Perioperative management of a pediatric patient with suspected type 1 von Willebrand disease undergoing tonsillectomy: a case report.
Confact F®
Plasma-derived factor VIII concentrate
VWD
VWF
von Willebrand disease
von Willebrand factor
Journal
JA clinical reports
ISSN: 2363-9024
Titre abrégé: JA Clin Rep
Pays: Germany
ID NLM: 101682121
Informations de publication
Date de publication:
27 Aug 2019
27 Aug 2019
Historique:
received:
16
08
2019
accepted:
22
08
2019
entrez:
7
2
2020
pubmed:
7
2
2020
medline:
7
2
2020
Statut:
epublish
Résumé
Von Willebrand disease (VWD) is the most common inherited bleeding disorder in humans. Coagulopathies such as VWD are evidently risk factors for post-surgical bleeding. Perioperative management of patients with VWD remains controversial and is a major clinical concern. A 5-year-old girl was scheduled for tonsillectomy under general anesthesia. Preoperative laboratory tests revealed prolongation of activated partial thromboplastin time and a mild decrease in von Willebrand factor (VWF) activity. Prophylactic administration of desmopressin or VWF was not performed. During tonsillectomy, oozing from the surgical wound was uncontrollable by conventional hemostasis techniques, but complete hemostasis was ensured by plasma-derived coagulation factor VIII concentrate containing VWF. Pediatric patients with mild abnormalities in preoperative laboratory tests may have coagulopathies. Prophylactic intervention and/or the preparation of a sufficient amount of coagulation factor VIII concentrate containing VWF may be required in patients suspected of having VWD or with mild VWF deficiency.
Sections du résumé
BACKGROUND
BACKGROUND
Von Willebrand disease (VWD) is the most common inherited bleeding disorder in humans. Coagulopathies such as VWD are evidently risk factors for post-surgical bleeding. Perioperative management of patients with VWD remains controversial and is a major clinical concern.
CASE PRESENTATION
METHODS
A 5-year-old girl was scheduled for tonsillectomy under general anesthesia. Preoperative laboratory tests revealed prolongation of activated partial thromboplastin time and a mild decrease in von Willebrand factor (VWF) activity. Prophylactic administration of desmopressin or VWF was not performed. During tonsillectomy, oozing from the surgical wound was uncontrollable by conventional hemostasis techniques, but complete hemostasis was ensured by plasma-derived coagulation factor VIII concentrate containing VWF.
CONCLUSION
CONCLUSIONS
Pediatric patients with mild abnormalities in preoperative laboratory tests may have coagulopathies. Prophylactic intervention and/or the preparation of a sufficient amount of coagulation factor VIII concentrate containing VWF may be required in patients suspected of having VWD or with mild VWF deficiency.
Identifiants
pubmed: 32026008
doi: 10.1186/s40981-019-0276-4
pii: 10.1186/s40981-019-0276-4
pmc: PMC6966984
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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