Therapeutic phlebotomy is a medical procedure involving the removal of blood from the body for treatment purposes. Unlike routine diagnostic blood draws, this therapeutic intervention aims to reduce excessive blood components, managing various health conditions. The process is similar to blood donation, but its intent is to improve a patient’s health.
Medical Conditions It Addresses
Therapeutic phlebotomy treats several medical conditions characterized by an overload of certain blood components. One primary condition is hereditary hemochromatosis, a genetic disorder where the body absorbs too much iron from food. This excess iron can accumulate in organs like the liver, heart, and pancreas, leading to potential damage over time, including liver disease or diabetes. Regular removal of red blood cells through phlebotomy helps to deplete the body’s iron stores, as red blood cells contain iron-rich hemoglobin. This reduction in iron levels can prevent or mitigate organ damage and related symptoms.
Another significant condition managed by therapeutic phlebotomy is polycythemia vera. This is a rare blood disorder where the bone marrow produces too many red blood cells, and sometimes white blood cells and platelets. The increased number of red blood cells thickens the blood, which can slow blood flow and increase the risk of blood clots, heart attack, or stroke. Phlebotomy reduces the total red blood cell mass, effectively thinning the blood and lowering the risk of clot formation. The goal for individuals with polycythemia vera is often to maintain a hematocrit (the proportion of red blood cells in the blood) below 45 percent.
The Procedure Explained
A therapeutic phlebotomy session typically occurs in a medical office, hospital, or blood donor center. The procedure is performed by a trained healthcare professional, often a nurse or phlebotomist. The patient is usually positioned comfortably in a reclining chair or on a bed, with an arm extended and supported. The healthcare professional selects a suitable vein, commonly in the antecubital fossa area of the arm, which is the inner crease of the elbow.
After cleaning the skin over the chosen vein, a sterile needle connected to a collection tube and bag is inserted. Blood then flows from the vein into the sterile collection bag, a process similar to standard blood donation. The typical volume of blood removed during a session is about 500 milliliters, which is equivalent to one pint. The actual blood collection usually takes between 10 to 15 minutes, with the entire procedure, including preparation and post-procedure monitoring, lasting approximately 30 to 60 minutes. During the blood collection, patients may experience a slight pinch upon needle insertion and then a sensation of pressure.
Preparing for and Recovering from the Procedure
Proper preparation can contribute to a smoother therapeutic phlebotomy experience. It is recommended to drink plenty of fluids, typically eight to ten glasses of water, in the 24 hours leading up to the appointment. Consuming a light meal a few hours before the procedure is also advised, and patients should discuss any medications with their doctor. Wearing comfortable clothing that allows easy access to the arm can enhance comfort during the session.
After blood removal, common temporary effects include lightheadedness, dizziness, or fatigue. Bruising or soreness may occur at the needle insertion site. To manage these, patients are advised to remain seated or lying down for 15 to 20 minutes immediately after the procedure. Staying well-hydrated by drinking extra fluids for one to two days afterward is important, while avoiding alcohol and caffeinated beverages. Patients should also refrain from strenuous activities or heavy lifting with the arm for at least 24 hours.