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Anesth Analg 2009; 108:434-436
© 2009 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31818d3f48
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CARDIOVASCULAR ANESTHESIOLOGY

Thromboemboli, Acute Right Heart Failure and Disseminated Intravascular Coagulation After Intraoperative Application of a Topical Hemostatic Matrix

Marla B. Ferschl, MD, and Mark D. Rollins, MD, PhD

From the Department of Anesthesia and Perioperative Care, University of California, San Francisco, California.

Address correspondence to Mark D. Rollins, MD, PhD, 513 Parnassus Ave., S-455, Box 0464, San Francisco, CA 94143-0464. Address e-mail to rollinsm{at}anesthesia.ucsf.edu.

Abstract

Topical hemostatic agents are frequently used in spine surgeries to control or reduce bleeding. Although there are a number of commercially available products, at our institution, an absorbable gelatin powder (SurgifoamTM) is mixed with bovine thrombin and used for this purpose. We report the case of a patient undergoing a posterior spinal fusion for scoliosis who developed acute right heart failure, cardiac arrest, and disseminated intravascular coagulation after probable intravascular hemostatic agent-induced emboli. Clinicians need to be aware of this potentially deadly complication associated with topical hemostatic agents.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2009 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2009 by the International Anesthesia Research Society.