Isolated Prolonged Activated Partial Thromboplastin Time and Contact Factor Deficiencies: Case Series and Management Review
Journal Title: Research and Practice in Anesthesiology – Open Journal - Year 2016, Vol 1, Issue 1
Abstract
Background: Contact factor deficiencies are rare disorders that can cause grossly prolonged activated partial thromboplastin time (aPTT) and activated clotting time (ACT) while rarely affecting in vivo hemostasis. This in vitro laboratory phenomenon poses a particular challenge in surgical procedures that require anticoagulation monitoring. Case: Here we report two cases of contact factor deficiencies; a 67-year-old morbidly obese female with factor XII deficiency requiring revascularization of a graft and a 58-year-old female with prekallikrein (PK) deficiency undergoing routine muscle biopsy. Conclusion: Peri-operative anticoagulation monitoring poses a significant challenge in contact factor deficiency patients. Awareness of the challenges of contact factor deficiencies allows for optimal peri-operative management. Emerging literature supports that contact factors play a role in fibrinolysis. Increased surveillance of thrombotic events as well as avoidance of fibrinolytics may be necessary in these patients.
Authors and Affiliations
Majed A. Refaai
The Importance of Optimizing Acute Post-Surgical Pain
In February 1992, AHCPR released a clinical practice guideline1 to help surgeons, nurses, and anesthesiologists manage acute post-operative pain more effectively. The guideline was developed by an 18-member private-secto...
Pediatric Emergence Agitation
Emergence Agitation (EA) is still remaining as a major problem during the early stage of recovery from general anesthesia in children. EA was first reported in 1960’s and it has been considered as a mental disturbance du...
Post intubation Pharyngolaryngeal Pain in Otorhinolaryngology Surgery: Efficiency of Intra cuff and Extra cuff Lidocaine
Introduction:Post-operative sore throat (POST) represents a real discomfort for patients. In short duration surgeries, sore throat complain can replace the post-operative pain. Many studies intended to reduce its inciden...
Factors Affecting Post-Operative Mortality Rate after Major Lower Extremity Amputations in a Tertiary Institution in Singapore
Background: Non-traumatic Major Lower Extremity Amputation (MLEA) surgeries are associated with high post-operative morbidity and mortality rates. There are few studies evaluating factors associated with post-operative m...
Respiratory Depression on the Wards: Why Better Monitoring may be the Answer?
Although, deaths during anesthesia are rare, deaths in the post-operative period are not.1 The third leading cause of death in the United States is mortality after surgery, during the ‘recovery and rehabilitation’ period...