Perioperatives Management bei Zeugen Jehovas

Abstract

The religious organization of Jehovah's Witnesses numbers more than 7 million members worldwide, including 165,000 members in Germany. Although Jehovah's Witnesses strictly refuse the transfusion of allogeneic red blood cells, platelets and plasma, Jehovah's Witness patients may nevertheless benefit from modern therapeutic concepts including major surgical procedures without facing an excessive risk of death. The present review describes the perioperative management of surgical Jehovah's Witness patients aiming to prevent fatal anemia and coagulopathy. The cornerstones of this concept are 1) education of the patient about blood conservation techniques generally accepted by Jehovah's Witnesses, 2) preoperative optimization of the cardiopulmonary status and correction of preoperative anemia and coagulopathy, 3) perioperative collection of autologous blood, 4) minimization of perioperative blood loss and 5) utilization of the organism's natural anemia tolerance and its acute accentuation in the case of life-threatening anemia.

Perioperative Blutung bei einem Zeugen Jehovas

“…Wichtigstes Ziel in der Behandlung einer akuten Blutung bei Patienten, die eine Gabe von Erythrozytenkonzentraten ablehnen, ist die Aufrechterhaltung der Gewebeoxygenierung [3]. Unter Ausschöpfung aller therapeutischen Optionen können erstaunlich niedrige Hbbzw.…”

Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes

“…Postoperative measures include meticulous postoperative monitoring of the patient, early recognition of blood loss [39,47], minimisation of phlebotomy blood sampling [39], enhancement of hemopoiesis [45], optimisation of cardiopulmonary status [48] and minimisation of oxygen consumption to provide adequate perfusion to tissues [14]. Albumin may be continuously infused by gynecologic oncologists early on postoperatively in order to stabilise blood pressure and establish fluid load [22].…”

Major abdominal surgery for Jehovah’s Witnesses: Challenge while practicing bloodless medicine in a middle income country

“…1 Furthermore, if the patient presents with severe anemia, this can further complicate the situation, as surgery may be necessary to address the underlying condition causing the anemia, but this can also increase the risk of significant blood loss during the procedure. 1,2 In these challenging circumstances, healthcare providers must navigate the tension between respecting the patient's religious beliefs and ensuring the highest standard of medical care. This requires a multidisciplinary approach involving the patient, their family, and the healthcare team to arrive at a shared decision-making process that considers the patient's health, religious beliefs, and cultural background.…”

“…1 Furthermore, if the patient presents with severe anemia, this can further complicate the situation, as surgery may be necessary to address the underlying condition causing the anemia, but this can also increase the risk of significant blood loss during the procedure. 1 , 2 …”