Medicine Cabinet
By Teodoro B. Padilla
In June, the World Blood Donor Day was celebrated to raise awareness about voluntary blood donation. This is needed to maintain a blood service that gives patients access to blood and blood products in sufficient quantity.
There are patients, on the other hand, for whom blood transfusion is not an option, whether for religious reasons or safety concerns. With this in mind, healthcare providers worldwide are instituting patient blood management (PBM) programs that are associated with improved patient outcomes, reduced transfusions and product-related costs, according to a medical article published on the National Center for Biotechnology Information’s PubMed.
Penn Medicine, for example, explained that bloodless medicine and surgery is a safe, proven and effective method of treating patients without the use of blood or blood products. It added that patient blood management is “increasingly recognized as the gold standard of care” in medicine and surgery.
Pennsylvania Hospital’s Center for Transfusion-Free Medicine is one healthcare provider which offers blood transfusion alternatives that afford benefits to patients. As Penn Medicine explained, those who choose bloodless medicine often experience faster healing times, faster recovery times, fewer reactions from blood stored for a longer period of time, less chance of infections, and reduced risks from receiving the wrong blood in error.
The Johns Hopkins Center for Bloodless Medicine and Surgery also has a team of experts that caters to patients seeking healthcare without the use of blood or blood products. Their program utilizes a wide variety of patient blood conservation methods and techniques that are approved by the US Food and Drug Administration (FDA) and have been shown to significantly improve health outcomes.
For one, the Johns Hopkins Center performs minimally invasive surgery to help minimize blood loss. To help maintain a proper volume of blood without transfusion, they also perform hemodilution. The technique involves removing some of the patient’s blood shortly before surgery and replacing this with a water- and mineral-based solution called volume expander thereby diluting the blood. This technique minimizes the effects of blood loss and can help with clotting.
Mt. Sinai, which operates a string of hospitals, is also offering bloodless medicine throughout its health system. They likewise accept bloodless medicine referrals for patients coming from other countries. They said that the use of pharmaceuticals, surgical procedures and technologies that avoid blood and its components allow them to serve their patients who require nonblood procedures.
For pharmaceuticals, for example, they may use a synthetic hormone to stimulate red blood cell production, hemostatic agents to reduce blood loss during surgery, and intravenous iron infusions for anemia. Biological products like fibrin sealants to cover large areas of bleeding tissue can also be used.
Even if a patient does not request blood management, Mt. Sinai said that efforts are made to avoid unnecessary transfusions. Their blood management techniques include low-volume blood draws, transfusion alternatives for anemia, and minimally invasive procedures.
Citing Acts 15:28-29, Jehovah’s Witnesses are among those who have individually decided to receive medical care that is compatible with their Bible-based belief to avoid blood.
In support of this, they work with healthcare professionals and hospitals worldwide to provide information about nonblood clinical strategies. They formed the Hospital Liaison Committees (HLCs) which is an international network of trained volunteers who offer 24/7 assistance to Witness patients, their families, and physicians for quality healthcare without the use of blood.
In assisting healthcare professionals, the HLCs provide access to peer-reviewed medical information for clinicians about medical and surgical procedures performed successfully without the use of blood. They also facilitate physician-to-physician consultations with specialists.
In the Philippines, the East Avenue Medical Center in Quezon City has established a bloodless medicine program. Other hospitals also offer nonblood procedures upon the request of their patients, according to the Public Information Desk of Jehovah’s Witnesses.
Apart from the thrust to promote patient-centered care that is associated with improved health outcomes, the Penn Medicine provided more reasons for hospitals and healthcare organizations to consider a patient blood management program. The institution said that bloodless medicine reduces the hospital’s costs related to maintaining blood inventory, lowers the chances of blood transfusion errors, trims down blood storage-related issues, and eases the demand for blood and blood products, among others.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.