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
Keywords
Related Articles
- EP ID EP546363
- DOI 10.17140/RPAOJ-1-105
- Views 173
- Downloads 0
Physiologic Advantages of Peripheral Nerve Blockade Translate to Decreased Length of Stay and Improved Patient Satisfaction
Peripheral nerve blockade is an effective modality involved in controlling perioperative pain. When compared with patient controlled analgesia, neuraxial analgesia, and other anesthetic methods such as periarticular infi...
Mind the Gap Between the Bench and the bad: The General Anesthetics-Induced Neurotoxicity in the Real World
From the very beginning of Morton’s successful demonstration of surgical anesthesia, reversibility has been identified as one of the unique characteristics of anesthesia. However, recent studies just reveal the opposite;...
Isolated Prolonged Activated Partial Thromboplastin Time and Contact Factor Deficiencies: Case Series and Management Review
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 i...
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...