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Surgery Among jehovah's witnesses

Harrison Plunkett, Henry Gass, Richard Gross
No abstract text is available yet for this article.
June 2015: Journal of the South Carolina Medical Association
Esther K Hogervorst, Peter M J Rosseel, Leo M G van de Watering, Anneke Brand, M Bentala, Johanna G van der Bom, Nardo J M van der Meer
OBJECTIVES: Increasing evidence suggests benefits from restrictive red blood cell transfusion (RBC) thresholds in major surgery and critically ill patients. However, these benefits are not obvious in cardiac surgery patients with intraoperative anemia. The authors examined the association between uncorrected hemoglobin (Hb) levels and selected postoperative outcomes as well as the effects of RBCs. DESIGN: Cohort study with prospectively collected data from a cardiac surgery registry...
April 2016: Journal of Cardiothoracic and Vascular Anesthesia
Deshka Foster, Mohammad F Shaikh, Elizabeth Gleeson, Blake D Babcock, Daniel Ringold, Wilbur B Bowne
BACKGROUND: Criteria for selecting patients with advanced cancer for palliative surgery (PS) remains poorly defined. Decision making for PS requires realistic treatment goals with well-defined criteria. Here we discuss a 71-year-old Jehovah's Witness with advanced stage renal cell carcinoma (RCC) who presented with profound anemia due to intractable bleeding from gastric metastasis. After repeated attempts with endoscopic and angiographic management, she underwent surgical palliation...
January 2016: Journal of Palliative Medicine
Nishant, Renu Kumari
The Jehovah's Witness religion is a Christian movement, founded in the US in the 1870s, with 7 million followers worldwide with only 0.002% in India. There is minimal to complete absence of awareness about the existence of this community in our society. Astonishing is that fact that among medical professionals, there is almost no awareness about this unique population, regarding the fact that they completely refuse of blood transfusion even if it leads to their death. This is integral to their faith. Besides legal and ethical issues in treating these group of patients, the biggest challenge exist even in the western world is their management in trauma scenario where few options exist...
July 2014: Journal of Emergencies, Trauma, and Shock
Thomas Bernasek, Devanand Mangar, Hesham R Omar, Steven Lyons, Rachel A Karlnoski, Ren Chen, Adam Baumgarten, Collin J Sprenker, Enrico M Camporesi
Primary total hip arthroplasty (THA) and revision THA are associated with blood loss that can be significant. The purpose of this retrospective study was to compare the efficacy of intra-arterial occlusive balloons in reducing blood loss during primary and revision THA. Twelve patients (Jehovah’s Witnesses) scheduled for a primary (n=6) or revision (n=6) THA who refused blood transfusions were compared with 48 control-matched patients (primary THA, n=24; revision THA, n=24). All Jehovah’s Witnesses received an intra-arterial balloon preoperatively, and all control patients underwent conventional surgery...
December 2013: Orthopedics
Kyung Il Jo, Jeong Won Shin, Tae Yoon Choi, Yu Jin Park, Wook Youm, Moon Jung Kim
BACKGROUND: The Soonchunhyang University Hospital Bloodless Center was established in 2000, and more than 2000 bloodless surgeries has been performed there since. This study was carried out to analyze the characteristics of patients who underwent bloodless surgery and the influences of postoperative lowest hemoglobin level (H(blow)) along with the lowest postoperative Hb/preoperative Hb ratio (H(blow/pre)) on successful completion of bloodless surgery. STUDY DESIGN AND METHODS: A total of 1407 patients were included...
May 2013: Transfusion
Gregory Pattakos, Colleen G Koch, Mariano E Brizzio, Lillian H Batizy, Joseph F Sabik, Eugene H Blackstone, Michael S Lauer
BACKGROUND: Jehovah's Witness patients (Witnesses) who undergo cardiac surgery provide a unique natural experiment in severe blood conservation because anemia, transfusion, erythropoietin, and antifibrinolytics have attendant risks. Our objective was to compare morbidity and long-term survival of Witnesses undergoing cardiac surgery with a similarly matched group of patients who received transfusions. METHODS: A total of 322 Witnesses and 87 453 non-Witnesses underwent cardiac surgery at our center from January 1, 1983, to January 1, 2011...
