[abstract] TRAUMATIC AMPUTATION IN A JEHOVAH’S WITNESS: OPTIONS FOR ENHANCING OXYGEN DELIVERY.

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[abstract] TRAUMATIC AMPUTATION IN A JEHOVAH’S WITNESS: OPTIONS FOR ENHANCING OXYGEN DELIVERY.

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Title: [abstract] TRAUMATIC AMPUTATION IN A JEHOVAH’S WITNESS: OPTIONS FOR ENHANCING OXYGEN DELIVERY.
Author: Perdrizet, GA; Rutland, R; Shapter, C; Keating, K; Abbensetts, K
Abstract: BACKGROUND: The management of traumatic injuries relies upon blood transfusion to support oxygen delivery. Jehovah’s Witnesses do not accept the administration of blood or blood products for any medical indication. The development and degree of oxygen debt will determine outcome. We present a case in which a Jehovah’s Witness presented to our trauma for treatment of a severe soft-tissue injury. MATERIALS AND METHODS: Case report, Level I trauma center, University teaching hospital which is also designated as a “Bloodless Surgical Center” for Jehovah’s Witnesses. RESULTS: A 49 year old white male, Jehovah’s Witness was transferred to our center for the management of a severe crush injury of the right upper extremity following a motorcycle crash. The patient required emergent shoulder disarticulation. The initial serum hemoglobin level dropped from 9 to 3 gm/dL following surgery. Arterial oxygen saturation was maintained at 98-100% at all times. Sedation, neuromuscular blockade and mechanical ventilation were instituted to limit metabolic demands and oxygen consumption. Normothermia was maintained by the combined use of a cooling blanket and systemic antipyretic therapy. It was determined that Jehovah’s Witnesses will accept transfusion of stromal-free hemoglobin preparations, so plans were made to administer PolyHeme per manufacturer’s guidelines. HBO2T (2,4 ATA, 90 min, daily x 10) was started on hospital day 2 to support wound healing and aid in systemic oxygen delivery. The patient remained hemodynamically stable (cardiac index of 5.3 L/m2) for 7 days with no evidence of metabolic acidosis, cardiac ischemia or elevated serum lactate. During hospital day 7 the patient became febrile (103 ºF), serum hemoglobin decreased to 2.6gm/dl and the patient succumbed to septic shock on hospital day 10. CONCLUSIONS: The management of severe anemia in the setting of major trauma is a challenging problem that may benefit from a multi-disciplinary approach involving HBO2T.
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting held June 14-16, 2007. Ritz-Carlton Kapalua Maui, Hawaii (http:www.uhms.org)
URI: http://archive.rubicon-foundation.org/5087
Date: 2007

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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