Mechanical ventilation (MV) is a vital life support measure, but prolonged use is associated with morbidity. Indications include apnea, respiratory distress, hypoxemia, and hypercapnia. MV unloads the increased work of breathing and stops the development of acidosis with respiratory depression. There are no absolute contraindications, but tension pneumothorax, bronchopleural fistula, right ventricular failure, and hypovolemic shock are relative contraindications. A thorough understanding of the different modes of MV is essential for successful application. The common terms used with MV should be known, and efforts should be focused on MV liberation as soon as the patient meets criteria for safe extubation.
We report a challenging case of a rare cause of post operative bleeding that occurred after the coronary artery bypass graft procedure. We believe that acquired hemophilia A was the main culprit. Patient post CABG developed nonsurgical bleeding with new isolated PTT prolongation. Bleeding was resistant to conventional therapy. Mixing studies didn't correct PTT, thus we ruled out factor defi ciencies. Heparin effect was excluded by normal factor X levels. Patient received factor VIII inhibitor bypass therapy after which corrected PTT and stopped bleeding. The triad of acquired coagulopathy, noncorrectable PTT, and exclusion of heparin effect, make acquired hemophilia A the most likely diagnosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.