Anesthetic Management for Abdominal Aortic Aneurysm Surgey without Homologous Blood Transfusion in Adult Jehovah'sWitness : A case report.
- Author:
Ji Yeon JEONG
1
;
Won Seok HUR
;
Jeong Rim LEE
;
Chul Woo JUNG
;
Kook Hyun LEE
Author Information
1. Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea. leekh@plaza.snu.ac.kr
- Publication Type:Case Report
- Keywords:
acute normovolemic hemodilution;
aortic aneurysm;
cell saver;
erythropoietin;
Jehovah's Witness
- MeSH:
Adult*;
Aged;
Anesthesia;
Aortic Aneurysm;
Aortic Aneurysm, Abdominal*;
Blood Transfusion*;
Coronary Artery Disease;
Disulfiram;
Erythropoietin;
Hematocrit;
Hemodilution;
Humans;
Intensive Care Units;
Jehovah's Witnesses;
Lower Extremity;
Middle Cerebral Artery;
Stents;
Stroke, Lacunar
- From:Anesthesia and Pain Medicine
2006;1(1):68-72
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Jehovah's Witnesses present a challenge for the anesthesia professionals on account of their refusal to accept blood and blood products. Therefore, anesthesiologists must be able to individualize their treatment depending on the patients' condition. We report a case of a stent removal and aorto-biiliac bypass surgery in a Jehovah's Witness. A 69 year-old, hypertensive man presented with claudication of both lower extremities due to the distal migration of an endoaneurysmal stent. According to his previous medical history, he had a lacunar infarction in the right middle cerebral artery territory, ischemic coronary artery disease with a stent in situ, and a stent inserted for an abdominal aortic aneurysm by radiological intervention. Because he strongly refused a transfusion, human recombinant erythropoietin was used before surgery. After the erythropoietin treatment, hemoglobin level increased to 14.8 g/dl (hematocrit 47.6%). During the operation, closed-circuit cell saver was used and transfused autologous blood was saved by acute normovolemic hemodilution. The patient recovered uneventfully from the anesthesia and was transferred to the intensive care unit. He was discharged on the ninth postoperative day without complications with a hematocrit level of 28.9%.