August 13, 2012: Archives of Internal Medicine
E Hansen, T Seyfried
With increasing demands for blood transfusions, the costs and shortages, clinically relevant risks and doubts on the efficacy, blood conservation is an important issues. Among the available methods cell salvage is of great importance as it has proven effective and safe. The high availability and cost efficacy allows fast processing of at least half of the lost red blood cells. The method has wide applications in cardiac and vascular surgery, in abdominal and transplantation surgery, in orthopedics and emergency medicine, in massive hemorrhage and for Jehovah's Witnesses, and by the use of blood irradiation also in cancer surgery...
April 2011: Der Anaesthesist
Aaron A R Tobian, Paul M Ness, Helaine Noveck, Jeffrey L Carson
BACKGROUND: Mortality increases as hemoglobin (Hb) levels fall. Among severely anemic patients, the clinical course, cause of death, and whether there are any warning signs before death are unknown. STUDY DESIGN AND METHODS: A retrospective cohort study was performed of surgical patients who refused red blood cell transfusions for religious reasons and died with a Hb concentration 6 g/dL or less. Mortality was defined as death that occurred during hospitalization...
July 2009: Transfusion
Duncan B Hughes, Brant W Ullery, Philip S Barie
BACKGROUND: Jehovah's Witnesses are widely known for their prohibition on the acceptance of blood transfusion. Such refusal serves as a potential obstacle to optimal therapeutic intervention among critically injured Jehovah's Witnesses. As such, care of these patients requires an aggressive and multidisciplinary approach to therapy. METHODS: A review of the pertinent English language literature. RESULTS: Jehovah's Witnesses exercise the right of any adult with capacity to refuse medical treatment and often carry advance directive cards indicating their incontrovertible refusal of blood...
July 2008: Journal of Trauma
Leeann J Putney
Blood transfusions after cardiac surgery are very common, and the rates are highly variable among institutions. Transfusion carries the risk of infectious and noninfectious hazards and is often clinically unnecessary. This article discusses the history of bloodless cardiac surgery, the hazards of transfusion, the benefits of reducing or eliminating transfusion, and strategies to conserve blood. It also provides a list of resources for those who are interested in learning more about bloodless care.
July 2007: Critical Care Nursing Quarterly
Craig I Coleman, Vera T Rigali, Jonathan Hammond, Jeffrey Kluger, Kenneth W Jeleniowski, C Michael White
OBJECTIVES: Aprotinin is a drug used to reduce bleeding in patients undergoing cardiothoracic surgery with cardiopulmonary bypass. A recent cohort evaluation found elevated risks of renal, cardiovascular, and cerebrovascular events when aprotinin was used. We sought to determine the impact of aprotinin on safety variables among patients receiving cardiothoracic surgery with cardiopulmonary bypass from a single US hospital that reserves aprotinin for complex surgeries and Jehovah's Witnesses and does not utilize celite-based activated clotting time determinations...
June 2007: Journal of Thoracic and Cardiovascular Surgery
O T Oladapo
In a retrospective study at a university hospital, the perioperative morbidity associated with elective total abdominal hysterectomy in 23 Jehovah's Witnesses was compared with that of 46 non-Witness controls. The mean operative blood loss was significantly less, the procedure was lengthier and the average postoperative hospital stay was longer in the study than in the control group. Febrile morbidity was insignificantly more frequent among the study group (OR: 2.05, CI: 0.61-6.88) and there was no significant difference between the overall morbidity experienced by patients in both groups (study: 43...
