyperbaric chamber to flood patients' blood with higher concentrations of oxygen so that they can better withstand surgical procedures and low blood levels, while oximetry devices and other noninvasive monitoring equipment keep close watch over oxygen levels...
During surgery, bloodless practitioners often do everything they can to stave off any blood loss that might require a transfusion. Among the techniques: cryosurgery to freeze tissue to be removed, or use of a harmonic scalpel, a vibrating laser that simultaneously cuts tissue and clots blood. Brain surgeons treating tumors and repairing blood-vessel malformations are also using a state-of-the-art gamma "knife" that delivers a high dose of radiation to precise points in the head through tiny holes in a helmet that resembles a salon hair dryer...
Still, except for such techniques as radiosurgery, virtually no surgery is completely bloodless. The blood that is shed during operations at places like Englewood may be suctioned out by cell-saving machinery, cleaned and then returned to the patient's body. Red blood cells can also be saved through hemodilution. In this procedure, hemoglobin-rich blood is pumped unit by unit from a vein and replaced by an equal number of units of a nonblood fluid to expand the volume to normal; the patient's own drawn blood is held for use after surgery. In another technique, doctors...
Since the Englewood program began in 1994, it has performed more than 1,500 bloodless procedures, twice that of any other institution. Most of them have been major operations that usually involve extensive blood loss and transfusions: liver resections, hip replacements, abdominal aortic aneurysms, hysterectomies and brain surgery. "From a medical point of view, there are no technical barriers to performing bloodless surgeries," says Dr. Sharo Raissi, a cardiac surgeon at Brotman Medical Center, one of a dozen hospitals in Los Angeles that offer such services. "There is no limit as to what can be done for patients, from open...