Cardiopulmonary bypass in a child with severe Factor XII deficiency. (April 2022)

• Record Type: Journal Article
• Authors: Shrimpton, Nicole; Patukale, Aditya; Rane, Mark; Barbaro, Pasquale; Alphonso, Nelson; Venugopal, Prem
• Is Part Of: Perfusion. Volume 37:Number 3(2022)
• Page Start: 316
• Page End: 320
• Publication Date: 2022-04
• Subjects: Factor XII -- prolonged activated partial thromboplastin time -- cardiopulmonary bypass -- activated clotting time -- paediatric; Perfusion (Physiology) -- Periodicals; Blood -- Circulation, Artificial -- Periodicals; Heart -- Surgery -- Periodicals; Extracorporeal Circulation -- Periodicals; Perfusion -- Periodicals; Circulation extracorporelle -- Périodiques; Perfusion -- Périodiques; 617.41
• DOI: 10.1177/0267659121999305
• Languages: English
• ISSNs: 0267-6591

Abstract

Factor XII (FXII) deficiency presents as a prolonged activated partial thromboplastin time (aPTT) but is not associated with clinically significant bleeding. Activated clotting time (ACT) is used routinely to monitor anticoagulation with unfractionated heparin in patients undergoing cardiopulmonary bypass (CPB). The coagulation activator reagents in most ACT tests are dependent on adequate FXII concentrations to initiate contact factor coagulation pathways. We report the case of a 14.7 kg girl undergoing CPB with a pre-admission FXII concentration of <1% and aPTT >200 seconds. The child was transfused with fresh-frozen plasma to replenish FXII, allowing safe ACT monitoring of heparin anticoagulation throughout CPB.