Prevention of cryoprecipitation during cardiopulmonary bypass in a patient with HIV-HCV co-infections

Détails

ID Serval
serval:BIB_FFC39B17A77C
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Prevention of cryoprecipitation during cardiopulmonary bypass in a patient with HIV-HCV co-infections
Périodique
Perfusion
Auteur(s)
Fontana M., Ruchat P., Horisberger J., Aubert V., Mayor C., Spertini F.
ISSN
0267-6591 (Print)
Statut éditorial
Publié
Date de publication
2006
Volume
21
Numéro
5
Pages
263-5
Notes
Case Reports Journal Article
Résumé
BACKGROUND: There are no guidelines for the management of patients with cryoglobulins during cardiopulmonary bypass (CPB) necessitating core hypothermia. OBJECTIVE: To evaluate a simple, pragmatic protocol of in vitro temperature-dependent cryoprecipitation of serum in patients with cryoglobulinemia before elective cardiac surgery with CPB. METHODS: A 44-year-old female patient was known for chronic hepatitis C and type III cryoglobulinemia. Elective surgery was planned for an aortic arch aneurysm. A differential serum cryoprecipitation profile was established in vitro prior to surgery. RESULTS: Whereas, at temperatures < or = 15 degrees C, cryoglobulin levels were > or = 0.112 g/L (normal value < 0.05 g/L), at 20 degrees C and above, the precipitate was < or = 0.016 g/L. Accordingly, surgery was performed without any cryoglobulin-related complications at an extracorporeal circulation temperature of 22-24 degrees C, to minimise the risk of cryoprecipitation. CONCLUSION: In elective cases of surgery with CPB and hypothermia, temperature-dependent differential serum cryoprecipitation profile may be an easy and efficient way to assess a safe peroperative level of temperature to avoid complications due to cryoglobulins, without enhancing the patient's tissue ischemia risks.
Mots-clé
Adult Aorta/surgery Aortic Aneurysm/complications/*surgery Aortic Valve Insufficiency/surgery *Cardiopulmonary Bypass Cryoglobulinemia/*etiology Cryoglobulins/*chemistry Extracorporeal Circulation/methods Female HIV Infections/*complications Hepatitis C, Chronic/*complications Humans Precipitation Preoperative Care Surgical Procedures, Elective Temperature
Pubmed
Web of science
Création de la notice
25/01/2008 15:19
Dernière modification de la notice
20/08/2019 16:30
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