Korean J Anesthesiol.  2003 Jul;45(1):157-160. 10.4097/kjae.2003.45.1.157.

Anesthetic Management for the Open Heart Surgery in a Patient with Cold Agglutinin Disease: Case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Anesthesiology and Pain Medicine, Hallym University Hospital, Seoul, Korea. noninvasive@hanmail.net

Abstract

Cold agglutinins are serum autoantibodies activated at reduced body temperatures to produce red blood cell agglutination and hemolysis. They are commonly found in the sera of healthy people but rarely become clinically important, because most of them exist at very low titers, and exert their greatest effect at low temperatures. By contrast, during open heart surgery, systemic hypothermia and cold cardioplegia are commonly used, and cold agglutinins can be a appreciable threat. This report describes a patient with documented cold agglutinins who successfully underwent atrial septal defect closure and patent ductus arteriosus ligation by normothermic cardiopulmonary bypass in an effort to avoid the adverse effects of hypothermia.

Keyword

cold agglutinin; cardiopulmonary bypass; normothermia

MeSH Terms

Agglutination
Agglutinins
Anemia, Hemolytic, Autoimmune*
Autoantibodies
Body Temperature
Cardiopulmonary Bypass
Ductus Arteriosus, Patent
Erythrocytes
Heart Arrest, Induced
Heart Septal Defects, Atrial
Heart*
Hemolysis
Humans
Hypothermia
Ligation
Thoracic Surgery*
Agglutinins
Autoantibodies
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