Extracorporeal membrane oxygenation in Jehovah's Witness patients: Case report, literature review, and summary of recommendations.
Abrahán MeraEduard ArgudoMaría Martínez-MartínezClara PalmadaCamilo BonillaAndrés PachecoLuis Chiscano-CamónGemma MarínBeatriz LozanoElisabet GallartJordi RieraPublished in: Perfusion (2021)
Extracorporeal Membrane Oxygenation (ECMO) is commonly associated with a high blood transfusion requirement. Jehovah's Witness patients present a particular challenge. The impossibility of transfusing blood cells and starting anticoagulation treatment are common contraindications for this supportive measure. Here we report the case of a Jehovah's Witness patient with refractory hypoxemia due to influenza A H1N1 pneumonia who required venovenous ECMO for 11 days. We describe the use of a bloodless approach to reduce the waste of blood, avoiding anticoagulation, and improving red blood cell production. We then summarize the current literature on the use of ECMO in Jehovah's Witness patients and, finally, we propose some recommendations for their management.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- case report
- end stage renal disease
- respiratory failure
- ejection fraction
- newly diagnosed
- prognostic factors
- peritoneal dialysis
- venous thromboembolism
- atrial fibrillation
- risk assessment
- red blood cell
- cell death
- oxidative stress
- endoplasmic reticulum stress
- heavy metals
- patient reported
- sewage sludge