This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Fontana, M. Articles by Spertini, F. Search for Related Content PubMed PubMed Citation Articles by Fontana, M. Articles by Spertini, F. Pubmed/NCBI databases Medline Plus Health Information Aortic Aneurysm Social Bookmarking                         What's this?

Prevention of cryoprecipitation during cardiopulmonary bypass in a patient with HIV-HCV co-infections

Division of Immunology and Allergy, CHUV, 1011 Lausanne, Switzerland

Patrick Ruchat

Judith Horisberger

Division of Cardiovascular Surgery, CHUV, 1011 Lausanne, Switzerland

Vincent Aubert

Carole Mayor

François Spertini

Division of Immunology and Allergy, CHUV, 1011 Lausanne, Switzerland

Background: There are no guidelines for the management of patients with cryoglobulins during cardiopulmonary bypass (CPB) necessitating core hypothermia. Objective: To evaluate a simple, pragmatic protocol of in vitro temperature-dependent cryoprecipitation of serum in patients with cryoglobulinemia before elective cardiac surgery with CPB. Methods: A 44-year-old female patient was known for chronic hepatitis C and type III cryoglobulinemia. Elective surgery was planned for an aortic arch aneurysm. A differential serum cryoprecipitation profile was established in vitro prior to surgery. Results: Whereas, at temperatures 15°C, cryoglobulin levels were 0.112 g/L (normal value <0.05 g/L), at 20°C and above, the precipitate was 0.016 g/L. Accordingly, surgery was performed without any cryoglobulin-related complications at an extracorporeal circulation temperature of 22-24°C, to minimise the risk of cryoprecipitation. Conclusion: In elective cases of surgery with CPB and hypothermia, temperature-dependent differential serum cryoprecipitation profile may be an easy and efficient way to assess a safe peroperative level of temperature to avoid complications due to cryoglobulins, without enhancing the patient's tissue ischemia risks.

References

• Kotsuka Y, Nakejima J, Mayairi T et al. Coronary artery bypass grafting in a patient with cryoglobulinemia . J Cardiovasc Surg 1991; 32: 53-55 .[Medline] [Order article via Infotrieve]
• Murata S, Tabayashi K, Shinozaki S, Shimizu M, Ito T, Konnai T. Successful cardiac surgery using normothermic cardiopulmonary bypass in an elderly patient with cryoglobulinemia . Nippon Kyobu Geka Gakkai Zasshi 1995; 43: 65-68 .[Medline] [Order article via Infotrieve]
• Osada T, Kawachi K, Uchino T, Hirayama T, Ishimaru S, Furukawa K. A successful case of thoracic aortic aneurysm with mixed cryoglobulinemia . Nippon Kyobu Geka Gakkai Zasshi 1992; 40: 1100-1104 .[Medline] [Order article via Infotrieve]
• Yatsu Y, Kimura F, Muraoka M, Tsubo T, Ishihara H, Matsuki A. Perioperative management of a patient with cryoglobulinemia for open heart surgery . Masui 1998; 47: 53-56 .[Medline] [Order article via Infotrieve]
• Brouet JC, Clauvel JP, Danon F, Klein M, Seligmann M. Biologic and clinical significance of cryoglobulins. A report of 86 cases . Am J Med 1974; 57: 775-788 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Ferri C, Zignego A, Pileri S. Cryoglobulins . J Clin Pathol 2002; 55: 4-13 .[Abstract/Free Full Text]
• Antonescu C, Mayerat C, Mantegani A, Frei PC, Spertini F, Tissot JD. Hepatitis C virus (HCV) infection: serum rheumatoid factor activity and HCV genotype correlate with cryoglobulin clonality . Blood 1998; 92: 3486-3487 .[Free Full Text]

Perfusion, Vol. 21, No. 5, 263-265 (2006)
DOI: 10.1177/0267659106073977


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Fontana, M. Articles by Spertini, F. Search for Related Content PubMed PubMed Citation Articles by Fontana, M. Articles by Spertini, F. Pubmed/NCBI databases Medline Plus Health Information Aortic Aneurysm Social Bookmarking                         What's this?