Factor XIII Deficiency and Thrombocytopenia Are Frequent Modulators of Postoperative Clot Firmness in a Surgical Intensive Care Unit

Transfusion Medicine and Hemotherapy : Offizielles Organ Der Deutschen Gesellschaft Fur̈ Transfusionsmedizin Und Immunham̈atologie
Sarah von RappardWolfgang C Korte

Abstract

Fibrinogen and factor XIII (FXIII) have been shown to critically influence clot firmness in the intraoperative setting and thus likely influence intraoperative bleeding. We were interested to identify potential modulators of postoperative clot firmness in a tertiary care hospital surgical intensive care unit setting, independent of their clinical course during surgery. 272 day-shift consecutive patients were evaluated for whole blood clot firmness evaluated by the ROTEM® EXTEM thrombelastometric assay and various potential modulators of clot firmness upon arrival at the surgical intensive care unit (SICU). Maximum clot firmness on the SICU was found to be independently influenced by the amount of colloids given during surgery as well as by platelet count, fibrinogen concentration, and FXIII activity at the time of SICU admission. In patients with lowest clot firmness, FXIII activity was the most important independent modulator of clot firmness; in patients with the highest clot firmness, platelet count and fibrinogen concentration were the most important modulators of clot firmness. Deficiencies (i.e., results below normal range) of these modulators of clot firmness were most prevalent for FXIII (activity < 70%: 45% of cases), ...Continue Reading

Citations

Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Mar 17, 2020·Journal of Thrombosis and Haemostasis : JTH·Christian HaslingerRoland Zimmermann
Jul 15, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ahmed El DamatyHeidi Baechli
Aug 28, 2020·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Fernando A ChuliberMarta E Martinuzzo
Apr 15, 2021·Thrombosis and Haemostasis·Patricia DuqueCristina Pascual
Jul 22, 2021·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Felix Carl Fabian SchmittSonja Alesci

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