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A Bloodless Surgical Journey: Alternatives to Transfusion

Wanderer, Jonathan P. MD, MPhil; Nathan, Naveen MD

doi: 10.1213/ANE.0000000000003939
Infographics: Infographic

Vanderbilt University School of Medicine (

Northwestern University Feinberg School of Medicine (

Published ahead of print 18 October 2018.

The authors declare no conflicts of interest.

The Infographic is composed by Jonathan P. Wanderer, MD, MPhil, Vanderbilt University School of Medicine (, and Naveen Nathan, MD, Northwestern University Feinberg School of Medicine ( Illustration by Naveen Nathan, MD.

Although blood transfusions are considered essential for many procedures, it is possible to perform surgery without the use of transfusions. Achieving this, however, may require concerted effort to be applied by a coordinated care team across the preoperative, intraoperative, and postoperative phases of care. These strategies include optimization of hemoglobin levels preoperatively, salvaging blood intraoperatively, and supporting hematopoiesis throughout perioperative care. In this infographic, we review specific interventions that can be performed to reduce or eliminate the need for transfusion, while describing some of the indications for bloodless surgery.

Cryo indicates cryoprecipitate; epo, erythropoietin; PCCs, prothrombin complex concentrates.

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1. Tan GM, Guinn NR, Frank SM, Shander A. Proceedings from the Society for Advancement of Blood Management Annual Meeting 2017: management dilemmas of the surgical patient—when blood is not an option. . Anesth Analg. 2019;128:144151.
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