• Semin Cardiothorac Vasc Anesth · Dec 2017

    Review Case Reports

    Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery.

    • Patrick Odonkor, Archana Srinivas, Erik Strauss, Brittney Williams, Michael Mazzeffi, and Kenichi A Tanaka.
    • 1 University of Maryland Medical System, Baltimore, MD, USA.
    • Semin Cardiothorac Vasc Anesth. 2017 Dec 1; 21 (4): 312-320.

    AbstractPerioperative 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.

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