title: [Jehova's Witnesses and severe injury with impending hemorrhaging : how complex is the treatment?].
abstract: Hemorrhage is frequently seen during the early phases of polytrauma management and intensive care treatment of the severely injured. Traumatic coagulopathy as well as the sometimes overlooked hyperfibrinolysis may lead to further complications. Therefore, transfusion of blood products and coagulation factors is often crucial. Jehova's Witnesses reject transfusions of blood and blood products due to religious convictions. In this case report a therapeutic approach of a multiple trauma patient suffering from traumatic brain injury, blunt chest trauma and liver laceration is described, who has been treated without blood products. As one main focus, ethical as well as legal aspects are discussed. Beside therapeutic concepts, such as the administration of coagulation factors, recombinant erythropoietin and iron, ethical and legal aspects remain part of the controversial discussion.
authors.affiliation: Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Deutschland. Zeckey.Christian@mh-hannover.de
authors.forename: C
authors.initials: C
authors.lastname: Zeckey
authors.forename: N
authors.initials: N
authors.lastname: Vanin
authors.forename: G
authors.initials: G
authors.lastname: Neitzke
authors.forename: P
authors.initials: P
authors.lastname: Mommsen
authors.forename: S
authors.initials: S
authors.lastname: Bachmann
authors.forename: M
authors.initials: M
authors.lastname: Frink
authors.forename: M
authors.initials: M
authors.lastname: Wilhelmi
authors.forename: C
authors.initials: C
authors.lastname: Krettek
authors.forename: F
authors.initials: F
authors.lastname: Hildebrand
mesh_terms: D000465:Algorithms; D001779:Blood Coagulation Factors / Q000008:administration & dosage; D001803:Blood Transfusion; D001930:Brain Injuries / Q000175:diagnosis* / Q000601:surgery; D000075202:Contraindications; D003288:Contusions / Q000175:diagnosis / Q000628:therapy; D003422:Critical Care / Q000379:methods; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D033221:Jehovah's Witnesses; D008099:Liver / Q000293:injuries*; D055370:Lung Injury / Q000175:diagnosis*; D009104:Multiple Trauma / Q000175:diagnosis / Q000628:therapy*; D012068:Religion and Medicine; D012421:Rupture; D013154:Spleen / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D001779:Blood Coagulation Factors; D004921:Erythropoietin