Cirugía mayor, hemoderivados y testigos de jehová

Ricardo Poveda Jaramillo, Michael De la Peña Martínez, Carlos Pérez Guzmán



Introducción: los Testigos de Jehová son una corriente ortodoxa que se rehúsa a la administración de cualquier hemoderivado basados en algunos pasajes de la Biblia. En caso de cirugía mayor, con elevado riesgo de sangrado, los hemoderivados son necesidad terapéutica. Sin embargo condicionamientos religiosos pueden plantear exigencias especiales.
Objetivo: presentar tres casos y realizar revisión de las alternativas terapéuticas que se pueden ofrecer a los pacientes Testigos de Jehová que se someten a cirugías mayores con alto riesgo de perdidas sanguíneas.
Caso clínico: tres casos de pacientes Testigos de Jehová sometidos a cirugía abdominal mayor por neoplasias avanzadas.
Conclusión: los pacientes Testigos de Jehová son un reto para el profesional de la salud cuando son sometidos a cirugías en las cuales inevitablemente ocurren pérdidas sanguíneas considerables. Las opciones terapéuticas comprenden: preoperatorio (provisión de alimentos y suplementos para favorecer la eritropoyesis, administración de eritropoyetina y auto-donación). Intra-operatorio (desmopresina, hipotensión controlada, adecuada técnica quirúrgica, hemodilución normovolémica aguda, aprotinina y ácido tranexamico, re-infusión intraoperatoria, transportadores de oxígeno). Post-operatorio (reducción de las pérdidas de sangre). Rev.cienc.biomed. 2012;3(1):141-148

Palabras clave

Testigos de Jehová; Anestesia; Hemorragia; Terapéutica.

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