Cold agglutinins complicating repair of aortic dissection using cardiopulmonary bypass and hypothermic circulatory arrest: case report and review

被引:20
作者
Hoffman, JW
Gilbert, TB
Hyder, ML
机构
[1] Univ Maryland, Med Syst, Dept Anesthesiol, Baltimore, MD 21201 USA
[2] Univ Maryland, Med Syst, Dept Med Cardiol, Baltimore, MD 21201 USA
来源
PERFUSION-UK | 2002年 / 17卷 / 05期
关键词
D O I
10.1191/0267659102pf601cr
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cold agglutinins (CAs) are autoantibodies that react reversibly with red blood cells (RBCs) at temperatures of, or below, the thermal amplitude for agglutination. This results in increased blood viscosity and sludging of RBC, and may impair perfusion to various organ systems. Although this phenomenon appears rarely in the clinical arena, the incidence of CA is increased substantially in cardiac surgery due to the routine use of hypothermia for organ preservation and systemic metabolic reduction. Once activated, CA are associated with microvascular occlusion, hemolysis, complement fixation, renal and hepatic insufficiency, cerebral insult, and myocardial infarction. Complications from CA may be minimized with appropriate screening, detection, and management in the perioperative period. A prototypical case is described, and pertinent issues regarding CA are reviewed.
引用
收藏
页码:391 / 394
页数:4
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