| Emergency Subtotal Colectomy in a Jehovah's Witness With Massive Lower Gastrointestinal Bleeding: Challenges Encountered and Lessons Learned. | |
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MedLine Citation:
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PMID: 21362723 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Shankar R Raman; Vellore S Parithivel; John M Cosgrove |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of critical care : an official publication, American Association of Critical-Care Nurses Volume: 20 ISSN: 1937-710X ISO Abbreviation: Am. J. Crit. Care Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9211547 Medline TA: Am J Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 176-8 Citation Subset: IM; N |
Affiliation:
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Shankar R. Raman is a resident, Vellore S. Parithivel is an attending surgeon, and John M. Cosgrove is chairman and program director, Department of Surgery, Bronx-Lebanon Hospital Center, Bronx, New York. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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