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Cardiopulmonary bypass in patients with cold agglutinins Locked Topic 1 C. Forum From the CBBS Editors:Several of us at institutions performing cardiac bypass procedures note that our transfusion services do not screen for cold autoantibodies in patients pre-operatively. In one study, even when screening was performed by the transfusion service, most of the time the surgical team did not modify cardiopulmonary bypass in response to the presence of a cold autoantibody (1). In this series, the rate of adverse events was low in patients with cold agglutinins identified by screening, whether or not cardiac bypass/cold cardioplegia was modified. If a cold agglutinin causes actual clumping in the cardiopulmonary bypass circuit, the temperature of the cardioplegia can be adjusted. In the rare patient with known symptomatic cold agglutinin disease or who has a procedure aborted due cold-associated clumping, further investigation with thermal amplitude testing and cold agglutinin titers may be useful to confirm the antibody’s clinical significance (2). 1. Jain et al. Seek and you shall find – but then what do you do? Cold agglutinin screening before cardiac surgery. Transfusion Med Reviews 2013 ( 2. Barbara et al. Cold agglutinins in patients undergoing cardiac surgery requiring cardiopulmonary bypass. J. Thoracic and Cardiovasc Surgery 2013 (
by C. Forum
Wednesday, August 24, 2016
Transfusing Wisely Locked Topic 0 D. Fipps The video uplink on the posting did not create a hyoerlink above.
by D. Fipps
Thursday, March 3, 2016
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