TITLE

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

AUTHOR(S)
Fontana, Massimiliano; Ruchat, Patrick; Horisberger, Judith; Aubert, Vincent; Mayor, Carole; Spertini, François
PUB. DATE
September 2006
SOURCE
Perfusion;Sep2006, Vol. 21 Issue 5, p263
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
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 ≤15°C, cryoglobulin levels were ≥0.112 g/L (normal value <0.05 g/L), at 20°C and above, the precipitate was ≤0.016 g/L. Accordingly, surgery was performed without any cryoglobulin-related complications at an extracorporeal circulation temperature of 22–24°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.
ACCESSION #
23259297

 

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