Özgür MEHTAP, Tülay ÇARDAKÖZÜ, Zeki TALAS, Burhan KÜÇÜK, Muhip KANKO

HİPERFİBRİNOLİZİS; KARDİOPULMONER BYPASS SONRASI GELİŞEN CİDDİ ve MORTAL BİR KOMPLİKASYON: OLGU SUNUMU

Kanama, kardiyopulmoner bypass (CPB) kullanılarak yapılan kalp cerrahisinin en önemli komplikasyonlarından biridir. Her türlü tıbbi ve cerrahi tedaviye rağmen baypas sonrası kanama hala ciddi bir problemdir. Ağır travmada olduğu gibi hipotermi, asidoz, hipovolemi, hipoperfüzyon nedeni ile CPB da pıhtılaşma sürecinin bozulmasına neden olur. Majör travma ve majör cerrahi sonrasında gelişebilen Hiperfibrinoliz (HF), yaşamı tehdit eden ciddi kanama bozukluğuna sebep olabilir. Kalp cerrahisi sonrası HF görülme sıklığı % 15 ile % 20 arasında tahmin edilmektedir. HF tanısında altın standart trombelastografi veya trombelastometridir. Hiperfibrinoliz tedavisinde kan ürünleri ve traneksemik asit kullanılır. HFtedavisinde traneksemik aside alternatif olarak kullanılabilen ajanlar aprotinin ve epsilon aminokaproik asittir. Kalp cerrahisi sonrası gelişen kanama problemlerinde HF tanısı gözden kaçabilir. Bu nedenle erken teşhis ve tedavinin hayat kurtarıcı olduğu bu nadirpatolojiyi paylaşmak istedik.

HYPERFIBRINOLYSIS; A SERIOUS and MORTAL COMPLICATION AFTER CARDIOPULMONARY BYPASSES: CASE REPORT

Hemorrhage is one of the major complications of cardiac surgery when using cardiopulmonary bypass (CPB). Despite all kinds of medical and surgicaltreatment, post bypass bleeding is still a serious problem. Hypothermia, acidosis, hypovolemia, and hypoperfusion lead to disruption of the coagulationprocess in severe trauma as well as in CPB. Hyperfibrinolysis (HF) is a life-threatening bleeding disorder in major trauma patients. The incidence ofHF has been estimated in the range of 15% to 20%. The gold standard for the detection of HF is thrombelastography or thromboelastometry. Bloodproducts and tranexamic acid are used in the treatment of hyperfibrinolysis. The agents that can be used as an alternative to tranexamic acid in HFtreatment are aprotinin and epsilon aminocaproic acid.Early diagnosis and treatment of HF are life-saving. For this purpose, we wanted to share this rare pathology.

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