Management of hemorrhagic shock when blood is not an option
National Study Center for Trauma and Emergency Medical Systems, University of Maryland School of Medicine, Baltimore, MD 21201, USA.Journal of Clinical Anesthesia (Impact Factor: 1.19). 12/2008; 20(7):538-41. DOI: 10.1016/j.jclinane.2008.05.012
Objective: To describe an alternative approach to management of severe life- threatening hemorrhagic shock and the outcome when blood was not a treatment option. Design: Case Report of the use of a Hemoglobin Based Oxygen Carrier (HBOC-201)when control of hemorrhage and intravenous crystalloids were unsuccessful in reversal of hemorrhagic shock and progressive ischemia. Setting: Trauma Center. Patients: Jehovah's Witness. Outcome: Hospital discharge and 6 month follow-up uneventful. (C) 2008 Elsevier Inc. All fights reserved.
- Journal of Clinical Anesthesia 12/2008; 20(7):489-91. DOI:10.1016/j.jclinane.2008.07.001 · 1.19 Impact Factor
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ABSTRACT: A 66-year-old woman who was a Jehovah's Witness had massive lower gastrointestinal bleeding and subsequent hypovolemic shock, necessitating a subtotal colectomy. During the postoperative period, her hemoglobin level decreased to a low of 2.6 g/dL, prolonging her dependence on mechanical ventilation. Prudent perioperative care resulted in a successful outcome. Blood-conserving techniques are indispensable in the management of Jehovah's Witnesses who have massive blood loss. Maximizing oxygen transport, minimizing blood loss, using a cell saver when permissible, providing optimal ventilatory support, performing tracheostomy early if prolonged mechanical ventilation is expected, and augmenting hemoglobin production with administration of iron and erythropoietin are techniques that can facilitate successful outcome in patients who refuse blood transfusion.American Journal of Critical Care 03/2011; 20(2):179, 176-8. DOI:10.4037/ajcc2011498 · 2.12 Impact Factor
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