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• W4242655765 abstract "To the Editor: The Jehovah's Witness surgical patient presents the surgeon and anesthesiologist with special ethical and medical considerations that arise from the refusal of blood transfusion. However, an extracorporeal circulation during cardiac surgery is often acceptable because the continuity between the collecting venous side and the arterial reinfusion port is maintained [1]. Conventional autotransfusion devices, such as the Haemonetics Cell Saver (Haemonetics, Munich, Germany), however, are not accepted by all Jehovah's Witnesses because the salvaged blood is processed in batches, and continuity of blood is no longer provided. The acceptance of such a discontinuous blood processing is up to each individual patient. Newer technology allows the continuous processing of salvaged blood (CATS; Fresenius AG, Bad Homburg, Germany). Shed blood continuously enters the rotating washing chamber, is washed while it moves from the inner to the outer port of the washing chamber, and is finally pumped into the retransfusion bag. These three steps of blood processing take place simultaneously, thus creating an uninterrupted flow of red blood cells back to the patient [2]. We report the use of the CATS in a Jehovah's Witness patient. A 74-yr-old woman (weight 64 kg) presented for coronary artery bypass grafting. She was willing to accept the extracorporeal bypass, but she strictly refused the autotransfusion of blood remaining in the extracorporeal circuit at the end of bypass. Her argument against this procedure was its discontinuity when conventional autotransfusion devices are used. The attending anesthesiologist discussed with her the opportunity of a continuous autotransfusion using the CATS. The patient agreed and underwent the operation. Before removal of the aortic inflow, the processing of blood remaining in the heart lung machine was initiated using the CATS. As soon as processed blood reached the retransfusion bag, the bag was connected to the patient, and retransfusion of the processed blood was begun. The aorta was then decannulated. A total of 1266 mL of blood was processed, resulting in 313 mL of autologous blood with a hematocrit of 84.9%. After retransfusion, the hematocrit increased from 22% to 31%. The patient's recovery was uneventful. In summary, the CATS may be extremely helpful in Jehovah's Witness patients. Although the acceptance of this autotransfusion technique is up to each individual patient, the attending anesthesiologist should emphasize that any patient who refuses this continuous system should also refuse the heart lung machine. M. Booke, MD, PhD* C. Schmidt, MD* H. Van Aken, MD, PhD* B. Asfour, MD[dagger] D. Stanojevic[dagger] N. Rolf, MD, PhD* *Klinik und Poliklinik fur Anasthestologie und operative Intensivmedizin; [dagger]Klinik fur Thorax-, Herz- und GefaBchirurgie; University of Munster; 48129 Munster, Germany" @default.
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• W4242655765 date "1999-07-01" @default.
• W4242655765 modified "2023-09-23" @default.
• W4242655765 title "Continuous Autotransfusion in a Jehovah's Witness Undergoing Coronary Artery Bypass Grafting" @default.
• W4242655765 cites W2085651013 @default.
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• W4242655765 doi "https://doi.org/10.1213/00000539-199907000-00066" @default.
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