BACKGROUND: Low levels of hemoglobin (Hb) are not rare in patients who refuse blood components but this case is unique due to the severity of anemia and the possibility that her previous episode of acute normovolemic hemodilution has influenced her outcome. CASE REPORT: We report an incident involving acute blood loss after surgery with an extremely low hematocrit. Despite her Hb levels (2.8 g/dL) she remained lucid, expressing her wish not to receive transfusion. When the patient lost consciousness (Hb, 1.4 g/dL) she was promptly sedated, curarized, and put onto mechanical controlled ventilation. Aggressive erythropoietin therapy increased the patient's Hb level by 240% in 10 days, despite a high platelet count. This case demonstrates that critical levels of oxygen delivery may be lower than previously thought possible. CONCLUSION: This case is an example of the resilience of the human body in an extreme circumstance. It might be the most severe case of anemia that a person has survived without any sequelae.
BACKGROUND: Low levels of hemoglobin (Hb) are not rare in patients who refuse blood components but this case is unique due to the severity of anemia and the possibility that her previous episode of acute normovolemic hemodilution has influenced her outcome. CASE REPORT: We report an incident involving acute blood loss after surgery with an extremely low hematocrit. Despite her Hb levels (2.8 g/dL) she remained lucid, expressing her wish not to receive transfusion. When the patient lost consciousness (Hb, 1.4 g/dL) she was promptly sedated, curarized, and put onto mechanical controlled ventilation. Aggressive erythropoietin therapy increased the patient's Hb level by 240% in 10 days, despite a high platelet count. This case demonstrates that critical levels of oxygen delivery may be lower than previously thought possible. CONCLUSION: This case is an example of the resilience of the human body in an extreme circumstance. It might be the most severe case of anemia that a person has survived without any sequelae.
Authors: Joana M Esteves; Joana Fernandes; Pedro Oliveira Monteiro; Mariana Almeida; Luis Nogueira-Silva; Jorge Almeida Journal: Eur J Case Rep Intern Med Date: 2021-03-05
Authors: Antônio Alceu dos Santos; José Pedro da Silva; Luciana da Fonseca da Silva; Alexandre Gonçalves de Sousa; Raquel Ferrari Piotto; José Francisco Baumgratz Journal: Rev Bras Cir Cardiovasc Date: 2014 Oct-Dec
Authors: Antonio Alceu Dos Santos; Jose Francisco Baumgratz; Jose Henrique Andrade Vila; Rodrigo Moreira Castro; Rodrigo Freire Bezerra Journal: Cardiol Res Date: 2016-05-04