This Article Full Text Full Text (PDF) CME: Take the course for this article: Management of Coagulopathies in Patients Who Refuse Blood Components Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Sniecinski, R. M. Articles by Tanaka, K. A. Search for Related Content PubMed PubMed Citation Articles by Sniecinski, R. M. Articles by Tanaka, K. A.

---

CARDIOVASCULAR ANESTHESIA

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

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.

This article has been cited by other articles:

				D. Bolliger, G. Sreeram, A. Duncan, R. J. Molinaro, F. Szlam, E. P. Chen, and K. A. Tanaka Prophylactic Use of Factor IX Concentrate in a Jehovah's Witness Patient. Ann. Thorac. Surg., November 1, 2009; 88(5): 1666 - 1668. [Abstract] [Full Text] [PDF]

				R. Sniecinski, F. Szlam, E. P. Chen, S. O. Bader, J. H. Levy, and K. A. Tanaka Antithrombin Deficiency Increases Thrombin Activity After Prolonged Cardiopulmonary Bypass Anesth. Analg., March 1, 2008; 106(3): 713 - 718. [Abstract] [Full Text] [PDF]

				K. A. Tanaka, T. Taketomi, F. Szlam, A. Calatzis, and J. H. Levy Improved Clot Formation by Combined Administration of Activated Factor VII (NovoSeven(R)) and Fibrinogen (Haemocomplettan(R) P) Anesth. Analg., March 1, 2008; 106(3): 732 - 738. [Abstract] [Full Text] [PDF]

				H. J. Schiller Optimal Care for Patients Who Are Jehovah's Witnesses Anesth. Analg., April 1, 2007; 104(4): 755 - 756. [Full Text] [PDF]

				L. Elder Coagulopathy After Cardiopulmonary Bypass in Jehovah's Witness Patients: Management of and for the Individual Rather than the Religious Institution Anesth. Analg., April 1, 2007; 104(4): 757 - 758. [Full Text] [PDF]