PTT Reversal

[MikeyBoy]

Figured I'd see if any of you braniacs can shed some light onto this one;

 

I was talking to a classmate on my way home today- She's on her surgery rotation and said a surgeon put a woman on prednisone during preop to lower her PTT.

 

I've heard of protamine to reverse Heparin before...but a corticosteriod? Huh!?

 

...After a google search, I've found case studies that say Corticosteriods may help increase Factor VIII levels, therefore affecting the Intrinsic pathway. I wasn't able to find much on the matter, so I'm not too sure what to believe.

 

Has anyone seen/used this before ? Or did I forget basic medicine after being at Family Medicine for the last 2 months :;;D:

[cinntsp]

Corticosteroids raise both intrinsic and extrinsic factor levels, reducing APTT.

[andersenpa]

A surgical pt w/a prolonged PTT probably needs heme consult.

Steroids preop for coagulopathy- no not basic medicine.

 

PTT prolongation (if isolated) is either the contact activation component (not a bleeding risk) or a significant factor deficiency (hemophilia etc).

[MikeyBoy]

Thanks Andersen!