Undiagnosed Factor VII Deficiency in Cardiac Surgery Complicated by Bleeding: A Case Report.

IF 0.5

A&A Practice Pub Date : 2023-09-01 DOI:10.1213/XAA.0000000000001713

Ziyad O Knio, Mickey S Ising, Kenan W Yount, Kenichi Tanaka, John S McNeil

引用次数: 0

Abstract

Rare bleeding disorders in the perioperative period call for targeted resuscitation strategies. Factor VII deficiency, for instance, is often corrected with exogenous administration of recombinant factor VIIa. This activated clotting factor, initially designed for patients with hemophilia A or B with factor inhibitors, is gaining popularity as a salvage therapy for severe and persistent traumatic and surgical bleeding. This article describes the management of a cardiothoracic surgical patient with undiagnosed isolated factor VII deficiency who experienced significant postoperative bleeding which subsided after the administration of recombinant factor VIIa. In this case, EXTEM failed to detect a clotting factor deficiency.

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心脏手术合并出血的未确诊因子7缺乏1例报告。

围手术期罕见出血性疾病需要有针对性的复苏策略。例如，因子VII缺乏通常通过外源性给予重组因子VIIa来纠正。这种活化的凝血因子最初是为具有因子抑制剂的A或B型血友病患者设计的，作为严重和持续性外伤性和外科出血的补救性治疗越来越受欢迎。这篇文章描述了一个心胸外科患者的治疗方法，未确诊的孤立性因子7缺乏症患者在给予重组因子VIIa后出现明显的术后出血。在这种情况下，EXTEM未能检测到凝血因子缺乏。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.