Outcomes in cardiac surgery in 500 consecutive Jehovah's Witness patients: 21 year Experience
| Autor: | Nicolas Dalibon, Touhami Bouharaoua, Herve Michon, Philippe Abbas, Philippe Maribas, Michel Habis, Oliver Ponzio, Claude D Vaislic, Maguette Ba, Francois Baget, Bruno Robine, Antoine Chedid, Nicolas Kasanin, Georges Chaoul, Michel Sportiche, Yves Olliver, Christiane Dupuy, Jean-Michel Ruat, Franck Lagneau, Eric Jugan, Gaillard D |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Jehovah s witness Population lcsh:Surgery Bloodless Medical and Surgical Procedures Group B Statistics Nonparametric Cohort Studies lcsh:RD78.3-87.3 Hemoglobins Study Protocol Risk Factors medicine Humans Cardiac Surgical Procedures Mortality education Jehovah's Witnesses Aged education.field_of_study Ejection fraction business.industry General Medicine lcsh:RD1-811 Middle Aged Cardiac surgery Surgery Treatment Outcome Cardiothoracic surgery lcsh:Anesthesiology Female Fast track business Cardiology and Cardiovascular Medicine Cohort study |
| Zdroj: | Journal of Cardiothoracic Surgery, Vol 7, Iss 1, p 95 (2012) Journal of Cardiothoracic Surgery |
| ISSN: | 1749-8090 |
| Popis: | Background Refusal of heterogenic blood products can be for religious reasons as in Jehovah's Witnesses or otherwise or as requested by an increasing number of patients. Furthermore blood reserves are under continuous demand with increasing costs. Therefore, transfusion avoidance strategies are desirable. We describe a historic comparison and current results of blood saving protocols in Jehovah's Witnesses patients. Methods Data on 250 Jehovah's Witness patients operated upon between 1991 and 2003 (group A) were reviewed and compared with a second population of 250 patients treated from 2003 to 2012 (group B). Results In group A, mean age was 51 years of age compared to 68 years in group B. An iterative procedure was performed in 13% of patients in group B. Thirty days mortality was 3% in group A and 1% in group B despite greater operative risk factors, with more redo, and lower ejection fraction in group B. Several factors contributed to the low morbidity-mortality in group B, namely: preoperative erythropoietin to attain a minimal hemoglobin value of 14 g/dl, warm blood cardioplegia, the implementation of the Cornell University protocol and fast track extubation. Conclusions Cardiac surgery without transfusion in high-risk patients such as Jehovah Witnesses can be carried out with results equivalent to those of low risk patients. Recent advances in surgical techniques and blood conservation protocols are main contributing factors. |
| Databáze: | OpenAIRE |
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