title: Utility of thromboelastography in managing acquired Factor VIII inhibitor associated massive haemorrhage.
abstract: Disorders of clotting and coagulation are common in the intensive care unit. Diagnosis, treatment and monitoring of these disorders are traditionally based on conventional coagulation tests such as activated partial thromboplastin time (APTT) and international normalised ratio (INR). We present here a patient who developed massive postoperative haemorrhage secondary to an acquired factor VIII inhibitor. The case highlights the utility and sensitivity of thromboelastography (TEG) in the diagnosis of the condition and monitoring the response to therapy.
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Victoria.
authors.forename: C
authors.initials: C
authors.lastname: Fisher
authors.forename: A
authors.initials: A
authors.lastname: Mo
authors.forename: S
authors.initials: S
authors.lastname: Warrillow
authors.forename: C
authors.initials: C
authors.lastname: Smith
authors.forename: D
authors.initials: D
authors.lastname: Jones
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D001803:Blood Transfusion / Q000379:methods; D016889:Endometrial Neoplasms / Q000150:complications / Q000601:surgery*; D015942:Factor VIIa / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000150:complications / Q000188:drug therapy; D006467:Hemophilia A / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D010314:Partial Thromboplastin Time / Q000379:methods; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000188:drug therapy*; D011860:Radiography, Abdominal / Q000379:methods; D011994:Recombinant Proteins / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy; D017582:Renal Replacement Therapy / Q000379:methods; D012121:Respiration, Artificial / Q000379:methods; D012131:Respiratory Insufficiency / Q000150:complications / Q000628:therapy; D013916:Thrombelastography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014148:Tranexamic Acid / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D011994:Recombinant Proteins; C025667:prothrombin complex concentrates; D014148:Tranexamic Acid; C103587:recombinant FVIIa; D015942:Factor VIIa
keywords: acquired Factor VII inhibitor; thromboelastography