Title | Viscoelastic Testing and Factor Concentrate Therapy to Reduce Bleeding and Transfusions in the Surgical Separation of Ischiophagus Twins: A Case Report. |
Publication Type | Journal Article |
Year of Publication | 2022 |
Authors | Sarmiento IA, Brenner AC, Haas T, Cushing MM |
Corporate Authors | Contributors |
Journal | A A Pract |
Volume | 16 |
Issue | 6 |
Pagination | e01594 |
Date Published | 2022 Jun 01 |
ISSN | 2575-3126 |
Keywords | Blood Transfusion, Child, Hemorrhage, Humans, Twins, Conjoined |
Abstract | The surgical procedure to separate conjoined twins represents a rare and major challenge. One of the most feared perioperative scenarios is the presence of coagulopathy secondary to bleeding. We present a case of the surgical separation of ischiopagus tetrapus twins using a patient blood management strategy encompassing a tranexamic acid infusion, intraoperative viscoelastic testing, and early fibrinogen supplementation to reduce bleeding and transfusions. This approach allowed early detection and treatment of acquired hypofibrinogenemia, which resulted in minimal exposure to blood products. This case reflects the increasing clinical interest in early avoidance of fibrinogen deficiency in complex noncardiac pediatric surgery. |
DOI | 10.1213/XAA.0000000000001594 |
Alternate Journal | A A Pract |
PubMed ID | 35732023 |
Related Faculty:
Melissa Cushing, M.D.