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Perioperative use of modified thrombelastography in factor XI deficiency: a helpful method to assess drug effects
Author(s) -
Dirkmann D.,
Hanke A. A.,
Görlinger K.,
Peters J.
Publication year - 2007
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2007.01284.x
Subject(s) - hyperfibrinolysis , tranexamic acid , medicine , thrombelastography , fibrinolysis , perioperative , aprotinin , thromboelastography , coagulopathy , coagulation , thromboelastometry , anesthesia , antifibrinolytic , aminocaproic acid , fresh frozen plasma , coagulation disorder , surgery , blood loss , platelet
Factor XI deficiency is a rare, hereditary bleeding disorder associated with a trauma‐related bleeding tendency, caused by insufficient generation of the thrombin activatable fibrinolysis inhibitor (TAFI) evoking increased fibrinolysis. We present the case of a five year old girl with homozygote, severe factor XI deficiency presenting for surgery on two occasions. Modified thrombelastography (ROTEM™) was used to assess effects of factor XI deficiency on coagulation, endogenous fibrinolysis, and potential effects of tranexamic acid, aprotinin and recombinant, activated Factor VII in an in vitro model of hyperfibrinolysis. According to our data and in consideration of the mechanisms of factor XI deficiency we decided on prophylactic use of tranexamic acid.