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Management of Coagulopathies in Patients Who Refuse Blood Components
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Anesth Analg 2007;104:763-765
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000250913.45299.f3


CARDIOVASCULAR ANESTHESIA

Coagulopathy After Cardiopulmonary Bypass in Jehovah’s Witness Patients: Management of Two Cases Using Fractionated Components and Factor VIIa

Roman M. Sniecinski, MD, Edward P. Chen, MD, Jerrold H. Levy, MD, Fania Szlam, MMSc, and Kenichi A. Tanaka, MD

From the Department of Anesthesiology, Emory University School of Medicine; Division of Cardiothoracic Anesthesiology and Critical Care; and Division of Cardiothoracic Surgery (EC), Emory Healthcare, Atlanta, Georgia.

Address correspondence and reprint requests to Roman M. Sniecinski, MD, Department of Anesthesiology, Emory University Hospital, 1364 Clifton Rd., NE, Atlanta, GA 30322, (O) 404-778-5188. Address e-mail to roman.sniecinski{at}emoryhealthcare.org.

BACKGROUND: Changes in the Jehovah's Witness (JW) blood refusal policy now give members the personal choice to accept certain processed fractions of blood, such as factor concentrates and cryoprecipitate.

METHODS: Two JW patients undergoing complex aortic surgery who developed severe microvascular bleeding after prolonged use of cardiopulmonary bypass were treated with recombinant activated factor VII, cryoprecipitate, and antithrombin concentrate.

RESULTS: Cardiopulmonary bypass-induced coagulopathy was successfully treated, allowing chest closure without evidence of thrombotic complications.

CONCLUSIONS: Processed blood fractions can be a valuable adjuvant to drugs when treating bleeding in JW patients.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2007 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.