Author/Editor		Rabič, F; Gabrijelčič, A
Title		Anaesthesia for coronary artery by-pass surgery, without homologous blood transfusion, conducted on a Jehovah's witness
Type		članek
Source		In: Rafaj T, Rus-Vaupot V, editors. Proceeding book of 8th anaesthesia symposium Alpe-Adria; 1995 May 26-28; Portorož. Ljubljana: Slovenian association of anaesthesia and intensive medicine,
Publication year		1995
Volume		str. 217-21
Language		eng
Abstract		The case reported, is of a 68 years old Jehovah's witness who has recently undergone a coronary artery by-pass surgery, in our Department of cardiovascular surgery, University Medical Centre Ljubljana. According to the patient's agreement, acute hypervolemic hemodilution (AHH) and intraoperative autotransfusion with a cell-saver, were used. The patient refused all homologous blood products, with the exception of human albumin's (HA), which were to be used only if necessary. Good cooperation between the surgeon and the anaesthetist was most importance to keep the blood loss within safe margins. Despite that, the estimated blood loss reached the level of about 50 percent of patient's calculated blood volume. By using the hipervolemic hemodilution technique and a cell saver, this loss was compensated to the acceptable level needed for patient's normal postoperative recovery in the intensive care unit (ICU). Ethical considerations and techniques for undertaking surgery without blood transfusion in Jehova's witness patients are well reported in the literature. Differences in opinion on the acceptance of alternatives to homologous blood transfusion, such as autologous blood transfusion, exist among the members of the religion. It is of conceptual importance to Jehova's witness, that once blood has left the corporal circulation, it can no longer be used as a replacement fluid. Two techniques have been used successfully. In patients who are members of this religious group, these are autologous transfusion and hemodilution. In this report the case history of Jehova's witness patien t.
Descriptors		CORONARY ARTERY BYPASS BLOOD TRANSFUSION, AUTOLOGOUS ANESTHESIA HEMODILUTION BLOOD VOLUME HEMODYNAMICS