Coagulopathy After Cardiopulmonary Bypass in Jehovah’s Witness Patients: Management of Two Cases Using Fractionated Components and Factor VIIa

@article{Sniecinski2007CoagulopathyAC,
  title={Coagulopathy After Cardiopulmonary Bypass in Jehovah’s Witness Patients: Management of Two Cases Using Fractionated Components and Factor VIIa},
  author={Roman M. Sniecinski and Edward P. Chen and Jerrold H. Levy and Fania Szlam and Kenichi A. Tanaka},
  journal={Anesthesia \& Analgesia},
  year={2007},
  volume={104},
  pages={763-765}
}
BACKGROUND:Changes in the Jehovah's Witness (JW) blood refusal policy now give members the personal choice to accept certain processed fractions of blood, such as factor concentrates and cryoprecipitate. METHODS:Two JW patients undergoing complex aortic surgery who developed severe microvascular bleeding after prolonged use of cardiopulmonary bypass were treated with recombinant activated factor VII, cryoprecipitate, and antithrombin concentrate. RESULTS:Cardiopulmonary bypass-induced… 
Coagulopathy after cardiopulmonary bypass in Jehovah's Witness patients: management of and for the individual rather than the religious institution.
  • Lee Elder
  • Medicine
    Anesthesia and analgesia
  • 2007
TLDR
Lee Elder Jehovah’s Witnesses read with interest the case study by Sniecinski et al. (1) concerning advances in treating patients who refuse certain products made from blood, and is grateful to medical science for advances facilitating safe perioperative care for patients with this preference.
Bleeding and management of coagulopathy.
Recombinant Activated Factor VII (rFVIIa) Treatment of Refractory Bleeding in Cardiac Surgical Patients
TLDR
In patients undergoing cardiac surgery exhibiting refractory bleeding, rFVIIa at a mean dose of 93.7 ± 17 μg/kg improved significantly hemostasis and decreased additional administration of blood products, without any complication related to rF VIIa.
Thresholds for Perioperative Administration of Hemostatic Blood Components and Coagulation Factor Concentrates: An Unmet Medical Need.
TLDR
Improvements in transfusion medicine include better donor testing, more stringent donation criteria, and improvements in both blood quality and blood component characteristics, all of which have contributed to the reduction of blood components-related complications.
Optimal care for patients who are Jehovah's Witnesses.
Harvey Jon Schiller, MD The article by Sniecinski et al. (1) on the treatment of two Jehovah’s Witnesses with coagulopathy presents a laudable approach toward improved communication with patients who
Acute Intracardiac Thrombosis and Pulmonary Thromboembolism After Cardiopulmonary Bypass: A Systematic Review of Reported Cases
TLDR
Case literature is provided to provide an update of case literature of a postbypass hypercoagulable state and further efforts to elucidate pathomechanisms and optimize anticoagulation during CPB and hemostatic interventions after CPB are warranted.
Reduced levels of fibrin (antithrombin I) and antithrombin III underlie coagulopathy following complex cardiac surgery.
Changes in plasma concentrations of fibrinogen and antithrombin after cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). Data from 22 patients who underwent ascending aortic
The old and new: PCCs, VIIa, and long-lasting clotting factors for hemophilia and other bleeding disorders.
  • M. Ragni
  • Medicine, Biology
    Hematology. American Society of Hematology. Education Program
  • 2013
TLDR
Understanding the comparative coagulation studies of established prohemostatic agents, the pharmacokinetics of new long-acting clotting factors, and their correlation with bleeding outcomes will provide opportunities to optimize the hemostatic management of both congenital and acquired he mostatic disorders.
Overcoming Challenges in the Management of Critical Events During Cardiopulmonary Bypass
TLDR
Hematologic abnormalities such as cold agglutinins, antithrombin III deficiency, and hemoglobin S have been discussed with emphasis on managing complications arising from their altered pathophysiology and the need to monitor for organ perfusion in altered physiologic states emanating from hemodilution, hypothermia, and acid–base alterations.
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