Kleber Christian, Sablotzki Armin, Casu Sebastian, Olivieri Martin, Thoms Kai-Martin, Horter Johannes, Schmitt Felix C F, Birschmann Ingvild, Fries Dietmar, Maegele Marc, Schöchl Herbert, Wilhelmi Michaela
Medical Center, Orthopaedic, Trauma and Plastic Surgery Clinic, University of Leipzig, Leipzig, Germany.
The Clinics of Anesthesiology, Critical Care and Pain Therapy, Klinikum St. Georg GmbH Leipzig, Delitzscher Strasse141, 04129, Leipzig, Germany.
Crit Care. 2022 Mar 24;26(1):69. doi: 10.1186/s13054-022-03940-2.
Factor XIII (FXIII) is a protein involved in blood clot stabilisation which also plays an important role in processes including trauma, wound healing, tissue repair, pregnancy, and even bone metabolism. Following surgery, low FXIII levels have been observed in patients with peri-operative blood loss and FXIII administration in those patients was associated with reduced blood transfusions. Furthermore, in patients with low FXIII levels, FXIII supplementation reduced the incidence of post-operative complications including disturbed wound healing. Increasing awareness of potentially low FXIII levels in specific patient populations could help identify patients with acquired FXIII deficiency; although opinions and protocols vary, a cut-off for FXIII activity of ~ 60-70% may be appropriate to diagnose acquired FXIII deficiency and guide supplementation. This narrative review discusses altered FXIII levels in trauma, surgery and wound healing, diagnostic approaches to detect FXIII deficiency and clinical guidance for the treatment of acquired FXIII deficiency.
因子 XIII（FXIII）是一种参与血液凝块稳定的蛋白质，在创伤、伤口愈合、组织修复、妊娠甚至骨代谢等过程中也发挥着重要作用。手术后，围手术期失血患者中观察到 FXIII 水平较低，对这些患者给予 FXIII 与减少输血相关。此外，在 FXIII 水平较低的患者中，补充 FXIII 可降低包括伤口愈合不良在内的术后并发症发生率。提高对特定患者群体中潜在低 FXIII 水平的认识有助于识别获得性 FXIII 缺乏症患者；尽管观点和方案各不相同，但 FXIII 活性约为 60-70% 的临界值可能适用于诊断获得性 FXIII 缺乏症并指导补充治疗。本叙述性综述讨论了创伤、手术和伤口愈合中 FXIII 水平的变化、检测 FXIII 缺乏症的诊断方法以及获得性 FXIII 缺乏症治疗的临床指导。
