Clinical Report

Journal of Anesthesia

, Volume 23, Issue 3, pp 436-438

First online:

Anesthetic management for ascending aorta replacement in a patient who refused autologous transfusion for religious reasons

  • Shinju ObaraAffiliated withDepartment of Anesthesiology, Fukushima Medical University School of Medicine
  • , Masayuki NakagawaAffiliated withDepartment of Anesthesiology, Fukushima Medical University School of Medicine
  • , Shinichiro TakahashiAffiliated withDepartment of Anesthesiology, Fukushima Medical University School of Medicine
  • , Masahiko AkatuAffiliated withDepartment of Anesthesiology, Fukushima Medical University School of Medicine
  • , Tsuyoshi IsosuAffiliated withDepartment of Anesthesiology, Fukushima Medical University School of Medicine
  • , Masahiro MurakawaAffiliated withDepartment of Anesthesiology, Fukushima Medical University School of Medicine

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Abstract

We report on the anesthetic management of a 69-year-old female Jehovah’s Witness undergoing cardiopulmonary bypass to replace the ascending aorta; the patient refused transfusion of stored autologous or allogeneic blood products for religious reasons. The strategy involved preoperative hematopoiesis with recombinant human erythropoietin and iron, intraoperative acute normovolemic hemodilution, the use of a cell-saver system, administration of high-dose tranexamic acid, controlled hypotension, avoidance of low body temperature, simplification of the surgery, and lower blood dilution during cardiopulmonary bypass.

Key words

Acute normovolemic hemodilution Cardiac anesthesia Jehovah’s Witness