The use of artificial intelligence and machine learning monitoring to safely administer a fluid-restrictive goal-directed treatment protocol to minimize the risk of transfusion during major spine surgery of a Jehovah's Witness: a case report

Sara Denn; Emmanuel Schneck; Fidaa Jablawi; Michael Bender; Götz Schmidt; Marit Habicher; Eberhard Uhl; Michael Sander

doi:10.1186/s13256-022-03653-8

The use of artificial intelligence and machine learning monitoring to safely administer a fluid-restrictive goal-directed treatment protocol to minimize the risk of transfusion during major spine surgery of a Jehovah's Witness: a case report

J Med Case Rep. 2022 Nov 12;16(1):412. doi: 10.1186/s13256-022-03653-8.

Authors

Sara Denn^#¹, Emmanuel Schneck^#², Fidaa Jablawi³, Michael Bender³, Götz Schmidt¹, Marit Habicher¹, Eberhard Uhl³, Michael Sander¹

Affiliations

¹ Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Justus Liebig University of Giessen, Rudolf-Buchheim-Street 7, 35392, Giessen, Germany.
² Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Justus Liebig University of Giessen, Rudolf-Buchheim-Street 7, 35392, Giessen, Germany. emmanuel.schneck@chiru.med.uni-giessen.de.
³ Department of Neurosurgery, Justus Liebig University of Giessen, Giessen, Germany.

^# Contributed equally.

Abstract

Background: The Hypotension Prediction Index (HPI) displays an innovative monitoring tool which predicts intraoperative hypotension before its onset.

Case presentation: We report the case of an 84-year-old Caucasian woman undergoing major spinal surgery with no possibility for the transfer of blood products given her status as a Jehovah's Witness. The hemodynamic treatment algorithm we employed was based on HPI and resulted in a high degree of hemodynamic stability during the surgical procedure. Further, the patient was not at risk for either hypo- or hypervolemia, conditions which might have caused dilution anemia. By using HPI as a tool for patient blood management, it was possible to reduce the incidence of intraoperative hypotension to a minimum.

Conclusions: In sum, this HPI-based treatment algorithm represents a useful application for the treatment of complex anesthesia and perioperative patient blood management. It is a simple but powerful extension of standard monitoring for the prevention of intraoperative hypotension.

Keywords: Blood transfusion; Case report; Hemodilution; Hemodynamic monitoring; Hypotension; Jehovah’s Witnesses.

Publication types

Case Reports

MeSH terms

Aged, 80 and over
Artificial Intelligence
Blood Transfusion
Clinical Protocols
Female
Goals
Humans
Hypotension* / etiology
Hypotension* / prevention & control
Jehovah's Witnesses*
Machine Learning