The Usefulness of Preoperative Screening for Bleeding Disorders

Sandoval, Claudio; García, C. Lorca; Visintainer, Paul; Özkaynak, M. Fevzi; Jayabose, Somasundaram

doi:10.1177/000992280304200308

Cited by 11 publications

(13 citation statements)

References 17 publications

(5 reference statements)

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“…Every patient persisted with prolonged aPTT at follow-up. Frequency of vWD in our study was 16.6% (0,9% of all patients that had surgery), correlating with published data [14].…”

Section: Discussionsupporting

confidence: 92%

“…Another possibility is the presence of transitory LA, which correlates with the peak in prevalence of LA around 5 years of age reported by Male et al, corresponding with the age group analyzed in the present study [20] and the levels of LA reported as a cause of isolated prolonged aPTT in literature. These reports exceed the levels that we could confirm in our study (up to 53, 1% v/s 10% respectively) [2] [13] [14] [17] [21]. Looking back at the time interval between both samples obtained from our patients, most of these were retrieved after 3 months (average in weeks), which is greater than the time interval described for LA study in children [5] [6].…”

Section: Discussioncontrasting

confidence: 89%

“…In our study, 7.5% of patients that had preoperative coagulation tests had a prolonged aPTT, figure that is within published ranges [11] [14] [15] [19].…”

Section: Discussionsupporting

confidence: 89%

“…26.6% of the patients with prolonged aPTT were found to have a possible coagulation disorder that had not been identified previously (Von Willebrand disease or a coagulation factor deficiency), similar to available literature [14].…”

Section: Discussionsupporting

confidence: 81%

“…Prolonged aPTT due to coagulation factor deficiency was not common (10%), however it was higher if compared to published data [14] [17]. Every patient persisted with prolonged aPTT at follow-up.…”

Section: Discussionmentioning

confidence: 74%

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Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

Aguirre¹,

Córdova²,

Jaime³

et al. 2015

IJOHNS

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Introduction: Activated partial thromboplastin time (aPTT) is one of the most used coagulation tests in preoperative evaluation. Incidental detection of a prolonged aPTT is a problem in primary care, in which the general pediatrician should be able to attend its initial management. Objective: To describe final diagnosis of patients with prolonged aPTT in preoperative study. Materials and Methods: This is a descriptive study of patients referred from otorhinolaryngology. Results: Totally, 508 adenoidectomies and/or tonsillectomies were performed in our center, 38 of which referred patients (7.5%) with prolonged aPTT, and 30 of which met inclusion criteria. The median age was 4 years. 56.6% of patients were males. 76.6% of patients normalized aPTT at the second follow-up. Among these, 73.9% showed a normal study, 4.3% ha2d lupus anticoagulant and in 21.7% Von Willebrand disease was detected. Among patients that persisted with prolonged aPTT, 42.8% had coagulant factors deficiency, 28.5% had lupus anticoagulant and in 28.5% of patients a diagnosis could not be achieved with the tests used in the present study. Multivariate analysis did not show correlation between final diagnosis and the variables measured. Conclusion: The presence of a prolonged aPTT in children under preoperative study is due to a pre-analytic factor in the majority of cases or to the presence of lupus anticoagulant, normalizing values on follow-up. We suggest that a new aPTT be performed on these patients, and only those that persist altered or present a symptoms and family history of coagulation disorders be referred to hematology. N. Aguirre et al. 242

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“…Every patient persisted with prolonged aPTT at follow-up. Frequency of vWD in our study was 16.6% (0,9% of all patients that had surgery), correlating with published data [14].…”

Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 89%

“…In our study, 7.5% of patients that had preoperative coagulation tests had a prolonged aPTT, figure that is within published ranges [11] [14] [15] [19].…”

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 74%

See 3 more Smart Citations

Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

Aguirre¹,

Córdova²,

Jaime³

et al. 2015

IJOHNS

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Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

Guay

Moerloose

Lasne

2006

Can J Anesth/J Can Anesth

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Purpose: To summarize the physiology and pathophysiology relevant to perioperative blood loss in children. Strategies to reduce blood losses are reviewed. Methods:The literature was reviewed using the electronic library PUBMED and the Cochrane Database of Systematic Reviews. Relevant studies published in English or French with an English abstract are included. The following keywords were used: children, blood transfusion, surgical blood loss, erythropoietin, autologous blood, red blood cell saver, normovolemic hemodilution, desmopressin, aminocaproic acid, tranexamic acid, aprotinin, cardiac surgery, liver transplantation and scoliosis surgery. Main findings:For patients with idiopathic scoliosis, predonation with or without the addition of erythropoietin is a safe and effective way to avoid the use of allogenic blood products. For open heart procedures: whole blood of less than 48 hr is helpful for children of less than two years of age undergoing complex procedures; tranexamic acid may be helpful for cyanotic heart disease and, to a lesser degree, for reoperations; while antikallikrein blood levels of aprotinin may both reduce the need for allogenic blood transfusions and improve postoperative oxygenation in infants. Conclusion:Reducing perioperative allogenic blood transfusions is possible in pediatric patients provided that prophylactic measures are adapted to age, disease and type of surgery. I N normal children perioperative blood loss leading to administration of allogenic transfusion may be encountered if: the surgical site does not allow easy access to surgical hemostasis, the surgery is performed on highly vascularized tissues that are not easily sutured or cauterized (for example bone elements such as in spinal fusion or correction of craniosynostosis) or the surgery itself induces various disturbances of hemostasis (dilution of factors and induction of fibrinolysis as in cardiac surgery with the use of extracorporeal bypass). The pathology justifying the surgical procedure may also induce various coagulation and/or hemostatic abnormalities. Children suffering from congenital cardiac or liver dis- ease may have thrombocytopenia, abnormal platelet function (congenital heart disease) and/or inadequate amounts of various coagulation factors. Objectif1 Perioperative management of children with congenital coagulation and hemostatic diseases will not be discussed in this review. Developmental aspects of hemostasisAn excellent summary of the developmental physiology of coagulation, based mainly on the extensive work of Maureen Andrew, may be found in a recent review by Kuhle et al. and is summarized in Table I.2 Since maternal coagulation factors do not cross the placental barrier, blood levels measured at birth are the result of fetal synthesis that starts around the fifth week of gestation. Fetal blood becomes clottable around 11 weeks of gestation. Except fetal fibrinogen which has an increased content of sialic acid, all coagulation and inhibitor factors are qualitatively normal at birth, and differ from...

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Predictors of bleeding disorders in children with epistaxis: Value of preoperative tests and clinical screening

Elden

Reinders

Witmer

2012

International Journal of Pediatric Otorhinolaryngology

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The Usefulness of Preoperative Screening for Bleeding Disorders

Cited by 11 publications

References 17 publications

Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

Predictors of bleeding disorders in children with epistaxis: Value of preoperative tests and clinical screening

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