Perioperative use of modified thrombelastography in factor XI deficiency: a helpful method to assess drug effects.
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.
Dirkmann
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D
Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen, Universitätsklinikum Essen, Hufelandstrasse 5533, D-45122 Essen, Germany. Daniel.Dirkmann@uk-essen.de
Hanke
A A
AA
Görlinger
K
K
Peters
J
J
D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D005173:Factor XI Deficiency / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019990:Perioperative Care; D013916:Thrombelastography / Q000187:drug effects* / Q000379:methods; D014148:Tranexamic Acid / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid