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Anaesthetic considerations for patients with antiphospholipid syndrome undergoing non-cardiac surgery

Authors
  • Kim, Jae Won
  • Kim, Tae Woo
  • Ryu, Keon Hee
  • Park, Sun Gyoo
  • Jeong, Chang Young
  • Park, Dong Ho
Type
Published Article
Journal
The Journal of International Medical Research
Publisher
SAGE Publications
Publication Date
Jan 15, 2020
Volume
48
Issue
1
Identifiers
DOI: 10.1177/0300060519896889
PMID: 31937174
PMCID: PMC7113712
Source
PubMed Central
Keywords
License
Unknown

Abstract

Antiphospholipid syndrome (APS) is an acquired thrombotic autoimmune disorder that is clinically characterized by the development of thrombosis and obstetric morbidities in patients with antiphospholipid antibodies. Due to hypercoagulability, the focus of management is anticoagulation for the prevention of thrombosis and its recurrence. When such patients undergo surgery, however, the underlying risk of thrombosis increases as a result of anticoagulant withdrawal, immobilization, and/or intimal injury. Conversely, there is also an increased risk of bleeding due to thrombocytopaenia, possible disseminated intravascular coagulation, or progression to catastrophic APS, as a result of excessive anticoagulation, surgery, and infection. Measures for appropriate perioperative anticoagulation are discussed in this review, as well as anaesthetic considerations for preventing perioperative complications in patients with APS undergoing non-cardiac surgery.

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