TY  - JOUR
A1  - Schmitt, Felix
A1  - Forst, Maik von der
A1  - Miesbach, Wolfgang
A1  - Casu, Sebastian
A1  - Weigand, Markus A.
A1  - Alesci, Rosa Sonja
T1  - Mild acquired factor XIII deficiency and clinical relevance at the ICU - a retrospective analysis
T2  - Clinical and applied thrombosis, hemostasis
N2  - 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.
KW  - hemorrhage
KW  - factor XIII
KW  - critical care
KW  - blood transfusion
KW  - blood coagulation
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62219
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-622195
SN  - 1938-2723
VL  - 27.2021
SP  - 1
EP  - 7
PB  - Sage
CY  - Thousand Oaks, Calif.
ER  -