WSZSh1aVS1

ab`*b1-SS
*V S4+13*bn
]1`1WS,*ZSq V`\,S

b\+m S4+13*bn ]1`1WS,*ZSq V`\,SE Z1\+f\/SY\ \]bSY*WnZ\ 4*/1yab,\,*bn

aW1/dpkS1 ab`*b1-SSB \ab*Z\,Sbn V`\,\b1h1ZS1E a+1`1hn a\+ab,1ZZdp V`\,n
]*gS1Zb*E daSWSbn -1Y\]\o4 S ]\,maSbn ]1`1Z\aSY\abn *Z1YSSD 'b\ /\abSO
3SY\ +W*-\/*`q a,\1,`1Y1ZZ\Yd ]`SY1Z1ZSp a\\b,1bab,dpkSf Y1/SgSZaVSf
S fS`d`-Sh1aVSf b1fZSV /Wq a+1`131ZSq V`\,SE ]`S+\`\, S W1V*`ab,1ZZmf
]`1]*`*b\,D W*ZS`d1Y\1 S aSab1Y*bSh1aV\1 ]`SY1Z1ZS1 Z1aV\WnVSf ab`*b1O
-SyO*Wnb1`Z*bS, ]1`1WS,*ZSp V`\,S -`d]]\y a]1gS*WSab\, `*4WShZ\-\ ]`\eSO
Wq ]\4,\WSb S4+13*bn ]1`1WS,*ZSq *WW\-1ZZ\y V`\,S ]`\ab\E +14\]*aZ\ S oeO
e1VbS,Z\D
w ˙Wq W1h1ZSq ]*gS1Zb\, +14 ]1`1WS,*ZSq V`\,S b`1O
+d1baq ]`SY1Zqbn jS`\VSy a]1Vb` ab`*b1-Sy a+1`1O

x
31ZSq V`\,SE hb\+m S4+13*bn ]1`1WS,*ZSqE * Z1
]`\ab\ a\V`*bSbn V\WSh1ab,\ ]1`1WS,*ZSy
—Guinn NR, et al. Perioperative management of patients
for whom transfusion is not an optionD Anesthesiology
2021;134(6):939-48.
 ˘ aZS31ZS1 V`\,\]\b1`S
˘ abSYdWqgSq -1Y\]\o4*
˚ ˘ a+1`131ZS1 a\+ab,1ZZ\y V`\,S ]*gS1Zb*
L, SZb`*\]1`*gS\ZZ\Y S ]\aW1\]1`*gS\ZZ\Y ]1`S\/*fM
˘ ]\,mj1ZS1 ]1`1Z\aSY\abS *Z1YSS

`1/\]1`*gS\ZZ*q \g1ZV* S Zb`*\]1`*gS\ZZ\1 ,1/1ZS1

]W*ZS`\,*ZS1
k*b1WnZmy -1Y\ab*4 S fS`d`-Sh1aV*q
k*b1WnZmy a+\` *Z*YZ14* S Y1/\aY\b` b1fZSV*

*ZZqq /S*-Z\abSV*NW1h1ZS1 SWS S`d`-Sh1aVS1 ]`S+\`m /Wq -1Y\ab*4*

]`\eSW*VbSV* *Z1YSS LabSYdWqb\`m LZ*]`SY1`E b1`Y\V\*-dWqb\`E oW1Vb`\O
o`Sb`\]\o4*E ]`1]*`*bm 31W14*M V\*-dWqb\`E dWnb`*4,dV\,\y Z\3M

WSZSh1aV*q \g1ZV* S \]bSYS4*gSq *`Y*V\W\-Sh1aVS1 a`1/ab,*E abSYdWSO

V\*-dWqgS\ZZ\-\ ab*bda* +\WnZ\-\
`\/dY*ZZ\1 ]`SY1Z1ZS1 *ZbSV\*-dWqZO
b\,E *ZbSb`\Y+\gSb*`Zmf a`1/ab, S
/`d-Sf ]`1]*`*b\,E V\b\`m1 Y\-db
\b`Sg*b1WnZ\ ]\,WSqbn Z* a,1`bm,*ZS1
V`\,S
`dpkS1 -1Y\ab*4 LZ*]`SY1`E b*VS1
aSab1YZm1 ]`1]*`*bmE V*V b`*Z1Va*Y\O
,*q VSaW\b*E *YSZ\V*]`\Z\,*q VSaW\b*E
V\Zg1Zb`*bm e*Vb\`\, a,1`bm,*ZSq S
rFVIIaE * b*V31 Y1abZm1 -1Y\ab*bSh1aVS1
a`1/ab,*M S Y1f*ZSh1aVSy -1Y\ab*4N
\VVWp4Sq

