BMJ 1994;309:124 (9 July)

Letters

100% Oxygen at normal pressure is an alternative

EDITOR,--Two aspects of the management of patients who refuse blood transfusion deserve emphasis.1 The first point concerns the administration of 100% oxygen at normal pressure. When a patient is breathing air the concentration of oxygen in solution in arterial blood is only about 3 ml/l. This compares with a concentration of 25 ml/l for oxygen in combination with haemoglobin at a critical haemoglobin concentration of 20 g/l. If the patients breathes 100% oxygen the amount in solution should increase to about 20 ml/l, which is the equivalent of increasing the haemoglobin concentration (while the patient is breathing air) from 20 to 34 g/l, a concentration usually compatible with survival. Hyperbaric oxygen is even more effective, as James Watt notes, but is available in only few centres. Orthobaric oxygen is available in all hospitals, although its effective administration at 100% concentration requires attention to detail. Fluorocarbons may have a role in . . . [Full text of this article]


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Relevant Article

Managing patients who refuse blood transfusions: an ethical dilemma: Major trauma in two patients refusing blood transfusion
S Finfer, S Howell, J Miller, K Willett, and J Wilson-MacDonald
BMJ 1994 308: 1423-26. [Extract] [Full Text]

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