| Aortic dissection and hypothermic arrest in a Jehovah's Witness patient: a case for recombinant factor VIIa? | |
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MedLine Citation:
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PMID: 16575032 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To present a case of survival of a cognitively intact Jehovah's Witness patient with an aortic dissection who underwent hypothermic arrest. Recombinant factor VIIa, but no blood products were administered. CLINICAL FEATURES: An 83-yr-old female with an acute type A aortic dissection underwent emergent surgical repair. Proximal extension of the dissection necessitated prolonged cardiopulmonary bypass (CPB) and hypothermic circulatory arrest. Despite this, perioperative hemostatis was adequate. Recombinant factor VIIa 90 microg x kg(-1) i.v. was administered post-CPB. The patient had an uneventful postoperative course, and was discharged home neurologically intact. CONCLUSIONS: Patients who conscientiously object to the transfusion of blood products may present a considerable anesthetic challenge, especially those at risk from coagulopathy associated with CPB and hypothermic circulatory arrest. Recombinant factor VIIa may play a role in hemostasis management of these individuals, however, well-designed randomized controlled trials need to be undertaken to establish the efficacy and risks related to this potential indication. |
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Authors:
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Jenifer Ballen; Michael Raabe; Brian Muirhead |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 53 ISSN: 0832-610X ISO Abbreviation: Can J Anaesth Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-03-31 Completed Date: 2006-09-12 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: Canada |
Other Details:
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Languages: eng Pagination: 353-6 Citation Subset: IM |
Affiliation:
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Department of Anesthesia, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged, 80 and over Aorta / surgery*, ultrasonography Cardiopulmonary Bypass Dose-Response Relationship, Drug Echocardiography, Transesophageal Factor VII / therapeutic use* Factor VIIa Female Heart Arrest, Induced / methods* Hemostatics / therapeutic use* Humans Jehovah's Witnesses* Recombinant Proteins / therapeutic use Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Hemostatics; 0/Recombinant Proteins; 0/recombinant FVIIa; 9001-25-6/Factor VII; EC 3.4.21.21/Factor VIIa |
| Comments/Corrections | |
Comment In:
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Can J Anaesth. 2006 Apr;53(4):336-8
[PMID:
16575029
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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