Dan Oakes
The Age
SURGEONS could save lives by treating people as if they were Jehovah's Witnesses, a visiting US specialist told a conference yesterday.
Addressing the the annual scientific meeting of the Australian and New Zealand College of Anaesthetists, cardiothoracic specialist Bruce Spiess said blood transfusions hurt more people than they helped.
Jehovah's Witnesses refuse to accept blood transfusions, but Professor Spiess said a study in Sweden of 499 Witnesses showed their survival rates were higher than people who received transfusions.
He described blood transfusions as "almost a religion", because physicians practised them without any solid evidence that they helped.
"Blood transfusion has evolved as a medical therapy and it's never been tested like a major drug," he said. "A drug is tested for safety and efficacy, blood transfusion has never been tested for either one.
"There's a number of people around the world who are coming to these same conclusions and it's becoming more obvious that the old risks of hepatitis and AIDS have been defeated by blood bankers, and now what we're dealing with are events that make patients worse."
Transfusions increased the probability of post-operative complications, including pneumonia and wound infections.
"I think we need to focus on every possible mechanism we can to keep your own blood," Professor Spiess said.
"If you come to surgery, we should ethically treat every patient as if they were a Jehovah's Witness and say, my goal is to not to transfuse you and to use every other technique I possibly can, and then only as a very last result transfuse you."
He emphasised that in cases of severe trauma, blood transfusions were necessary, but pointed out that the majority of transfusions were of comparatively small amounts of blood.
Another area in which Professor Spiess is prominent is that of synthetic blood, which is composed of teflon-like fluorocarbons that carry oxygen far better than our own blood.
"We've just completed a study with traumatic brain injury — you're talking motor vehicle accidents and guns and head trauma — and we've just had a dramatic breakthrough with head trauma using the fluorocarbons as a way to deliver oxygen to the traumatised brain."
Professor Spiess is also researching the use of synthetic blood as a cure for decompression sickness, on behalf of the US Navy.
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