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Transfusions—The Key to Survival?Awake!—1990 | October 22
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IN 1941 Dr. John S. Lundy set a standard for blood transfusions. Apparently without any clinical evidence to back him up, he said that if a patient’s hemoglobin, the oxygen-carrying component of blood, goes down to a level of ten grams or less for every deciliter of blood, then the patient needs a transfusion. Thereafter that number became a standard for doctors.
This ten-gram standard has been challenged for nearly 30 years. In 1988 The Journal of the American Medical Association flatly stated that the evidence does not support the guideline. Anesthesiologist Howard L. Zauder says it is “cloaked in tradition, shrouded in obscurity, and unsubstantiated by clinical or experimental evidence.” Others simply call it a myth.
Despite all this vigorous debunking, the myth is still widely revered as a sound guideline. To many anesthesiologists and other doctors, a hemoglobin level of below ten is a trigger for transfusion to correct the anemia. It’s virtually automatic.
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Transfusions—The Key to Survival?Awake!—1990 | October 22
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However, many surgeons have successfully operated on Witnesses with hemoglobin levels of five, two, and even less. Says surgeon Richard K. Spence: “What I’ve found with the Witnesses is that the lower hemoglobin does not relate to mortality at all.”
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