Therapeutic principles of bloodless medical management, such as minimizing blood loss, maximizing oxygen delivery, and improving the red blood cell count, allows critical care nurses to conserve blood, anticipate and prepare for potential bleeding problems, and intervene before complications occur.

Medical professionals historically regarded blood transfusion as an integral component of major surgery or critical illness. A growing appreciation for the risks involved in transfusing donated blood, as well as the refusal of some patients to accept transfusion because of personal or religious beliefs, encouraged researchers and clinicians to develop techniques and strategies that allow transfusion-free surgery and medical care, that is, bloodless treatment. These developments also led to the emergence of a new specialty that minimizes transfusion for all patients.1 The number of formal bloodless management centers or programs in the United States increased from only a few in 19902 to approximately 130 today,3 indicating the...

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