Abstract:
:By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of perioperative and intraoperative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients. Planning prior to an anticipated event associated with blood loss or anemia (such as elective surgery, pregnancy, and chemotherapy) is critical. Specifically, bloodless medicine programs should prioritize vigilant early screening and management of anemias, early establishment of patient wishes regarding transfusion, and the incorporation of those wishes into multidisciplinary medical and surgical care. Although there are now a variety of human-based and nonhuman-based products available as transfusion alternatives, the degree and quality of evidence to support their use varies significantly between products and is also largely dependent on the clinical setting.
journal_name
Am J Hematoljournal_title
American journal of hematologyauthors
Scharman CD,Burger D,Shatzel JJ,Kim E,DeLoughery TGdoi
10.1002/ajh.24889subject
Has Abstractpub_date
2017-12-01 00:00:00pages
1370-1381issue
12eissn
0361-8609issn
1096-8652journal_volume
92pub_type
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journal_title:American journal of hematology
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更新日期:1997-09-01 00:00:00
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