Perioperative management of rare coagulation factor deficiency states in cardiac surgery.
Br J Anaesth
; 119(3): 354-368, 2017 Sep 01.
Article
em En
| MEDLINE
| ID: mdl-28969316
ABSTRACT
Rare bleeding disorders (RBDs) include the hereditary deficiency of fibrinogen, factor (F)II, FV, FV + FVIII, FVII, FX, FXI or FXIII. RBDs do not confer a protective effect against atheromatous plaque formation, and thus the need for cardiovascular (CV) surgery in RBD patients is expected to increase with improved healthcare access (diagnosis and management) and longevity of the population. Clinical data regarding the management of RBDs in this setting are sparse, but the perioperative care team is obliged to gain a better understanding on available biological and pharmacological hemostatic agents. Perioperative management of RBDs in CV surgery is further complicated by heparin anticoagulation, haemodilution, and consumption of procoagulant and anticoagulant proteins associated with cardiopulmonary bypass (CPB). The aims of this review are to summarize pathophysiology of RBDs and laboratory monitoring pertinent to CV surgery, available factor replacement agents, and to provide the framework for perioperative coagulation management of RBD patients.
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Base de dados:
MEDLINE
Assunto principal:
Transtornos da Coagulação Sanguínea
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Assistência Perioperatória
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Procedimentos Cirúrgicos Cardíacos
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article