Cold agglutinins complicating repair of aortic dissection using cardiopulmonary bypass and hypothermic circulatory arrest: case report and review
Cold agglutinins complicating repair of aortic dissection using cardiopulmonary bypass and hypothermic circulatory arrest: case report and review
复制标题
冷凝集素使体外循环和低温停循环主动脉夹层修复复杂化：病例报告和综述
DOI：
10.1191/0267659102pf601cr
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
ML Hyder
中科院分区：
文献类型：
--
作者：
JW Hoffman;TB Gilbert;ML Hyder
冷凝集素（CA）是在凝集的热振幅或低于凝集的热振幅的温度下与红细胞（RBC）可逆地反应的自身抗体。这导致血液粘度增加和RBC淤积，并可能损害对各种器官系统的灌注。虽然这种现象在临床竞技场中很少出现，但由于常规使用低温保存器官和减少全身代谢，CA的发生率在心脏手术中显著增加。一旦激活，CA与微血管闭塞、溶血、补体结合、肾和肝功能不全、脑损伤和心肌梗死相关。在围手术期进行适当的筛查、检测和处理，可以最大限度地减少CA的并发症。一个典型的情况下进行了描述，有关CA的问题进行了审查。
Cold agglutinins (CAs) are autoantibodies that react reversibly with red blood cells (RBCs) at temperatures of, or below, the thermal amplitude for agglutination. This results in increased blood viscosity and sludging of RBC, and may impair perfusion to various organ systems. Although this phenomenon appears rarely in the clinical arena, the incidence of CA is increased substantially in cardiac surgery due to the routine use of hypothermia for organ preservation and systemic metabolic reduction. Once activated, CA are associated with microvascular occlusion, hemolysis, complement fixation, renal and hepatic insufficiency, cerebral insult, and myocardial infarction. Complications from CA may be minimized with appropriate screening, detection, and management in the perioperative period. A prototypical case is described, and pertinent issues regarding CA are reviewed.