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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

Advance Directive - A document in which a capable person sets out what, how or by whom health care decisions are to be made in the event that he or she is not capable of making health care decision on his /her own. Two types of advance directives are instruction directives and proxy directives:

  • Instruction Directives - a directive in which the maker specifies what type of health care and treatment he or she wishes to receive or not receive.
  • Proxy Directive - a document (sometimes referred to as an "enduring" or "durable" power of attorney for health care decisions) in which a capable person of 19 years or older names a proxy to make health care decisions for him/her in the event that he or she is not capable of making those decisions on his/her own. Proxy directives must be in writing, must be dated and signed by the maker; and must be witnessed by someone other than the proxy or the proxy's spouse.
Albumin (serum albumin) - A mixture of albumins that 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. Albumin is a component (up to 4%) of the blood plasma. Types of albumin are found in plants, foods such as milk and eggs, and breast milk.

Blood Product - Any therapeutic product derived from human blood or plasma, and produced by a manufacturing process that pools multiple units (usually more than 12) e.g. human serum albumin, immunoglobulin preparations, and coagulation products (factors VIII and IX, fibrinogen, anti-thrombin III, etc.).

Clotting Factors - Clotting factors are in plasma (less than 1%) that help the thinning and clotting of blood. Many are known only by Roman numerals (1-13). One of the clotting factors, factor XI, contributes to the formation of an enzyme that plays an important role in the development of a protein called fibrin, a key clotting agent in the blood. They are also used in medical glues to seal wounds and stop bleeding.

Cryoprecipitate - A plasma blood fraction used to treat deficiencies of Factor VIII, and fibrinogen in the treatment of Hemophilia A. The product is made by thawing frozen plasma at 4°C which results in a precipitate. This precipitate is removed and is named "cryoprecipitate".

Desmopressin (DDAVP) - a medication that improves clotting capacity in nearly all patients. It is a valuable aid in stopping bleeding quickly and is short in duration, so it does not cause fear of excessive clotting.

Dialysis - The circulation of blood through a machine that filters out impurities and returns the filtered blood to the owners' circulatory system via intravenous catheters.

Erythropoietin (EPO) - Erythropoietin (EPO) is a medication given to stimulate the bone marrow to produce more red blood cells. It may contain albumin.

Folic Acid - a component of the Vitamin B complex that is necessary for red blood cell production. Recommended in cases of anemia.

Fresh Frozen Plasma (FFP) - The fluid portion of one unit of human blood that has been centrifuged, separated and frozen solid at -18°C (-0.4°F) (or colder) within 8 hours of collection.

Heart-Lung Pump - The heart-lung pump is used in heart surgery to recirculate and oxygenate the patient's own blood. At a crucial point during heart surgery, the surgeon can direct the patient's blood from the heart to the pump through tubing. The pump circulates the blood until the time when the surgeon is ready to redirect it back to the patient. This recirculation of blood allows the surgeon time to work on the vessels and the heart without the full flow of blood.

Immunoglobulins - (up to 3% of plasma) Antibodies produced in the lymphatic cells to combat infections or other invading substances. RhoGAM is a blood product used for pregnant women who may have the Rh factor. Using RhoGAM early during a pregnancy may prevent the Rh factor reaction in the unborn child.

Intraoperative Blood Salvage (Cell Saver) - A system that collects a patient's own blood from a open wound or incision, cleansing, and reinfusing it back into the patient.

Intraoperative hemodilution - Removal of a specific amount of blood during surgery, replace with intravenous (IV) fluids, and returned after surgery. This means the blood loss during surgery will contain less erythrocytes (red blood cells) and more water. Doing so will effectively reduce the amount of blood lost during surgery.

Microsampling - Blood sampling equipment that uses the least amount of blood possible for diagnostic purposes.

Packed Red Blood Cells - PRBCs Red blood cells (also called erythrocytes) serve two important functions: 1. Carry oxygen from the lungs to cells in all parts of the body. 2. Take carbon dioxide back to the lungs from the cells; carbon dioxide is released as a waste product of cell processes. They are the most commonly transfused blood component, and can restore the blood's oxygen carrying capacity. Usually infused when a patient is severely anemic or bleeding.

Plasmapheresis - similar to dialysis. The removal, treatment, and return of blood products from a person back to that person through a filtering machine.

Platelet Gel - Platelets are removed from your own blood, spun and mixed with thrombin substance to create a gel to be applied to the surgical site. The gel seals, reduces bleeding, reduces swelling, reduces pain, stimulates tissue growth, and enhances healing.

Platelet Rich Plasma (PRP) - A concentrated source of autologous platelets, PRP contains and releases at least seven different growth factors that stimulate bone and soft tissue healing. Platelet-rich plasma is an alternative source of growth factors to promote wound healing

Tissue adhesives/ Fibrin Glue - Tissue Adhesives or surgical glue are a combination of the fibrinogen and thrombin mixed with the drug aprotinin. Tissue adhesives can be helpful in trauma when specific organ(s) (liver, spleen, pancreas) are losing blood. The mixture is sprayed or painted on the organ(s) during surgery to stop or slow blood loss.

Volume Expanders - Intravenous fluids made with water, salts, sugars or starched that help maintain the correct amount if fluid in the blood vessels

  • Crystalloids - normal saline, lactated Ringer's solutions
  • Colloids - albumin, hetastarch
Voluven - a plasma volume substitute indicated for the treatment and/or prevention of hypovolemia. A synthetic starch that is NOT derived from RBCs or blood components.