Massive blood loss in adult jehovah´s witness Patient Sangrado mayor en paciente adulto. Testigo de Jehová

Abstract

Major bleeding (MB) is defined as the loss of volume over a less-than-24-hour period of time or the loss of 50% of volume in a less-tha-3-hour time in a previously healthy individual. Considering the firm determination to reject any transfusion of blood or blood components on the part of Jehovah's Witnesses, the management of major bleeding in them is a challenge whether in emergency room or surgery services. This fact has serious ethical and legal implications. Preventing major bleeding in Jehovah's Witnesses allows the introduction of preventive measures to hypovolemic shock. For the treatment of Jehovah's Witness patients having major bleeding, therapeutic targets are proposed including the implementation of hemostatic or pharmacological interventions during surgical treatment; likewise in the postoperative period it is proposed appropriate hemodynamic and mechanic ventilation goals. It is a narrative review of the last 10-year literature and preventive actions, therapeutic goals and different interventions currently at disposal to deal with MB are presented.