Bruttocao, A

Gruppo, M

Mazzalai, F

Nistri, R

Terranova, C

English

PubMed

R Nistri

C Terranova

A Bruttocao

M Gruppo

F Mazzalai

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Elderly surgical “not transfusible” patients

Gruppo M

Bruttocao A

Terranova C

Nistri R

Mazzalai F

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BMC Geriatrics

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MEETING ABSTRACT Open Access
Elderly surgical “not transfusible” patients
R Nistri2*, C Terranova2, A Bruttocao1, M Gruppo1, F Mazzalai1
From de Senectute: Age and Health Forum
Catanzaro, Italy. 5-7 December 2009
Background
Non transfusible patients’ care presents complex ethical,
legal and medical problems when their refusal is related
to a religious belief. This kind of patient may need both
elective and emergency treatment that they generally
accept, with the exception of blood transfusion.
Materials and methods
25 patients were evaluated in our Institution (14 males
and 11 females) for curative surgical operations: 8 gall-
bladders, 5 ventral median incisional hernias, 7 sigmoid
diverticulosis, 5 inguinal hernias. Different intraoperative
techniques were analyzed: normovolemic acute hemo-
dilution, use of hemo-recovery device and anaesthesia
with controlled hypothermia and hypotension. Patients
were monitored for 8 – 10 days.
Results
Surgical operation was regular and free of complications
in all cases. One patient, treated with hypotensive anaes-
thesia, developed transient hypercapnia immediately cor-
rected by an adequate pulmonary ventilation; 2 patients
operated in controlled hypothermia developed a transi-
ent hypertensive peak, which was pharmacologically
controlled. Postoperative hospital stay was regular
and free of complications for all patients, which were
discharged after 8-10 days without any evidence of
bleeding.
Conclusions
The most important complication in “non transfusible”
patients’ operations is bleeding and the impossibility to
treat it with blood transfusions. In these conditions, pru-
dent conduct becomes extremely important as well as
careful operative and postoperative management with
the possibility of particular anaesthetic protocol, the
need of close cooperation between surgeon and anaes-
thesist and valid legal support.
Author details
1Clinic of Geriatric Surgery, Hospital University of Padua, Italy. 2Unit of
Forensic Toxicology and Antidoping.
Published: 19 May 2010
doi:10.1186/1471-2318-10-S1-A19
Cite this article as: Nistri et al.: Elderly surgical “not transfusible”
patients. BMC Geriatrics 2010 10(Suppl 1):A19.
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2Unit of Forensic Toxicology and Antidoping
Nistri et al. BMC Geriatrics 2010, 10(Suppl 1):A19
http://www.biomedcentral.com/1471-2318/10/S1/A19
© 2010 Nistri et al; licensee BioMed Central Ltd.


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Elderly surgical “not transfusible” patients

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