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
Table 1. Summary of trauma cases involving Jehovah’s Witness patients in the past 20 years.
| Age/case | Hemoglobin level | Management | Outcome | Journal |
|---|---|---|---|---|
| 1. A 67-year-old male patient experienced a motor vehicular accident and sustained right-sided rib fractures, right anterior chest wall and mediastinal hematomas, left pneumothorax, bilateral pulmonary contusions, and fractures of the left distal humerus and left distal femur (2004) []11 | 3 g/dL | IronFolic acidVitamin B12Vitamin KErythropoietin | Survived | Journal of Clinical Anesthesia |
| 2. A 6-year-old male patient experienced a motor vehicular accident and sustained cranial depression, periorbital edema on the right, hematoma on the right thigh with femur fracture, a contusion-laceration wound on the left thigh, and scrotal region and glans penis hematoma (2006) []26 | 5 g/dL | Folic acidVitamin KErythropoietinRight Frontal craniotomy | Survived | Journal of Hematology |
| 3. A 76-year-old female patient experienced blunt abdominal trauma, rib fractures, and grade III splenic injury (2008) []27 | 9 g/dL | Laparoscopic Splenectomy | Survived | Surgical Laparoscopy, Endoscopy and Percutaneous Techniques |
| 4. A 36-year-old male patient experienced severe burn encompassing 35% of the TBSA (2014) []28 | 8.6 g/dL | Vitamin KIronTranexamic acidErythropoietinFascial excision and split-thickness skin grafting | Survived | Journal of Burn Care and Research |
| 5. A 65-year-old male patient experienced a fall and sustained multiple rib fractures, splenic rupture, and multiple intestinal ischemic perforations (2013) []12 | 3.5 g/dL | IronVitamin B12ErythropoietinSplenectomy and Ileocecal resection | Survived | Blood Transfusion |
| 6. A 51-year-old female patient experienced an automobile collision and sustained bilateral femoral, tibial, and fibular fractures (2001) []29 | 3 g/dL | IronVitamin KErythropoietinCryoprecipitate | Deceased | Critical Care Nurse |
| 7. A 23-year-old male patient crushed between two cars and sustained grade III liver laceration and active pelvic hemorrhage (2016) []30 | 3.9 g/dL | IronErythropoietinHemopurePercutaneous pinning of pelvic fractures | Survived | Archives of Trauma Research |
| 8. A 39-year-old male patient experienced fall and underwent popliteal artery and vein transection after knee dislocation (2010) []31 | 3.4 g/dL | VasopressorExternal fixation | Deceased | Obesity Surgery |
| 9. A 49-year-old male patient experienced a motor vehicular accident and sustained bilateral acetabular fracture (2005) []32 | 8.4 g/dL | ErythropoietinAutologous blood transfusion (cell saver)AprotininOpen reduction and internal fixation of acetabular fracture | Survived | Journal of Orthopedic Trauma |
| 10. A 21-year-old male patient experienced a high-speed motor vehicular accident and underwent near-total traumatic left ankle amputation and transection of superficial femoral artery and vein (2009) []33 | 2.7 g/dL | Religion unknown preoperative: administered with PRBC, FFP, and platelet concentratePostoperative: CryoprecipitateIronVitamin KErythropoietin | Survived | Journal of Trauma and Acute Care Surgery |
| 11. A 44-year-old female patient experienced a motor vehicular collision and sustained subarachnoid hemorrhage, bilateral pulmonary contusion, rib fractures, and grade I splenic laceration (2002) []34 | 3.2 g/dL | IronErythropoietinPolyHeme | Survived | The New England Journal of Medicine |
| 12. A 44-year-old male patient experienced impalement injury with 2 iron rods penetrating the thorax and 1 rod penetrating the thoracolumbar area (2005) []35 | 3.4 g/dL | ErythropoietinCrystalloids | Survived | The Journal of Thoracic and Cardiovascular Surgery |
| 13. A 21-year-old male patient experienced a vehicular accident and developed a degloving injury to the left forearm and abdomen and intracranial hemorrhage (2009) []24 | 3.2 g/dL | Religion unknown preoperative: Administered with PRBCPostoperative: Vitamin KErythropoietinFactor VIIaHemopure | Deceased | The Journal of AABB Transfusion |
| 14. A 23-year-old male patient experienced a motor vehicular accident and sustained grade III liver injury, multiple rib fracture, and pelvic fracture (2008) [] | 4.6 g/dL | IronVitamin KErythropoietinHemopure | Survived | Journal of Clinical Anesthesia |
| 15. A 24-year-old male patient experienced burns encompassing 60% of the TBSA (2004) []36 | 4.4 g/dL | IronErythropoietinFFP | Survived | Burns |
| 16. A 5-year-old female patient experienced a lawnmower injury with multiple open fracture of the left foot and ankle (2008) []37 | 4.3 g/dL | Vitamin KErythropoietin | Survived | Journal of Pediatric Anesthesia |
| 17. A 32-year-old female patient experienced a high-speed vehicular accident and sustained grade 4 spleen injury, bilateral rib fractures, left humeral and femoral fracture, and multi-level spinous process fracture (2011) [] | 2.9 g/dL | IronVitamin B12Folic acidErythropoietinFactor VIIaCryoprecipitateHemopure | Survived | The Medical Journal of Australia |
| 18. A 71-year-old male patient covered in soil and sustained bilateral multiple rib fractures, T10 compression fracture and left iliac wing fracture (2022) | 2.5 g/dL | Ferrous sulfate Iron isomaltosideFolic acidErythropoietinVitamin KNorepinephrineHydrocortisoneVasopressinMethylene Blue | Survived | American Journal of Case Reports [current case] |
| Hemopure – hemoglobin-based oxygen carrier; PolyHeme – first human polymerized hemoglobin product; * lactic acid – 4.3 mmol/L; ** lactic acid – 3.9 mmol/L; PRBC – packed red blood cell; FFP – fresh frozen plasma; TBSA – total body surface area. | ||||