scholarly journals Perioperative management including dual cell salvage in a Jehovah's Witness patient undergoing major urological surgery

2021 ◽  
Vol 9 (11) ◽  
Author(s):  
Thomas G. Smith ◽  
Irina Anastasescu ◽  
James M. Wight ◽  
Anicee Danaee ◽  
Rajesh Nair ◽  
...  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sarah A. Bachman ◽  
Ryan S. Peterson ◽  
Peter S. Burrage ◽  
Leigh C Hickerson

Abstract Perioperative management of pheochromocytoma in the setting of catecholamine-induced heart failure requires careful consideration of hemodynamic optimization and possible mechanical circulatory support. A Jehovah’s Witness patient with catecholamine-induced acutely decompensated heart failure required dependable afterload reduction for a cardio-protective strategy. This was emphasized due to the relative contraindication to perioperative anticoagulation required for mechanical circulatory support. A phenylephrine challenge clearly demonstrated adequate alpha blockade after only 24 hours of phenoxybenzamine treatment. This resulted in advancement of the surgery date. This case also highlights management of beta blockade, volume and salt loading, autologous blood transfusion, and profound post-operative vasoplegia in the setting of cardiogenic shock. Careful attention to hemodynamic optimization and cardio-protective strategies ultimately resulted in positive outcome for this challenging clinical scenario.


2000 ◽  
Vol 90 (1) ◽  
pp. 229-230 ◽  
Author(s):  
Jonathan H. Waters ◽  
Paul S. Potter

2007 ◽  
Vol 55 (6) ◽  
pp. 262-265 ◽  
Author(s):  
Takayuki Kadohama ◽  
Nobuyuki Akasaka ◽  
Tadahiro Sasajima ◽  
Kazutomo Goh ◽  
Nobuyoshi Azuma ◽  
...  

2017 ◽  
pp. 341-351
Author(s):  
Chantal Lerminiaux ◽  
Philippe Van der Linden

2007 ◽  
Vol 64 (4) ◽  
pp. 212-219 ◽  
Author(s):  
Nimesh P. Nagarsheth ◽  
Aryeh Shander ◽  
Robert Malovany ◽  
Jausheng Tzeng ◽  
Ibrahim Ibrahim

2018 ◽  
pp. bcr-2018-226486
Author(s):  
Sayaka Tachi ◽  
Noriko Yoneda ◽  
Satoshi Yoneda ◽  
Shigeru Saito

A 35-year-old Jehovah’s Witness patient with total placenta previa was referred to our hospital at 30 weeks of gestation. She refused autologous and allogeneic blood transfusions, but agreed to receive acute normovolaemic haemodilution, intraoperative blood salvage and biological products. At 35 weeks, she underwent emergent caesarean delivery because of labour pains. Multidisciplinary therapy, including the insertion of balloon catheters into the bilateral common iliac arteries, acute normovolaemic haemodilution and intraoperative blood salvage, avoided hysterectomy; however, blood loss included amniotic fluid which was estimated to be 1910 mL. These treatments may be effective for total placenta previa in blood-refusal patients.


Author(s):  
José Ramón Díez Rodríguez

El paciente testigo de Jehová y su rechazo a determinados tratamientos médicos, en concreto a las transfusiones de sangre, constituye uno de los problemas fundamentales con el que históricamente se ha tenido que enfrentar el derecho sanitario. La actual Ley 41/2002 de autonomía del paciente parece dejar claro el supuesto del paciente mayor de edad y la posibilidad de rechazar tratamientos médicos, pero mayores problemas plantean los supuestos del menor de edad, y especialmente la figura del menor maduro, y el supuesto de la mujer embarazada testigo de Jehová. Será necesario atender a la proporcionalidad de derechos en conflicto para determinar los criterios que en cada caso nos permitan inclinar la balanza a favor de una u otra posición.The Jehovah’s Witness patient and their rejection of certain medical treatments, namely blood transfusions, is one of the fundamental problems with which historically had to face the health law. The current Law 41/2002 of patient autonomy seems to clarify the adult patient’s adult and their possibility of refusing medical treatment, but major problems posed minor assumptions, especially the mature minor figure, and the course pregnant woman Jehovah’s Witness. It will be necessary to address the proportionality of conflicting rights, and determining criteria in each case allow us to tip the balance in favor of one position or another.


2002 ◽  
Vol 36 (4) ◽  
pp. 729-730 ◽  
Author(s):  
Ted Walton ◽  
Edwin J Macon

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