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Saturday, July 13, 2013

Too much blood: Researchers fear the ‘gift of life’ may sometimes endanger it



Too much blood: Researchers fear the ‘gift of life’ may sometimes endanger it

By Sharon Kirkey, Postmedia News
July 13, 2013 9:38 AM



Part 1
When doctors at a New Jersey hospital pioneered a “bloodless” surgery program for patients who refused blood transfusions on religious grounds, they discovered something totally unexpected: Jehovah’s Witnesses, who would choose death over a transfusion, recovered just as well as transfused patients — and in many cases, even better.
They suffered fewer post-surgery complications, spent less time on mechanical breathing machines and had shorter stays in intensive care.
Recently, doctors from the Cleveland Clinic in Ohio reported that Jehovah’s Witnesses who refused blood transfusions while undergoing cardiac surgery were significantly less likely to need another operation for bleeding compared with non-Witnesses who were transfused. They were also less likely to suffer a post-op heart attack or kidney failure.
Are the Jehovah’s Witnesses onto something?
In cases of massive “bleed outs” from trauma or hemorrhage, or for patients with leukemia or other cancers, blood transfusions can be lifesaving.
At the same time, experts say there is remarkably little evidence to show which patients — short of those suddenly losing large amounts of blood — actually benefit from blood transfusions.
In fact, a growing body of research links transfusions with an increased risk of post-surgery infections, cardiac arrest, heart attack, stroke, kidney failure, lung injury, multi-organ failure and death.
Transfused patients spend more time in hospital than those who don’t get blood; they spend more time in intensive care units connected to ventilators; and have a higher risk of acute respiratory distress, where the lungs become saturated with fluid, preventing enough oxygen from getting to the lungs and into the blood.
Studies suggest that up to half of all red-blood-cell transfusions may be unnecessary. Needless transfusions not only waste blood, they expose patients to risks — including potentially life-threatening human errors that are occurring at every step in the transfusion chain.
Three decades after Canada’s catastrophic tainted-blood tragedy left 2,000 people infected with HIV and another 30,000 with hepatitis C, the greatest threat to patients today isn’t the risk of contracting an infectious disease from blood, experts now say.
It’s getting blood they don’t need.

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