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Patient Options

A medical emergency or the need for surgery can arise suddenly. Patients who chose surgery without blood transfusions should periodically make sure that they are prepared for such a situation. It is very important to keep your Durable Power of Attorney for Health Care updated.

These are the blood conservation options the Kettering Health Network offers. Below is a glossary of terms that offer explanations of the options. These forms can be downloaded and filled out prior to coming to the hospital if you desire.

Blood Conservation Options Form

Albumin (up to 4% of plasma): Albumin normally constitutes more than half of the protein in blood serum, serves to maintain the osmotic pressure of the blood, and is used in transfusions especially for the treatment of shock. Types of albumin are also found in plants, in foods such as milk and eggs, and in the milk of nursing mothers.

Clotting factors (less than 1% of plasma): These are various proteins that help blood to clot in order to stop bleeding. Some are given to patients who tend to bleed easily. They are also used in medical glues to seal wounds and to stop bleeding in surgery. One combination of clotting factors is known as cryoprecipitate.

Dialysis: Functions as an organ. In hemodialysis, blood circulates through a machine that filters and cleans it before returning to the patient.

Desmopressin (DDAVP): A medication that greatly improves clotting capacity in almost all patients. Desmopressin works in two ways. First, it causes blood clotting factors that are stored in the cells to be released into the blood stream, causing high levels for short periods of time. Second, it has the ability to constrict arteries and thus decrease blood flow. Desmopressin is a valuable aid in stopping bleeding quickly and, since its effect is short in duration (30-60 minutes), it can be given without fear of excessive clotting.

Erythropoietin (EPO): A medication that is a genetically produced form of a naturally occurring hormone in the body. This drug directly stimulates the bone marrow to produce more red blood cells. The hormone may contain albumin (a minor component of blood) and, if so, taking it would be a conscience matter.

Folic acid: A medication that is a member of the Vitamin B complex family and is a necessary component for red blood cell production. It can be recommended almost universally in any case of anemia.

Heart-Lung/Bypass Machine: Maintains circulation. Blood is diverted to an artificial heart lung machine where it is oxygenated and directed back in to the patient.

Hemophiliac preparations (clotting factors, less than 1% of plasma): This is an effective clotting treatment for the hemophiliac patient. It is made up the pooled blood of many individuals. This is a religious conscience decision.

Immunoglogulins: (Up to 3% of plasma) Protein fractions that may be used in some medicines that fight viruses and diseases, such as tetanus, dipheria, viral hepatitis and rabies. They may also guard against some medical conditions that threaten the life of a developing baby or to counteract the effects of snake or spider venom.

Intraoperative blood salvage ("Cell Saver") A procedure that uses a device to aspirate shed blood from the operating field thereby recirculating and saving blood that might be lost during surgery. It filters the blood and returns either whole blood or washed red cells to the patient, usually in a continuous process. This is a conscience matter for Christians if blood is not stored and if the equipment is arranged in a circuit that is constantly linked to the patient's circulatory system.

Intraoperative Hemodilution: A procedure that involves directing a volume of a patient's blood outside the body and then adding a volume expander to dilute the remaining blood in the circulatory system. Diluting the patient's blood decreases the amount of red blood cells lost during surgery. After surgery, the volume of collected blood in the external circulation is returned to the body. This procedure is a conscience matter for Christians. Intraoperative hemodilution will keep the patient's blood in continuity with the patient's own circulation.

Microsampling: A procedure involving blood sampling equipment that is capable of using as little as 1/2ml or five drops of blood for diagnostic purposes. An adult sample ranges near 10ml. This procedure is vital in caring for newborns, children, or adults under intensive hospital care.

Packed Red Blood Cells: Packed red blood cells, the most commonly transfused blood component, can restore the blood's oxygen-carrying capacity. This component may be given to a person who is bleeding or who has severe anemia. The red blood cells are separated from the fluid component of the blood (plasma) and from the other cellular and cell-like components. This step concentrates the red blood cells so that they occupy less space, thus the term "packed." Red blood cells can be refrigerated for up to 42 days. In special circumstances – for instance, to preserve a rare type of blood – red blood cells can be frozen for up to ten years.

Plasmapheresis (similar to dialysis): The removal, treatment and return of components of blood plasma from the blood circulation.

Platelet Gel: Platelets are removed from your own blood, spun and mixed with thrombin/calcium substance to make a gel that is applied to the surgical site. The gel seals wounds, reduces bleeding, reduces swelling, decreases pain, stimulates tissue growth and enhances healing.

Voluven: A plasma volume substitute indicated for the treatment and/or prevention of hypovolemia. It is a synthetic starch that is not derived from RBC's or blood components.

Tissue adhesives/Fibrin glue: A medication that is derived from various products of blood clotting that is applied to certain areas of tissue that bleed easily, such as liver and spleen. This technique has limited use and its application would be a conscience matter for Christians comparable to that of other blood products.