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Old 04-08-2005, 08:08 PM
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Extreme Intraoperative Blood Loss and Hemodilution in a Jehovah's Witness: New Aspect

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Anesthesiology: Volume 91(6) December 1999 p 1949

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Extreme Intraoperative Blood Loss and Hemodilution in a Jehovah's Witness: New Aspects in Postoperative Management

Neff, Thomas A. M.D.*; Stocker, Reto M.D.â€*; Wight, Edward M.D.‡; Spahn, Donat R. M.D.§
*Resident, Institute of Anesthesiology. â€*Associate Professor and Head of Surgical Intensive Care, Department of Surgery. ‡Assistant Professor, Department of Gynecology. §Professor, Institute of Anesthesiology.

Received from the Institute of Anesthesiology, University Hospital, ZĂĽrich, Switzerland.

Submitted for publication February 19, 1999.

Accepted for publication July 15, 1999.

Address reprint requests to Dr. Spahn: Institute of Anesthesiology, University Hospital, Rämistrasse 100, CH-8091 Zürich, Switzerland. Address electronic mail to: donat.spahn@ifa.usz.ch



IN patients who refuse any blood components, global oxygen transport, cerebral oxygen delivery, and blood coagulation may be compromised during massive blood loss. This case report describes potential therapeutic options to improve blood coagulation and to monitor the adequacy of cerebral oxygen delivery by using the patient's own consciousness.

Case Report
We report the case of an 41-yr-old female Jehovah's Witness. Her body weight was 47 kg and her height was 160 cm. She was admitted for elective hysterectomy as a result of a uterine and intraligamentary myoma and failed intubation that occurred at the referring hospital. Her history was remarkable for a severe primary chronic polyarthritis. A preoperative echocardiography indicated...

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