-`*ZSh1ZS1 V\WSh1ab,* S h*ab\bm ,4qbSq +1`131ZS1 a\+ab,1ZZ\y V`\,S ]*gS1Zb*

V`\,S /Wq SaaW1/\,*ZSy a g1Wnp aZS31O
ZSq qb`\-1ZZ\y V`\,\]\b1`S
W*ZS`\,*ZS1 W1h1ZSq L]\ob*]Z\1
,m]\WZ1ZS1 aW\3Zmf \]1`*gSyE
d,1WSh1ZS1 fS`d`-Sh1aV\y
+`S-*/mNa\V`*k1ZS1 ]`\/\W3Sb1WnO
Z\abS \]1`*gSSE Y*W\SZ,*4S,Zm1
Y1b\/mE ]`\eSW*VbSh1aV*q ]`1/\]1`*O
gS\ZZ*q SWS SZb`*\]1`*gS\ZZ*q
*Z-S\-`*eSh1aV*q oY+\WS4*gSqM
LZ*]`SY1`E `1SZed4SqE -1Y\/SWpgSqM
˙`d-S1 Y1b\/m a+1`131ZSq V`\,S
LZ*]`SY1`E d]`*,Wq1Y*q -S]\b1Z4SqE
\]bSY*WnZ\1 ]\W\31ZS1 b1W* ,\ ,`1Yq
\]1`*gSSE Z\`Y\b1`YSqM
*W\SZ,*4S,Zm1 Y1b\/m LZ*]`SY1`E
W*]*`\aV\]SqE oZ/\aV\]SqE ab1`1\O
b*VaSh1aV*q `*/S\fS`d`-SqM
Z-S\-`*eSh1aV*q oY+\WS4*gSq
 \-W*adyb1 ]`S1YW1Y\abn Y1b\/* a ]*gS1Zb\YD
\aW1\]1`*gS\ZZ\1 ,1/1ZS1
\,mj1ZS1 ]1`1Z\aSY\abS *Z1YSS
\ab\qZZ*q \g1ZV* V\*-dWqgS\ZZ\-\
ab*bda*NV\Zb`\Wn V`\,\b1h1ZSq
mab`*q \ab*Z\,V* Wp+\-\ V`\,\b1h1ZSq 'ee1VbS,Z\abn ab`*b1-Sy
L]\,b\`Z*q \]1`*gSqE -1Y\ab*bSh1aVS1
a`1/ab,*E ]\W\31ZS1 ]*gS1Zb*E `1Zb-1O ˘ 1Znj1 ]\+\hZmf oee1Vb\,
ZoZ/\,*aVdWq`Z*q \VVWp4Sq
*`b1`S*WnZmf a\ad/\,M ˘ S31 h*ab\b* SZe1VgS\ZZmf
\aW\3Z1ZSy
\aW1\]1`*gS\ZZ*q `1SZed4Sq V`\,S
˘ \W11 V\`\bVSy a`\V ]`1+m,*O
1h1ZS1 *Z1YSS ZSq , +\WnZSg1 S , \b/1W1ZSS
\aab*Z\,W1ZS1 \+l1Y* gS`VdWS`dpk1y SZb1ZaS,Z\y b1`*]SS
V`\,S L]`\/dY*ZZ\1 ]`SY1Z1ZS1
`*ab,\`\, /Wq d,1WSh1ZSq  M ˘ ZS31ZS1 aY1`bZ\abS , +WSO
3*yjSy S \b/*W1ZZmy ]1`S\/
\Zb`\Wn *`b1`S*WnZ\-\ /*,W1ZSq S
b1Y]1`*bd`m b1W* ˘ ]1`*gSS Z1 \bY1Zqpbaq
S4O4* /1eSgSb* 4*]*a\, V`\,S
-`*ZSh1ZS1 ,4qbSq V`\,S /Wq
SaaW1/\,*ZSy ˘ \W11 ZS4VS1 \+k1+\WnZShZm1
 \-W*adyb1 ]`S1YW1Y\abn Y1b\/* a ]*gS1Zb\YD 4*b`*bm S 4*b`*bm Z* W1h1ZS1
\b/1WnZ\-\ ]*gS1Zb*
 b\ -\,\`qb a]1gS*WSabm

