This case is a 26 year old woman who is Jehovah's Witness who was admitted to the hospital with a left venous thrombosis of the superior sagittal sinus, left sigmoid sinus, left jugular bulb and proximal left jugual vein. Her hemoglobin on admission was 7.1 secondary to recent flare up of her ulcerative colitis, for which she was being treated with iron and Procrit, Asacol and steroids. She has been taking the contraceptive pill for 5 years also. Her neurologist thought there was a link to the Procrit, so on admission to critical care discontinued its use, along with the contraceptive pill and started IV Heparin to prevent further thrombosis. She started some menstrual bleeding after the pill was discontinued and her hemoglobin dropped to 5.9. Her neurological state has improved a little since admission - she is coherent, answers questions appropriately but slow to respond.
I am interested to know if anyone has comments regarding this complex case.
I am also interested to know if any HBOCs are being used for select cases such as this. I have already contacted Northfield Laboraties and they say no.

Julie Cade RN
Manager Blood Utilization
St Agnes Medical Center Fresno CA
Tel 559 450 2198