title: Bloodless surgery in geriatric surgery.
abstract: In bloodless surgery a series of measures has to be implemented to reduce the perioperative need for transfusion of whole blood or its components. Jehovah's Witness are the most representative group of patients opting for bloodless surgery as their faith follows strict believes that prohibits receiving blood. Geriatric patients requiring bloodless surgery are even more delicate and represent a challenge for surgeons. The physiological response of the over 65 year population to decreased hemoglobin level is slower and less effective than in young and adult patients. Herby we describe the perioperative protocol implemented in our surgical Department offered to geriatric Jehovah's Witness patients. Preoperative optimization of the patients is the key step in the preparation period. Intraoperative anesthetic and surgical measures are also required along with a strict postoperative follow-up. From our experience, bloodless surgery is feasible in the geriatric population as long as it is performed in specialized centers where a multidisciplinary team is prepared to specifically manage this scenario. Rigorous patients selection and preparation are mandatory.
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: salvatore.guarino@gmail.com.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Guarino
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: filippodimatteo@uniroma1.it.
authors.forename: Filippo Maria
authors.initials: FM
authors.lastname: Di Matteo
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: salvatore.sorrenti@uniroma1.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sorrenti
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: roberto_greco82@yahoo.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Greco
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: matteonardi@live.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Nardi
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: pasqualinofavoriti@gmail.com.
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Favoriti
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: enrico.deantoni@uniroma1.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: De Antoni
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: angelo.filippini@uniroma1.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Filippini
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Roma, Italy. Electronic address: Antonio.catania@uniroma.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Catania
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D057668:Bloodless Medical and Surgical Procedures / Q000379:methods*; D002985:Clinical Protocols; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D033221:Jehovah's Witnesses; D008297:Male; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies
keywords: Bloodless surgery; Elderly