September 2004: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Héctor Rodríguez Moyado
The origin of bloodless medicine was probably generated due to the religious impediment of Jehovah's witnesses. In 1988 in Brooklyn New York, U.S., a hospital information center was created help Jehovah's witnesses 24 h/7 days a week. There are 109 branches of these centers in 230 countries throughout the world. Some Jehovah's witnesses may accept blood derivatives such as immunoglobulin, interferons, topical hemostatic cements, or auto-transfusion techniques. At present, there are a substantial number of bloodless surgery procedures including cardiac and orthopedic procedures, and there are 75 hospitals functioning in the U...
May 2005: Revista Médica del Instituto Mexicano del Seguro Social
Nicolas Jabbour, Singh Gagandeep, Alice Cheng Peilin, Brendan Boland, Rod Mateo, Yuri Genyk, Rick Selby, Gary Zeger
Indisputably, liver transplantation is among the most technically challenging operations in current practice and is compounded by significant coagulopathy and portal hypertension. Recombinant human coagulation factor VIIa (rFVIIa) is a new product that was initially described to treat bleeding in hemophilia patients. We present in this paper 10 liver transplants in Jehovah's Witness patients using this novel product at University of Southern California-University Hospital. The subject population included nine males and one female with an average age of 50 years...
February 2005: American Surgeon
M J Carmichael, D A Cooley, R C Kuykendall, W E Walker
A retrospective study was done of 73 consecutive Jehovah's Witness children less than 2 years of age who were operated on for lesions of the heart and major vessels. The series was divided into three groups: (1) neonates less than 31 days old, (2) children between 31 days and 2 years, and (3) children requiring cardiopulmonary bypass. The overall mortality rate for the series was 12.3% (9/73). Only three of the nine deaths were complicated by blood loss and anemia. The mortality rate for Group I was 18.2% (2/11)...
March 1985: Texas Heart Institute Journal
Brian G Rubin, Luis A Sanchez, Eric T Choi, Gregorio A Sicard
Open surgical repair is the standard treatment for a ruptured infrarenal abdominal aortic aneurysm (rAAA). This approach is associated with mortality rates of up to 70%, with significant surgery-related morbidity among survivors. In selected patients, endoluminal repair (ER) of an rAAA under local anesthesia may allow emergent aneurysm repair with reduced perioperative stress, ideally resulting in improved outcomes. The authors report their initial experience using a commercially available bifurcated endoluminal stent-graft to treat patients with rAAA under local anesthesia...
May 2004: Vascular and Endovascular Surgery
Janet Cogliano, Debbie Kisner
Ideas about bloodless surgery are changing. It now is more than transfusion-free surgery for Jehovah's Witnesses. Technological advances and concerns about the safety and availability of blood have led to interest in bloodless surgery among non-Witnesses. Perioperative nurses need to be aware of bloodless surgery technology, which typically incorporates the use of recombinant human erythropoietin and special surgical techniques and equipment. They must have a proper attitude toward blood conservation and respect patient autonomy...
November 2002: AORN Journal
F Montiglio, V Dor, J Lecompte, D Fourquet, A Negrel, G N Dauvilliers
Since 1968, following Cooley's and Zubiate's group presentation, our team has been using extracorporeal circulation (ECC) with hemodilution without use of blood for priming of the circuit. Progressively this technique, that was only reserved to the Jehovah's Witnesses, became routine. Whereas in 1980, 30% of the patients operated by our group had not received any blood products during their stay in hospital, in the last few years, 1987-95, more than 80% of the patients could benefit from this technique. So, out of 15,573 cardiac surgeries under ECC performed between 1972 and 97, 14,798 (95%) were done in auto-perfusion, and 314 to Jehovah's Witnesses...
February 1998: Annals of Thoracic and Cardiovascular Surgery
N K Meidell, U Kongsgaard
Patients who are members of Jehovah's Witnesses refuse blood transfusion, even when the indication for giving blood is vital. This is a matter of controversy both in the clinical situation and in the medical literature and the press. All 430 members of the Norwegian Association of Anaesthesiology were sent a questionnaire requesting the guidelines issued by their hospitals, and their personal, professional opinion when dealing with this group of patients under life-threatening conditions caused by loss of blood...
September 30, 1996: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
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