Document Detail


Emergency Subtotal Colectomy in a Jehovah's Witness With Massive Lower Gastrointestinal Bleeding: Challenges Encountered and Lessons Learned.
MedLine Citation:
PMID:  21362723     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Shankar R Raman; Vellore S Parithivel; John M Cosgrove
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2011-03-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9211547     Medline TA:  Am J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  176-8     Citation Subset:  IM; N    
Affiliation:
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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