Approaches to Bloodless Surgery for Oncology Patients

Steven M Frank; Shruti Chaturvedi; Ruchika Goel; Linda M S Resar

doi:10.1016/j.hoc.2019.05.009

Approaches to Bloodless Surgery for Oncology Patients

Hematol Oncol Clin North Am. 2019 Oct;33(5):857-871. doi: 10.1016/j.hoc.2019.05.009. Epub 2019 Jul 31.

Authors

Steven M Frank¹, Shruti Chaturvedi², Ruchika Goel³, Linda M S Resar⁴

Affiliations

¹ Department of Anesthesiology/Critical Care Medicine, Center for Bloodless Medicine and Surgery, Johns Hopkins Health System Blood Management Clinical Community, The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins Medical Institutions, Zayed 6208, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address: sfrank3@jhmi.edu.
² Division of Hematology, Department of Medicine, The Johns Hopkins Medical Institutions, Johns Hopkins Hospital, Ross Building Room 1032, 1800 Orleans Street, Baltimore, MD 21287, USA.
³ Division of Transfusion Medicine, Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, 315 West Carpenter Street, Springfield, IL 62702, USA; Mississippi Valley Regional Blood Center.
⁴ Department of Medicine (Hematology), Oncology & Institute for Cellular Engineering, The Johns Hopkins Medical Institutions, Center for Bloodless Medicine and Surgery, Ross Building Room 1015, 1800 Orleans Street, Baltimore, MD 21287, USA.

PMID: 31466609
DOI: 10.1016/j.hoc.2019.05.009

Abstract

Providing optimal care to surgical oncology patients who cannot be transfused for religious or other reasons can be challenging. However, with careful planning, using a combination of blood-conserving methods, these "bloodless" patients have clinical outcomes that are similar to other patients who can be transfused. Bloodless surgery can be accomplished safely for most patients, including those undergoing technically challenging oncologic surgery. This article reviews best practices used in a bloodless program during the preoperative, intraoperative, and postoperative periods, with the aim of achieving optimal outcomes when transfusion is not an option for surgical oncology patients.

Keywords: Anemia; Blood conservation; Bloodless; Cancer; Oncology; Surgery.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Anesthesia / methods
Anesthesia / standards
Bloodless Medical and Surgical Procedures* / ethics
Bloodless Medical and Surgical Procedures* / methods
Bloodless Medical and Surgical Procedures* / standards
Disease Management
Health Personnel
Humans
Intraoperative Care
Medical Oncology* / ethics
Medical Oncology* / methods
Medical Oncology* / standards
Neoplasms / metabolism
Neoplasms / surgery*
Patient Acceptance of Health Care
Patient Care Team
Preoperative Care
Treatment Outcome