Division of Critical Care Medicine.
Division of Obstetric Anesthesiology.
Curr Opin Anaesthesiol. 2021 Apr 1;34(2):125-130. doi: 10.1097/ACO.0000000000000961.
More than 8.5 million people in the world observe the Jehovah's Witness faith, and require unique consideration for perioperative blood management as they generally refuse transfusion of blood and blood products. This review addresses a collaborative approach to each patient throughout the perioperative arena. The principles of this approach include optimization of hemoglobin levels preoperatively, attention to blood-salvaging methods intraoperatively, and minimization of blood draws postoperatively. In addition, we review the technologies currently in development as transfusion alternatives, including hemoglobin-based oxygen carriers.
Progress has been made recently in the field of synthetic blood alternatives and hemoglobin-based oxygen carriers, which may lead to improved outcomes in this patient population.
Utilization of multiple prevention and mitigation strategies to optimize oxygen supply and decrease oxygen demand will lead to decreased incidence of critical anemia and subsequent improved mortality in Jehovah's Witness patients.
全世界有超过 850 万人信奉耶和华见证人信仰，由于他们普遍拒绝输注血液和血液制品，因此在围手术期血液管理方面需要特殊考虑。本综述针对围手术期的每个患者提出了一种协作方法。该方法的原则包括术前优化血红蛋白水平，术中注意血液回收方法，以及术后尽量减少采血。此外，我们还回顾了目前正在开发的作为输血替代品的技术，包括血红蛋白基氧载体。
最近在合成血液替代品和血红蛋白基氧载体领域取得了进展，这可能会改善此类患者的预后。
使用多种预防和缓解策略来优化氧气供应并减少氧气需求，将降低危重性贫血的发生率，并随后降低耶和华见证患者的死亡率。
