While more and more hospitals are jumping on the bloodless medicine bandwagon, emergency medicine seems to be going the other direction. Paramedics in some locations are beginning to carry blood in their ambulances and helicopters.
Nearly every medical benefit – or supposed benefit – of transfused blood can now be achieved by some other treatment. So why is blood still being used?
I’m not a doctor. But I’ve written a lot about blood, and in the process I’ve learned a lot about blood medicine. The more I learn, the more appalled I am that doctors continue to consider blood transfusion an effective treatment – for anything. This brief column is intended to summarize what I’ve written previously.
You can read my other columns on the subject here:
- Advances in Blood Medicine
- Blood Medicine, Part Two
- Blood Medicine, Part Three
- Real Advances in Blood Technology
- Blood, Medical Ethics, and the Bible
- Hyperbaric Oxygen Therapy for Massive Blood Loss
As we discussed in the column Blood Medicine Part Two, it isn’t enough for the hemoglobin inside your red blood cells to absorb oxygen in the lungs. It also must let go of the oxygen when it gets to where it’s needed. Since oxygen is attracted to iron, releasing it is easier said than done. One ingredient that plays a key role in the release of oxygen from hemoglobin is a blood chemical called DPG. Lowering of DPG makes oxygen ‘stick’ to the hemoglobin – not good.
Blood pH must stay between 7.35 and 7.45 - always. A number outside that range will cause your body to stop all other functions until it has corrected its blood pH. Blood pH begins to fall in storage. Donated red blood cells are stored in a solution called ACD – acid-citrate-dextrose. ACD acidifies – lowers the pH – of the blood even more. The lower the pH, the ‘stickier’ the hemoglobin becomes. At 14 days, the pH of stored blood has fallen to 6.9. Since blood pH below 7.35 is considered an urgent problem, why does an emergency room doctor wants to give it to you?
In one study of patients who received 3 units of blood in emergency operations, the conclusion was:
“In [an] acute situation, when the organism (that’s you) needs restoration of the oxygen releasing capacity within minutes, the resynthesis [of DPG in stored blood] is obviously insufficient.”
Put simply, a transfusion of stored blood is the last thing you want in an emergency.
- Carries antigens unique to the donor that can kill the recipient.
- Carries Zika, malaria, hepatitis, HIV and a dozen other diseases.
- Has a low pH, forcing the patient’s body to try to raise it back above 7.35.
- Contains a high percentage of dead and dying cells that add to the workload of the patient’s spleen.
- Contains inflexible red blood cells that cause clots.
- Contains potassium at levels 4 times higher than are considered healthy
- Contains ammonia at up to 10 times the upper limit of what is considered safe.
- Contains free hemoglobin that steals oxygen from the patient and adds to the workload of the liver.
- Is deficient in DPG, lowering the patient’s cellular oxygenation.
- Is deficient in nitric oxide, lowering capillary dilation, causing reduced cellular oxygenation as well as clots.
- Adds anti-coagulants to an already bleeding patient.
- Raises blood pressure, straining and destroying fragile clots the body is trying to form at the wound site, increasing bleeding.
- Suppresses the patient’s immune system for, at best, days; at worst, permanently.
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