{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:10:08Z","timestamp":1790957408339,"version":"4.1.0"},"reference-count":17,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,20]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>Severe anaemia in patients who cannot receive blood transfusion is an indication for the use of hyperbaric oxygen therapy (HBO). Most reports of the use of HBO for anaemia involve patients with acute blood loss. This report details a case of HBO used for a patient with severe pernicious anaemia. A 35-year-old Jehovah\u2019s Witnesses believer presented to a hospital with fatigue, dyspnoea and haemoglobin of 26 g\/L. She was diagnosed with pernicious anaemia. As she could not receive blood transfusion due to her religious beliefs, vitamin B<jats:sub>12<\/jats:sub> supplementation and HBO were administered and resulted in significant improvement in her condition. The mechanisms of action of HBO, including increased systemic plasma oxygenation, can alleviate signs and symptoms of anaemia regardless of its aetiology. HBO administration can greatly enhance the plasma arterial oxygen content, leading to clinical improvement in patients with anaemia who cannot receive blood transfusion.<\/jats:p>","DOI":"10.1136\/bcr-2020-240619","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T11:59:43Z","timestamp":1618228783000},"page":"e240619","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Use of hyperbaric oxygenation as an adjunctive treatment for severe pernicious anaemia in a bloodless medicine patient"],"prefix":"10.1136","volume":"14","author":[{"given":"Kelly","family":"Johnson-Arbor","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA"},{"name":"MedStar Institute for Quality and Safety, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Verstraete","sequence":"additional","affiliation":[{"name":"Bloodless Medicine and Surgery Program, MedStar Georgetown University Hospital, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"2025082712422824000_14.4.e240619.1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2015.07.006"},{"key":"2025082712422824000_14.4.e240619.2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2014.1.553"},{"key":"2025082712422824000_14.4.e240619.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.19.jrv80007"},{"key":"2025082712422824000_14.4.e240619.4","first-page":"133","article-title":"Life without blood (a study of the influence of high atmospheric pressure and hypothermia on dilution of the blood)","volume":"13","author":"Boerema","year":"1959","journal-title":"J Cardiovasc Surg"},{"key":"2025082712422824000_14.4.e240619.5","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1097\/00000542-200010000-00044","article-title":"Hyperbaric oxygen reverses organ dysfunction in severe anemia","volume":"93","author":"Greensmith","year":"2000","journal-title":"Anesthesiology"},{"key":"2025082712422824000_14.4.e240619.6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.1999.01004.x"},{"key":"2025082712422824000_14.4.e240619.7","doi-asserted-by":"crossref","first-page":"756.e3","DOI":"10.1016\/j.ajem.2012.11.013","article-title":"Severe blood loss anemia in a Jehovah\u2019s Witness treated with adjunctive hyperbaric oxygen therapy","volume":"31","author":"Graffeo","year":"2013","journal-title":"Am J Emerg Med"},{"key":"2025082712422824000_14.4.e240619.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711133372007"},{"key":"2025082712422824000_14.4.e240619.9","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-10-569186"},{"key":"2025082712422824000_14.4.e240619.10","first-page":"384","article-title":"Vitamin B12 deficiency: recognition and management","volume":"96","author":"Langan","year":"2017","journal-title":"Am Fam Physician"},{"key":"2025082712422824000_14.4.e240619.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2257.2006.00755.x"},{"key":"2025082712422824000_14.4.e240619.12","doi-asserted-by":"crossref","DOI":"10.1182\/blood.V106.11.949.949","article-title":"Survival in individuals with profound anemia treated without the use of blood transfusions","volume":"106","author":"Ford","year":"2005","journal-title":"Blood"},{"key":"2025082712422824000_14.4.e240619.13","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1186\/cc2845","article-title":"How low is too low? 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