12 October 2023
: Case report 
Successfully Managing Severe Anemia in a Trauma Patient Who Refused Blood Transfusion: A Case Report
Management of emergency care
Irene F. Sanchez
1ABCDEF, Han-young Lee 1ABCDEF, Jae-myeong Lee 1ABCDEF*
DOI: 10.12659/AJCR.940326
Am J Case Rep 2023; 24:e940326
Figure 1. The clinical course and management of a 71-year-old Korean trauma patient who declined blood transfusion, showing the hemoglobin (Hgb) levels, norepinephrine requirement, methylene blue dosage, and iron and erythropoietin supplementation given during hospital admission. Hemoglobin (blue bar) was at its lowest during hospital day 41, when the patient had melena due to a bleeding gastric ulcer and then began to increase. The norepinephrine dose requirement (orange line) increased from hospital day 37 and peaked at hospital days 41 to 43, associated with persistent hypotension. Therefore, high-dose methylene blue (green line) was given on days 42 and 43.