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Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis

Acquired FXIII deficiency is a relevant complication in the perioperative setting; however, we still have little evidence about the incidence and management of this rarely isolated coagulopathy. This study aims to help find the right value for the substitution of patients with an acquired mild FXIII...

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Autores principales: Schmitt, Felix Carl Fabian, von der Forst, Maik, Miesbach, Wolfgang, Casu, Sebastian, Weigand, Markus Alexander, Alesci, Sonja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299891/
https://www.ncbi.nlm.nih.gov/pubmed/34286623
http://dx.doi.org/10.1177/10760296211024741
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author Schmitt, Felix Carl Fabian
von der Forst, Maik
Miesbach, Wolfgang
Casu, Sebastian
Weigand, Markus Alexander
Alesci, Sonja
author_facet Schmitt, Felix Carl Fabian
von der Forst, Maik
Miesbach, Wolfgang
Casu, Sebastian
Weigand, Markus Alexander
Alesci, Sonja
author_sort Schmitt, Felix Carl Fabian
collection PubMed
description Acquired FXIII deficiency is a relevant complication in the perioperative setting; however, we still have little evidence about the incidence and management of this rarely isolated coagulopathy. This study aims to help find the right value for the substitution of patients with an acquired mild FXIII deficiency. In this retrospective single-center cohort study, we enrolled critically ill patients with mild acquired FXIII deficiency (>5% and ≤70%) and compared clinical and laboratory parameters, as well as pro-coagulatory treatments. The results of the present analysis of 104 patients support the clinical relevance of FXIII activity out of the normal range. Patients with lower FXIII levels, beginning at <60%, had lower minimum and maximum hemoglobin values, corresponding to the finding that patients with a minimum FXIII activity of <50% needed significantly more packed red blood cells. FXIII activity correlated significantly with general coagulation markers such as prothrombin time, activated partial thromboplastin time, and fibrinogen. Nevertheless, comparing the groups with a cut-off of 50%, the amount of fresh frozen plasma, thrombocytes, PPSB, AT-III, and fibrinogen given did not differ. These results indicate that a mild FXIII deficiency occurring at any point of intensive care unit stay is also probably relevant for the total need of packed red blood cells, independent of pro-coagulatory management. In alignment with the ESAIC guidelines, the measurement of FXIII in critically ill patients with the risk of bleeding and early management, with the substitution of FXIII at levels <50%-60%, could be suggested.
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spelling pubmed-82998912021-08-06 Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis Schmitt, Felix Carl Fabian von der Forst, Maik Miesbach, Wolfgang Casu, Sebastian Weigand, Markus Alexander Alesci, Sonja Clin Appl Thromb Hemost Original Manuscript Acquired FXIII deficiency is a relevant complication in the perioperative setting; however, we still have little evidence about the incidence and management of this rarely isolated coagulopathy. This study aims to help find the right value for the substitution of patients with an acquired mild FXIII deficiency. In this retrospective single-center cohort study, we enrolled critically ill patients with mild acquired FXIII deficiency (>5% and ≤70%) and compared clinical and laboratory parameters, as well as pro-coagulatory treatments. The results of the present analysis of 104 patients support the clinical relevance of FXIII activity out of the normal range. Patients with lower FXIII levels, beginning at <60%, had lower minimum and maximum hemoglobin values, corresponding to the finding that patients with a minimum FXIII activity of <50% needed significantly more packed red blood cells. FXIII activity correlated significantly with general coagulation markers such as prothrombin time, activated partial thromboplastin time, and fibrinogen. Nevertheless, comparing the groups with a cut-off of 50%, the amount of fresh frozen plasma, thrombocytes, PPSB, AT-III, and fibrinogen given did not differ. These results indicate that a mild FXIII deficiency occurring at any point of intensive care unit stay is also probably relevant for the total need of packed red blood cells, independent of pro-coagulatory management. In alignment with the ESAIC guidelines, the measurement of FXIII in critically ill patients with the risk of bleeding and early management, with the substitution of FXIII at levels <50%-60%, could be suggested. SAGE Publications 2021-07-21 /pmc/articles/PMC8299891/ /pubmed/34286623 http://dx.doi.org/10.1177/10760296211024741 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Manuscript
Schmitt, Felix Carl Fabian
von der Forst, Maik
Miesbach, Wolfgang
Casu, Sebastian
Weigand, Markus Alexander
Alesci, Sonja
Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis
title Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis
title_full Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis
title_fullStr Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis
title_full_unstemmed Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis
title_short Mild Acquired Factor XIII Deficiency and Clinical Relevance at the ICU—A Retrospective Analysis
title_sort mild acquired factor xiii deficiency and clinical relevance at the icu—a retrospective analysis
topic Original Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299891/
https://www.ncbi.nlm.nih.gov/pubmed/34286623
http://dx.doi.org/10.1177/10760296211024741
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