Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery

Patrick Odonkor; Archana Srinivas; Erik Strauss; Brittney Williams; Michael Mazzeffi; Kenichi A. Tanaka

doi:10.1177/1089253217702747

Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery

Patrick Odonkor, Archana Srinivas, Erik Strauss, Brittney Williams, Michael Mazzeffi, Kenichi A. Tanaka

Research output: Contribution to journal › Review article › peer-review

6 Scopus citations

Abstract

Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined. In this review, the effects of CPB and hemodilution on FVIII are shown in a case presentation, and perioperative laboratory testing in patients with hemophilia A having cardiac surgery is discussed along with perioperative and postoperative coagulation management.

Original language	English (US)
Pages (from-to)	312-320
Number of pages	9
Journal	Seminars in Cardiothoracic and Vascular Anesthesia
Volume	21
Issue number	4
DOIs	https://doi.org/10.1177/1089253217702747
State	Published - Dec 1 2017
Externally published	Yes

Keywords

cardiac surgery
cardiopulmonary bypass
coagulation monitoring
factor VIII
hemodilution
hemophilia A

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Anesthesiology and Pain Medicine

Access to Document

10.1177/1089253217702747

Cite this

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abstract = "Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined. In this review, the effects of CPB and hemodilution on FVIII are shown in a case presentation, and perioperative laboratory testing in patients with hemophilia A having cardiac surgery is discussed along with perioperative and postoperative coagulation management.",

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T1 - Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery

AU - Odonkor, Patrick

AU - Srinivas, Archana

AU - Strauss, Erik

AU - Williams, Brittney

AU - Mazzeffi, Michael

AU - Tanaka, Kenichi A.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined. In this review, the effects of CPB and hemodilution on FVIII are shown in a case presentation, and perioperative laboratory testing in patients with hemophilia A having cardiac surgery is discussed along with perioperative and postoperative coagulation management.

AB - Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined. In this review, the effects of CPB and hemodilution on FVIII are shown in a case presentation, and perioperative laboratory testing in patients with hemophilia A having cardiac surgery is discussed along with perioperative and postoperative coagulation management.

KW - cardiac surgery

KW - cardiopulmonary bypass

KW - coagulation monitoring

KW - factor VIII

KW - hemodilution

KW - hemophilia A

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Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery

Abstract

Keywords

ASJC Scopus subject areas

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