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 211
- Downloads 0
Hemostasis Management during Adult Extracorporeal Membrane Oxygenation: A Shot in the Dark?
Extracorporeal membrane oxygenation (ECMO) has been used increasingly in adult patients with cardiopulmonary failure.1 According to the Extracorporeal Life Support Organization’s (ELSO’s) 2012 report over 51,000 patients...
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...
A Comparative Study of Ropivacaine Alone Versus Ropivacaine With Dexmedetomidine in Supraclavicular Brachial Plexus Block
Background and Aims: Supraclavicular brachial plexus block is frequently used procedure to provide anaesthesia and good post-operative analgesia for surgery on upper limb. The purpose of this study was to compare the hem...
Anesthetic Considerations in a Case of Fahr and Primrose Syndrome
In this review article, brief description, concerns, anesthetic management, and perioperative care patients with Fahr syndrome and Primrose syndrome has been made. There is a paucity of literature with respect to managem...
A Rare Septic Transfusion Reaction: Case Report
Transfusion of packed red blood cells (PRBCs) is indicated in severely bleeding patients and in anemic patients who require increased oxygen-carrying capacity. According to the 2016 AABB guidelines, for patients who are...