title: [Anesthetic management of Jehovah's Witnesses patients undergoing open heart surgery with cardiopulmonary bypass].
abstract: BACKGROUND
  The anesthetic management of Jehovah's Witnesses (JW) patients undergoing open heart surgery with cardiopulmonary bypass (CPB) is associated with a major risk of anemic hypoxia.
  
  
  METHODS
  Fifteen patients from the community of JW underwent open heart surgery. The surgical procedures undertaken were aortic valve replacement in 7 patients, mitral valve plasty or replacement in 5 patients, repair of congenital heart diseases in 2 patients, and removal of left atrial myxoma in one patient. Hemoglobin values, cardiac output, and oxygen delivery (Do2) as well as consumption (Vo2) were evaluated during and after surgery.
  
  
  RESULTS
  After CPB, the mean hemoglobin (Hb) value decreased to 8.2 g x dl(-1) from the baseline level of 11.6 g x dl(-1) (P = 0.0007); however, it increased to 10.5 g x dl(-1) at the end of surgery Cardiac index remained unchanged. Oxygen delivery (Do2) decreased after CPB from its baseline level, whereas oxygen consumption remained unchanged. Twenty-four hours after surgery, Do2 recovered to its baseline level because of an increase in cardiac output with the Hb value of 10.7 g x dl(-1) .
  
  
  CONCLUSIONS
  The decrease in Hb level is unavoidable in cardiac surgery with CPB in these JW patients. This survey showed that the decrease in Hb level may be compensated by conserved cardiac output avoiding the decrease of Do2 to its critical level when hypoxia occurs.
authors.affiliation: Division of Anesthesia, Hayama Heart Center, Kanagawa 240-0116.
authors.forename: Mineto
authors.initials: M
authors.lastname: Kamata
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Oda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nomura
authors.forename: Akira
authors.initials: A
authors.lastname: Yamasaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takahama
authors.forename: Naoki
authors.initials: N
authors.lastname: Yabuta
authors.forename: Harumasa
authors.initials: H
authors.lastname: Nakazawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D033221:Jehovah's Witnesses; D008297:Male; D008875:Middle Aged
chemical_list: D006454:Hemoglobins