Postoperative management of a severely anemic Jehovah's Witness

Preoperative preparation and intraoperative techniques to minimize blood loss comprise standard therapy for the patient who refuses blood products on religious grounds. The severely anemic postoperative patient presents a particular problem in dealing with oxygen transport and consumption. The management of a Jehovah's Witness with a hematocrit of 6.6% is presented. Oxygen consumption (VO2) was decreased 30-50% by the use of body surface cooling, neuromuscular blocking agents, and narcotic-barbiturate administration.