Modifications in surgical techniques may result in less blood loss. This may, however, result in a longer operative time. The use of lasers, electrocautery and the increased use of minimally invasive techniques has reduced the need for transfusions.
Devices such as arterial closures have reduced bleeding in some cardiac procedures. Other interventions such as the reduction in cardiopulmonary circuit size, elevating the surgical field and the use of tourniquets help reduce bleeding.
In some cases, controlled hypotension is used. Several criteria are used to define this state including a median arterial pressure of 50-60 mm Hg, a systolic pressure of 80-90 mm Hg, or the blood pressure reduced to 30% of the baseline median arterial pressure.
This is the most surgeon specific intervention for reducing transfusions. A surgeon's skill and willingness change are critical for the successful use of these techniques in reducing transfusion.
US Navy 060227-N-9742R-004 The Ship's Surgeon Lt. Cmdr. Michael Barker, center, and Senior Medical Officer Commander David Gibson, left, perform an urgent laparoscopic appendectomyPublic Domain
U.S. Navy photo by Photographer's Mate 2nd Class Milosz Reterski