Severe anemia in the Jehovah's Witness: case report and discussion

Collins, S.; Timberlake, Gregory A.

doi:10.4037/ajcc1993.2.3.256

Cited by 21 publications

(6 citation statements)

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“…Whatever the mechanism, the outcome in our patient and in patients of the other case reports [5][6][7][8][9][10] of severe anemia speaks to the amazing homeostatic mechanism of the body.…”

Section: Report Of Casesupporting

confidence: 56%

Right Hemicolectomy in a Severely Anemic Jehovah's Witness Patient With an Extremely Low Preoperative Hemoglobin Level and the Decision to Operate

Yeykal

Stausmire

Acns-Bc

et al. 2014

Journal of Osteopathic Medicine

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Severe anemia is associated with high mortality, and patients with this condition are typically treated with packed blood red cells. Patients of Jehovah's Witness faith, however, do not accept blood transfusion therapy. The authors report the case of a Jehovah's Witness patient who presented with lower gastrointestinal bleeding secondary to Clostridium difficile colitis. Because the patient refused blood transfusion therapy, he underwent a right hemicolectomy with a preoperative hemoglobin level of 2.7 g/dL and a postoperative hemoglobin level of 1.8 g/dL. He was neurologically intact and discharged to a skilled care facility on postoperative day 10. The surgical team worked with the patient, his family, the anesthesiologists, and the Jehovah's Witness Hospital Liaison Committee physician members to devise a care plan that fully supported and respected the patient's religious beliefs and allowed him to maintain complete autonomy in his treatment decisions. Health care providers should be aware of how a patient's ethical, cultural, and religious background may impact treatment options.

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“…Whatever the mechanism, the outcome in our patient and in patients of the other case reports [5][6][7][8][9][10] of severe anemia speaks to the amazing homeostatic mechanism of the body.…”

Section: Report Of Casesupporting

confidence: 56%

Right Hemicolectomy in a Severely Anemic Jehovah's Witness Patient With an Extremely Low Preoperative Hemoglobin Level and the Decision to Operate

Yeykal

Stausmire

Acns-Bc

et al. 2014

Journal of Osteopathic Medicine

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“…In the USA, 11·5 million units of blood were donated in 1997 [1]. Of all donated units, it is estimated that 50-70% are transfused in the surgical setting [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Overview of Transfusion Practices in Perioperative and Critical Care*

Hébert

McDonald

Tinmouth

2005

Transfus Alt Transfus Med

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“…Published reports of rHuEPO therapy in Jehovah's Witnesses experiencing traumatic injury, burns, general surgery, or gastrointestinal hemorrhage are limited to case reports and case series ( Table 1). [2][3][4][5][6][7][8][9][10][11][12][13] Although it is impossible to recommend a single dosing regimen that is effective for treatment of hemorrhage in a Jehovah's Witness during critical illness, these case reports illustrate that the drug is effective. Of note, publication bias occurs for case reports that are only positive.…”

Section: Recommended Use Of Recombinant Human Erythropoietin In Jehovmentioning

confidence: 99%

“…A 48-year-old man was given intravenous rHuEPO 4750 units/day (50 units/kg/day) starting 10 hours after hospital admission secondary to traumatic injuries sustained in an airplane crash; his hemoglobin level was 6.8 g/dl. 5 On hospital day 3, due to a continued decline in his hemoglobin level to 3.0 g/dl, his daily dose of intravenous rHuEPO was increased to 28,500 units (300 units/kg). This daily dose was maintained until day 13, then the frequency was decreased to every other day for a total of five doses.…”

Section: Published Reports Of Jehovah's Witnesses Treated With Recombmentioning

confidence: 99%

Recombinant Human Erythropoietin Therapy in Critically Ill Jehovah's Witnesses

Ball

Winstead

2008

Pharmacotherapy

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Blood transfusions and blood products are often given as a life-saving measure in patients with critical illness. However, some patients, such as Jehovah's Witnesses, may refuse their administration due to religious beliefs. Jehovah's Witnesses accept most available medical treatments, but not blood transfusions or blood products due to their religion's interpretation of several passages from the Bible. Since recombinant human erythropoietin (rHuEPO) became available, several cases have been reported in which rHuEPO was successfully administered to critically ill Jehovah's Witnesses. Administration of rHuEPO in combination with other blood conservation techniques has been shown to increase hemoglobin levels and survival in patients who experienced trauma, burns, general surgery, or gastrointestinal hemorrhage. We performed a literature search of the MEDLINE and International Pharmaceutical Abstracts databases of rHuEPO therapy in the Jehovah's Witness population. Fourteen cases were identified in which rHuEPO was administered to Jehovah's Witnesses who required the drug for critical care resuscitation as an alternative to blood products. In each clinical situation, rHuEPO enhanced erythropoiesis; however, time to the start of treatment, dosages, route of administration, and treatment duration varied widely. Supplementation with adjunctive agents, such as iron, folic acid, and vitamin B12, was also beneficial. Use of rHuEPO in Jehovah's Witnesses may provide an alternative to blood transfusions or blood products. Other alternatives, such as hemoglobin-based oxygen carriers and perfluorocarbons, are also being explored.

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Severe anemia in the Jehovah's Witness: case report and discussion

Cited by 21 publications

References 0 publications

Right Hemicolectomy in a Severely Anemic Jehovah's Witness Patient With an Extremely Low Preoperative Hemoglobin Level and the Decision to Operate

Right Hemicolectomy in a Severely Anemic Jehovah's Witness Patient With an Extremely Low Preoperative Hemoglobin Level and the Decision to Operate

Overview of Transfusion Practices in Perioperative and Critical Care*

Recombinant Human Erythropoietin Therapy in Critically Ill Jehovah's Witnesses

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