Blood Management Services a Growing Trend
Scott Gargan, Staff Writer

Published: 08:27 p.m., Monday, October 25, 2010

When Camelia Medina was rushed to Bridgeport Hospital in June after complaining of acute stomach pain, her health wasn't her only concern.
"I had to keep my integrity to God," said Medina, who was hemorrhaging in her gastrointestinal tract, and needed a blood transfusion.

Being a devout Christian, however, the 85-year-old Trumbull resident objected to the medical procedure. Instead, Medina was treated with intravenous iron therapy and Epogen -- a synthetic drug that controls red-cell production -- to stimulate her bone marrow.

"The blood test showed her red-cell count was up and after two weeks, she was able to come home," said Myrta Cicero, Medina's daughter. "Her problem was managed without the use of blood, and she did not violate her conscience."
Medina's case reflects a 50-year-old compromise between the medical and religious worlds regarding treatment and biblical doctrine. However, the use of bloodless medicine, which at Bridgeport Hospital falls under the department of Blood Management Services, has become more mainstream, as doctors and patients actively seek to avoid infections and other issues associated with blood transfusions.

To raise awareness of its services, the hospital will take part in National Blood Management Awareness Week, offering a free community event Nov. 2.

According to David Gonzales, coordinator of Blood Management Services at the hospital, 60 percent of patients who opt for bloodless medicine do so without religious motivation, an increase over the past few decades. In the past, those services were utilized almost exclusively by Jehovah's Witnesses.

Like members of the small Christian sect, Medina points to Acts 15:29 in the Bible as the motive for her decision. The passage instructs: "That you abstain from what has been sacrificed to idols, and from blood."

"So, we take a substitute," she said.

Those substitutes include blood-producing stimulants, primarily erythropoietins; blood substitutes, such as volume expanders and oxygen-carriers; and techniques to store the patient's own blood and return it after surgery (the most common being the auto-transfusion device Cell Saver).

Doctors said there also are medical benefits to avoiding transfusions. According to Gil Lancaster, medical director of Blood Management Services at Bridgeport Hospital, bloodless surgery carries a diminished risk of post-operative infection, while auto-transfusions eschew the use of foreign antibodies, which makes the immune system work harder.

"The healing process is much faster," he said. However, Lancaster added that transfusions may be the only "life saving" measure in an emergency situation, where the loss of blood is profuse.

While the hospital remains one of the few in the state to dedicate a department to blood management, many other facilities are beginning to adopt techniques associated with the field.

At Greenwich Hospital there has been a growing trend of patient requests for alternatives to transfusions. Denise Scherer, manager of the operating room at the hospital, attributes this to heightened awareness.

"Other than for religious reasons, people want to know they are getting back their own blood as opposed to a stranger's blood," she said. "Patients have so much access to information and they want to be safe."

The popularity of bloodless medicine ballooned in the 1980s, after an outbreak of HIV -- attributed, in part, to defective transfusions -- created a sense of urgency for safe alternatives. In addition, a vast majority of studies demonstrate "an association between red-blood cell transfusions and higher rates of complications such as heart attack, stroke, lung injury, infection, kidney failure and death," according to the Society for the Advancement of Blood Management.
It is a major goal of Bridgeport Hospital to spread awareness of these issues and the benefits of bloodless medicine, Gonzales said.

"We want to better educate consumers and health-care professionals about appropriate blood use," he added. "We want them to know the options are there."

Medina and thousands of patients at Bridgeport Hospital are thankful for that knowledge.

"The Bible says that we have to abstain from blood," she said. "The doctors have good intentions to help me."

Blood Management Services hosts a free community awareness event featuring experts in the field and free anemia screenings from 9 a.m. to 2 p.m. Nov. 2 in the main lobby of Bridgeport Hospital, 267 Grant St. For more information, call 203-384-3000, or visit Caring for Your Life - Bridgeport Hospital, CT.

Blood management services a growing trend - NewsTimes