Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery

Patrick Odonkor, Archana Srinivas, Erik Strauss, Brittney Williams, Michael Mazzeffi, Kenichi A. Tanaka

Research output: Contribution to journalReview articlepeer-review

Abstract

Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined. In this review, the effects of CPB and hemodilution on FVIII are shown in a case presentation, and perioperative laboratory testing in patients with hemophilia A having cardiac surgery is discussed along with perioperative and postoperative coagulation management.

Original languageEnglish (US)
Pages (from-to)312-320
Number of pages9
JournalSeminars in Cardiothoracic and Vascular Anesthesia
Volume21
Issue number4
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Keywords

  • cardiac surgery
  • cardiopulmonary bypass
  • coagulation monitoring
  • factor VIII
  • hemodilution
  • hemophilia A

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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