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Intrakranielle Vitamin-K-Mangel-Blutung trotz oraler Vitamin-K-Gabe bei einem Säugling

Auch eine anästhesiologische Herausforderung

Intracranial hemorrhage secondary to vitamin K deficiency in an infant despite oral vitamin K prophylaxis

Also a challenge for the anesthesiologist

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Zusammenfassung

Wir berichten über den Fall eines 6 Wochen alten Säuglings, der, trotz erfolgter oraler Vitamin-K-Prophylaxe und ansonsten normaler Entwicklung, eine schwere intrazerebrale und subdurale Blutung mit Indikation zur operativen Entlastung erlitt. Das in der westlichen Welt seltene Krankheitsbild der durch Vitamin-K-Mangel bedingten intrakraniellen Blutung wird erstmals in der anästhesiologischen Literatur dargestellt; die Therapie und das interdisziplinäre Vorgehen werden beschrieben. Auf übliche Empfehlungen zur Prophylaxe sowie spezielle Risikofaktoren wird eingegangen.

Abstract

This article presents the case of a 6-week-old infant who, despite oral vitamin K prophylaxis and otherwise normal developmental progress, suffered a severe intracerebral and subdural hemorrhage, which required surgical evacuation. The interdisciplinary approach is described with emphasis on the management of hemostasis. Furthermore, the clinical picture of intracranial bleeding due to vitamin K deficiency, which is nowadays rare in the Western World, is described in the anesthesiology literature for the first time. The usual recommendations regarding prophylaxis as well as certain risk factors are presented.

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Authors and Affiliations

  1. Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland

    S. Ackermann DESA &  J. Schimpf

  2. I. Klinik für Kinder und Jugendliche, Klinikum Augsburg, Augsburg, Deutschland

    M. Richter

Authors
  1. S. Ackermann DESA
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  2. J. Schimpf
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  3. M. Richter
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Correspondence to S. Ackermann DESA.

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Interessenkonflikt

S. Ackermann gibt an, von der Fa. CSL Behring Sponsoring für eine 2‑tägige Fortbildungsveranstaltung angenommen zu haben. J. Schimpf und M. Richter geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Fall von nichtmündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Ackermann, S., Schimpf, J. & Richter, M. Intrakranielle Vitamin-K-Mangel-Blutung trotz oraler Vitamin-K-Gabe bei einem Säugling. Anaesthesist 66, 598–603 (2017). https://doi.org/10.1007/s00101-017-0307-3

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  • DOI: https://doi.org/10.1007/s00101-017-0307-3

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