A 28-year-old man was admitted to our intensive care unit for profound anaemia associated with multivisceral impairment. He was a Jehovah's Witness and had been diagnosed with severe aplastic anaemia 1 month earlier, with haemoglobin 36 g/L, leucocyte count 2 ? 8 x 10~9/L, and platelet count 8 x10~9/L Because of his religious beliefs, he repeatedly refused transfusion of blood products and was treated with a combination of erythropoietin, granulocyte growth factors, iron, leucovorin, and cidosporin. However, 4 weeks after treatment initiation, his haemoglobin had dropped to 24 g/L and his condition worsened to extreme weakness, confusion, and acute respiratory failure. ECG showed evidence of myocardial ischaemia. The patient's confusion made it impossible to discuss treatment. After consulting with the patient's relatives and ascertaining that everything had been done to avoid transfusion of blood products, his life-threatening condition prompted the emergency transfusion of six units of packed red cells, aiming to achieve a haemoglobin of 90 g/L, and one unit of platelet concentrate.
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机译：一名28岁的男子因与多脏器损伤相关的严重贫血入院我们的重症监护室。他是耶和华见证人，在1个月前被诊断出患有严重的再生障碍性贫血，血红蛋白36 g / L，白细胞计数2？ 8 x 10〜9 / L，血小板计数8 x10〜9 / L由于他的宗教信仰，他一再拒绝输血，并接受促红细胞生成素，粒细胞生长因子，铁，亚叶酸钙和西多孢菌素的联合治疗。但是，开始治疗后4周，他的血红蛋白降至24 g / L，病情恶化至极度虚弱，神志不清和急性呼吸衰竭。心电图显示心肌缺血的证据。病人的困惑使其无法讨论治疗方法。在与患者的亲属协商并确定已采取一切措施避免输血后，他的危及生命的状况促使紧急输注六单位装满的红细胞，目的是使血红蛋白达到90 g / L，其中一浓缩血小板单位。
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