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Factor XII deficiency and cardiopulmonary bypass
M Wallock1, C Arentzen, J Perkins
1Department of Cardiovascular Surgery, Evanston Hospital, IL 60201, USA.
Perfusion
|January 1, 1995
Summary
Patients with factor XII deficiency undergoing cardiopulmonary bypass require plasma transfusions. This provides factor XII, enabling effective anticoagulation monitoring and potentially preventing postoperative bleeding complications.
Area of Science:
- Hematology
- Coagulation Science
Background:
- Factor XII initiates the intrinsic coagulation pathway.
- Factor XII deficiency impacts routine coagulation tests, rendering them unreliable during cardiopulmonary bypass (CPB).
Observation:
- A case study of a factor XII-deficient patient undergoing CPB is presented.
- Baseline coagulation tests showed significantly prolonged activated clotting time (ACT) and thrombin time.
- Plasma administration corrected the ACT, but high heparin doses during CPB still resulted in prolonged ACT and thrombin times.
Findings:
- Plasma infusion provides exogenous factor XII, enabling ACT test endpoint determination.
- Plasma may mitigate postoperative hypofibrinolytic complications in factor XII-deficient patients.
- A modified thrombin time assay could offer a reliable endpoint during high-dose heparinization.
Implications:
- This study highlights the challenges in managing coagulation during CPB in factor XII-deficient individuals.
- Plasma therapy and modified thrombin time assays represent potential strategies for improved patient management.
- Further research is warranted to optimize anticoagulation monitoring and minimize bleeding risks in this patient population.