Issue |
J Extra Corpor Technol
Volume 25, Number 1, June 1993
|
|
---|---|---|
Page(s) | 27 - 30 | |
DOI | https://doi.org/10.1051/ject/1993251027 | |
Published online | 21 August 2023 |
Case Report
Case Report: Monitoring the Adequacy of Anticoagulation During CPB in Factor XII Deficiency
1
Medical University of South Carolina, College of Health Related Professions, Department of Extracorporeal Circulation Technology
2
Medical University of South Carolina, Division of Cardiothoracic Surgery
3
Medical University of South Carolina, Hematology Department
* Address correspondence to: Jodie M. Ecklund, BS, CCP, Medical University of South Carolina, Program in Clinical Services, Department of Extracorporeal Circulation Technology, College of Health Related Professions, 171 Ashley Avenue, Charleston SC 29425
Cardiopulmonary bypass was performed on a 57 year old white male with a known Factor XII deficiency. Preoperative laboratory screening revealed an abnormal activated prothrombin time of 75.8 seconds and a pre-heparinized activated clotting time (ACT) of 560 seconds. Since this ACT was prolonged, heparin administration was managed using heparin concentrations. Thrombin times, soluble fibrin monomer complexes, and D-dimers were monitored while on bypass. Additional heparin was given to maintain heparin concentration> 3.5 U/ml. Postoperatively the patient experienced no coagulopathy, no excess bleeding, and required no homologous blood product administration. The use of heparin levels by protamine titration to monitor the adequacy of anticoagulation, as monitored by D-dimers and soluble fibrin monomer complexes proved to be successful in this patient.
Key words: cardiopulmonary bypass / Factor XII (Hageman Factor) deficiency / anticoagulation / intrinsic coagulation pathway
© 1993 AMSECT
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