Skip Navigation


BJA Advance Access originally published online on January 14, 2005
British Journal of Anaesthesia 2005 94(4):442-444; doi:10.1093/bja/aei068
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
94/4/442    most recent
aei068v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (5)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Schälte, G.
Right arrow Articles by Kuhlen, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schälte, G.
Right arrow Articles by Kuhlen, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions{at}oupjournals.org

CASE REPORT

Life-threatening postoperative blood loss in a Jehovah's Witness, treated with high-dose erythropoietin

G. Schälte1,*, H. Janz2, J. Busse2, V. Jovanovic3, R. Rossaint1 and R. Kuhlen1

1 Department of Anaesthesiology, University Hospital, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany. 2 Department of Anaesthesiology and Intensive Care Medicine and 3 Department of Gynecology and Obstetrics, Städtische Klinikum, Solingen, Germany

* Corresponding author: Klinik für Anästhesiologie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany. E-mail: gschaelte{at}ukaachen.de

Six hours after an uncomplicated extended resection of ovarian cancer, postoperative arterial bleeding led to life-threatening blood loss in a 44-yr-old Jehovah's Witness who refused blood transfusion. Haemoglobin (Hb) decreased from 2.5 g dl–1 directly after the emergency laparotomy, followed by a 10 h immeasurable period (below detectable minimum value of the analyser), to a measurable minimum of 1.5 g dl–1 after 20 h. Haematopoiesis was induced by high-dose i.v. erythropoietin therapy (600 IU kg–1) and continued on days 3, 6, 8, 10 and 13. Iron, folic acid and vitamins were given as supplements. The patient needed ventilatory assistance for 18 days and some inotropic support. Complications included increases in pancreatic enzymes and liver enzymes, jaundice and skin necrosis at the fingertips and toes. Myopathy led to transient tetraparesis. Haemoglobin rose from 1.5 to 3.4 g dl–1 (day 10) and the patient was discharged from the intensive care unit with haemoglobin 6.5 g dl–1 on day 24. She made a full recovery and is still free of cancer in remission.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.