Blood Transfusion Refusal

Albumin

A protein made by the liver. Albumin helps keep fluid in the blood from leaking out into the tissue and helps maintain blood volume. A small amount of albumin may be used to buffer other medications, including some versions of erythropoietin.

Clotting Factors

Clotting factors are proteins found in plasma and are used in some medications to help control bleeding.

Immune Globulins

Immune globulins are antibodies and proteins that are found in plasma. They are used in medications to fight viruses and bacteria. These are also found in the tetanus vaccine and antivenom agents for patients bitten by a venomous animal.

Erythropoietin

Erythropoietin is used in medications (erythropoiesis stimulating agents) to help build red blood cells in anemic patients, and some versions of the medication contain albumin.

Cryoprecipitates

Cryoprecipitates are clotting factors, including fibrinogen, taken from pooled plasma, and are used to stop bleeding. Each bag of cryoprecipitate contains about one to four teaspoons of plasma.

Topical Agents, Sealants and Sutures

Topical agents are medications that contain minor blood fractions, such as clotting factors, which can be applied internally or externally to control bleeding. Sealants and sutures are used in the OR, and some contain clotting factors or albumin.

RhoGAM

RhoGAM contains immune globulins and is given to pregnant women who have a negative blood type when the baby has a positive blood type. 

Cell Saver

Cell saver is a machine used in surgery to collect blood lost during surgery from the surgical site. The blood is then filtered, washed, mixed with a blood thinner and returned to the patient in a closed circuit

Heart-Lung Machine

This machine is used during open-heart surgery to maintain blood flow throughout the body. The blood runs through the machine, which gives it oxygen, and returns the blood to the patient’s body in a closed circuit.

Hemodialysis

A treatment required in patients with kidney failure, where blood is removed from the body and circulated through a machine that filters and clears blood of toxins before returning the blood to the body in a closed circuit.

Hemodilution

Blood is removed from the patient before the start of surgery and replaced with intravenous fluid (volume expander). The removed blood is stored in the same closed circuit and is returned to the patient during or at the end of surgery. 

Cell Tagging

This is a diagnostic tool that might be used to help find a bleeding source or cancer. A small amount of blood is withdrawn from the patient and mixed with nuclear material that allows for tracing through the body. The blood is then injected back into the patient for imaging.

Epidural Blood Patch

This procedure is performed by an anesthesiologist to treat a headache that may develop after a lumbar procedure. One to two tablespoons of blood are removed from the patient and injected into the epidural space of the spine.

Platelet Gel

Platelet gel is used in surgery to seal incisions. A small amount of the patient’s blood is removed from the cell saver machine and immediately spun to separate platelets. The platelets are then mixed with a clotting factor to form a gel, which is applied to an incision.

Apheresis

A procedure where the patient’s blood is removed and run through a machine to separate the desired cells. The blood then flows back to the patient through an uninterrupted circuit.

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