Postoperative management of severe acute anemia in a <scp>J</scp>ehovah's <scp>W</scp>itness

Azi, Liana Maria Tôrres de Araújo; Lopes, Fernando Muniz; Garcia, L

doi:10.1111/trf.12424

Cited by 32 publications

(21 citation statements)

References 28 publications

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“…Before this study, Viele and Weiskopf had performed a systematic literature search and identified 54 published reports with discernible data featuring 134 Jehovah's Witness patients with Hb levels of not more than 8 g/dL who were managed without transfusion. Other available literature in the field is predominantly individual case reports or limited case series, cohorts that were subsequently included in the study by Carson and colleagues, or cohorts of patients with higher Hb levels …”

Section: Discussionmentioning

confidence: 99%

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

et al. 2014

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Section: Discussionmentioning

confidence: 99%

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

et al. 2014

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“…While the data is conflicting, case reports document survival in JW patients with extremely low Hb levels (down to 10 g/L) with aggressive use of ESAs and/or other supportive measures 15,16 . The use of ESAs are at the discretion of the local unit, requiring local hospital drug committee authorisation and informed consent explaining the risks of hypertension and thrombosis.…”

Section: Erythropoiesis-stimulating Agents (Esas): Erythropoietin Damentioning

confidence: 99%

Caring for Pregnant Women for Whom Transfusion is Not an Option. A National Review to Assist in Patient Care

Kidson‐Gerber¹,

Kerridge²,

Farmer³

et al. 2017

Obstetric Anesthesia Digest

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Postpartum haemorrhage (PPH) is the leading cause of maternal mortality and morbidity globally. Obstetric bleeding can be catastrophic and management is challenging, involving a coordinated multidisciplinary approach, which may include blood products. In settings where blood transfusion is not an option, either because of patient refusal (most commonly in Jehovah Witnesses) or because of unavailability of blood, management becomes even more challenging. Observational studies have demonstrated an association between refusal of blood products in major obstetric haemorrhage and increased morbidity and mortality. This review draws upon evidence in the literature, physiological principles and expert opinion for strategies and guidance to optimise the outcomes of pregnant women in whom blood transfusion is either refused or impossible. The importance of a multidisciplinary antenatal and perinatal management plan, including optimisation of haemoglobin and iron stores pre-delivery, blood loss minimisation, early haemorrhage control and postpartum anaemia treatment, is discussed.

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“…Survival of transient acute anemia (hemoglobin 7 g/l) was reported [63]. Even without allogeneic blood transfusion, a nadir hemoglobin of 14 g/l was survived by a patient refusing blood products [64].…”

Section: Acute Anemia Hemodilution and Anemia Tolerance (The Individmentioning

confidence: 99%

Transfusion strategy in multiple trauma patients

Theusinger

Stein

Spahn

2014

Current Opinion in Critical Care

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PURPOSE OF REVIEW To point out the tolerance of anemia, the possible use of alternatives to allogeneic blood products as well as the pathophysiological effects of transfusions in the context of multiple trauma patients. RECENT FINDINGS Restrictive transfusion triggers are beneficial for patient outcome in trauma.The actual European Trauma Treatment Guidelines suggest the use of point-of-care devices, the use of transfusion algorithms and factor concentrates to control coagulopathy. The use of high ratios of plasma to red blood cells to improve survival has been shown to suffer from a time-dependent survival bias. In massive bleeding, factor-based treatment of coagulopathy is feasible and preferable to plasma transfusion, if available. In nonmassive bleeding, allogeneic transfusion of blood products increases the appearance of serious adverse events and mortality and should be avoided unless clearly indicated. SUMMARY Transfusion in trauma has to be an individual decision for a specific patient, not for a specific laboratory value. Transfusion management must aim at reducing or even avoiding the use of allogeneic blood products. This may lead to a new gold standard with cost reduction and amelioration of outcome of major trauma patients.

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Postoperative management of severe acute anemia in a Jehovah's Witness

Abstract: This case is an example of the resilience of the human body in an extreme circumstance. It might be the most severe case of anemia that a person has survived without any sequelae.

Cited by 32 publications

References 28 publications

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

Caring for Pregnant Women for Whom Transfusion is Not an Option. A National Review to Assist in Patient Care

Transfusion strategy in multiple trauma patients

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