Ultra-short natural therapies before surgery avoids blood transfusions

Blood transfusions are burdensome and an additional risk for patients. A large-scale study led by Prof. Donat R. Spahn, Director of the Institute of Anesthesiology at the University Hospital Zurich, now shows that patients still benefit from measures applied shortly before surgery that reduce blood transfusions.

Blood transfusions can be lifesaving. © Depositphotos/vladem

Blood transfusions can be life-saving. However, foreign blood places a burden on patients even when it is optimally tolerated and therefore always carries the risk of complications such as heart attacks, strokes, organ failure or infections. Reducing the risk with targeted patient blood management Doctors therefore the administration of foreign blood for some years now. Gentle surgical techniques and the preparation and re-transfusion of blood lost during surgery are important measures here. In addition, the patient's blood situation is analyzed several weeks before a planned operation and often undetected anemia is treated with drugs that stimulate blood formation. Anemia is one of the biggest risk factors for blood transfusions during or after surgery. This package of measures has led to a massive reduction in the need for blood transfusions and blood products in hospitals that work with "Patient Blood Management" in recent years, and as a result the complication and mortality rates of patients have fallen significantly.

Short-term therapy shows comparably positive effects

In a large-scale, randomized, double-blind study, researchers have now shown that patients still benefit from short-term therapy to improve their blood levels. The study enrolled 1006 patients prior to planned heart surgery. Fifty-five of them had been previously diagnosed with anemia and/or iron deficiency. Half of the study participants were treated with a combination therapy of intravenous iron administration, subcutaneously administered vitamin B12 and erythropoietin alpha, and orally taken folic acid. This was usually only one day before surgery or on Friday of the previous week if surgery was scheduled for Monday.

All patients who received this therapy showed significantly better hemoglobin and reticulocyte values than the control group. The number of hemoglobin and reticulocyte counts recorded at the Operation and blood transfusions required in the seven subsequent days fell to almost zero in the treated group.

Fewer transfusions mean less risk

Prof. Donat R. Spahn, Director of the Institute of Anesthesiology at the University Hospital Zurich and head of the study, sees the results of the study as a major step forward for a vulnerable patient group: "Every blood transfusion less means a decrease in the burden and risk for patients. Our study confirms that we can still massively improve patients' blood levels even with short-term preoperative treatment. This increases the number of patients who benefit from Patient Blood Management." The specialist in Patient Blood Management also points to other positive effects: "Fewer blood products also mean lower costs. We also owe it to our donors to use blood products sparingly and carefully."

More info

www.usz.ch

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