w `SZgS] d,*31ZSq *,b\Z\YSS ]*gS1Zb* b`1+d1b SaO

]\Wn4\,*ZSq V*h1ab,1ZZmf +1aV`\,Zmf Y1b\/\, W1O
w `\-`*YYm  Y1Z1/3Y1Zb V`\,S ]*gS1Zb* *VO
bS,Z\ ,Z1/`qpbaq aSab1Y*YS 4/`*,\\f`*Z1ZSq ,a1O
h1ZSq /Wq b1fE Vb\ ,\4`*3*1b ]`\bS, ]1`1WS,*ZSq -\ YS`* h*abShZ\ ]\b\YdE hb\ obS ]`\-`*YYm ]\4,\O
V`\,SD 1aV`\,Z*q Y1/SgSZ* S fS`d`-Sq ]\/`*4dY1O Wqpb dY1ZnjSbn hSaW\ ]1`1WS,*ZSy V`\,SE aZS4Sbn

x
,*pb aW1/\,*ZS1 ]`\b\V\Wd ]`SY1Z1ZSq ]`\abmfE Z\ ab\SY\abn W1h1ZSqE * b*V31 ]`SZ\aqb f\`\jS1 `1O
ab*Z/*`bZmf b1fZ\W\-Sy P YdWnbSY\/*WnZmf Y1b\O 4dWnb*bm /Wq ]*gS1Zb\,


x
/\, S Y13/SagS]WSZ*`Zmf ]\/f\/\,E P a dh1b\Y —Zeller MP, et al. Safeguarding the patient’s own blood
]\b`1+Z\ab1y V\ZV`1bZ\-\ ]*gS1Zb* supply. JAMA 2019;321(10):943-5.

w
—Usoro NI, et al. Bloodless management of severe obstetric 
hemorrhage with very severe anemia: a case report. *ab1b hSaW\ /\V*4*b1Wnab,E a,S/1b1Wnab,dpkSf
A A Pract 2021;15(2):e01396.

\ b\YE hb\ ]`SY1Z1ZS1 ]`\/dVb\, V`\,S ,1/1b V ]\O

w
b1ZgS*WnZmY ]`\+W1Y*YE , hSaW1 V\b\`mf /WSb1WnO
+1`131ZS1 V`\,S ,m-\/Z\ V*V , oV\Z\YSh1aV\Y 
Z*q SaVdaab,1ZZ*q ,1ZbSWqgSq W1-VSfE ]\,mj1ZZmy

x x
\bZ\j1ZSSE b*V S LV*V ,S/Z\ S4 ]`S,1/1ZZmf e*VO `SaV SZeSgS`\,*ZSq S /\W-\1 ]`1+m,*ZS1 , +\WnO
b\,M , Y1/SgSZaV\Y ZSg1 V*V a`1/S ,4`\aWmfE b*V S a`1/S /1b1y
—Adamson JW. New blood, old blood, or no blood? —Kato H, et al. Are blood products routinely required in
N Engl J Med 2008;358(12):1295-6. pediatric heart surgery? Pediatr Cardiol 2020;41(5):932-8.

w a]1jZ\1 ,Z1/`1ZS1  Y1Z1/3Y1Zb V`\,S ]*O

x
gS1Zb* a,q4m,*pb a\ 4Z*hSb1WnZmY a\V`*k1ZS1Y
\aW\3Z1ZSy S aY1`bZ\abS
—Althoff FC, et al. Multimodal patient blood management
program based on a three-pillar strategy: a systematic
review and meta-analysis. Ann Surg 2019;269(5):794-804.

*V ]\WdhSbn +\Wnj1 SZe\`Y*gSS

 ,S/1b1W1y 1-\,m /1yab,d1b ,a1YS`Z*q a1bn S4 +\O
W11 h1Y 6 >>> V\YSb1b\, ]\ a,q4qY a +\WnZSg*YS L MD
'b* a1bn ]`1/\ab*,Wq1b *,b\`Sb1bZdp SZe\`Y*gSp \bZ\O
aSb1WnZ\ VWSZSh1aVSf ab`*b1-SyE ]\Y\-*pkSf S4+13*bn
]1`1WS,*ZSq V`\,SE S a\/1yab,d1b ]\Wdh1ZSp Y1/SgSZaV\y
]\Y\kS ]*gS1Zb*YO,S/1b1WqYD

b\+m a,q4*bnaq a ]`1/ab*,Sb1W1Y Y1abZ\-\ E ]\3*Wdyab*E

4*y/Sb1 Z* a*yb www.jw.org/ru/Y1/SgSZaV*qO+S+WS\b1V*
S \bV`\yb1 ,VW*/Vd w,q4*bnaq a Y1abZmY ]`1/ab*,Sb1W1YxD

Wd3+* +\WnZShZ\y SZe\`Y*gSS

230102

/Wq ,S/1b1W1y 1-\,m

abt-U

13/dZ*`\/Zmy \eSa
˘ 2012 Watch Tower Bible and Tract Society of Pennsylvania
2/22 1WDB 5 ;5<D9:>D8;>>  HISjwDorg