Cirugía cardiaca en testigos de Jehová. Experiencia en Santander / Cardiac surgery in Jehovah’s witnesses. Experience in Santander, Spain

RESUMEN

Los testigos de Jehová constituyen una población de difícil tratamiento para las intervenciones de cirugía cardiaca. Entre 1998 y 2004, todos los pacientes testigos de Jehová con indicación de cirugía cardiaca (n = 10) fueron intervenidos por un mismo equipo. El descenso medio del hematocrito fue, durante la circulación extracorpórea, del 30%, durante el postoperatorio, del 35% y en el alta, del 22%. Un paciente precisó una reintervención precoz por sangrado importante de origen esternal. Todos los pacientes fueron dados de alta y durante el seguimiento un enfermo falleció de causa respiratoria. Las medidas para disminuir y recuperar la pérdida de sangre permiten realizar intervenciones de riesgo hemorrágico en pacientes testigos de Jehová (AU)

ABSTRACT

As patients who are Jehovah's Witnesses are against blood transfusion, they are difficult to manage when a cardiac intervention is required. Between 1998 and 2004, all Jehovah's Witness patients with an indication for cardiac surgery (n=10) were operated on by the same multidisciplinary team. The mean fall in hematocrit was 30% during cardiopulmonary bypass, 35% during the postoperative period, and 22% at discharge. One patient required cardiac re-exploration because of sternal bleeding. All patients survived operation and were discharged. At follow-up, 1 patient died due to respiratory failure. Technological developments that reduce bleeding and enable lost blood to be recovered have made it possible to perform operations involving a risk of hemorrhage in Jehovah's Witnesses (AU)