Which of the following is incorrect about managing a patient having been given plasminogen activators and have sudden emergencies that require surgical intervention?
A. Discontinuing plasminogen activator infusion, replenishing plasma fibrinogen with either whole plasma or cryoprecipitate
B. Providing fresh platelets to correct a prolonged bleeding time
C. If the plasminogen activator is not yet cleared from the circulation, fibrinolytic activity can be neutralized by infusion of fibrinolytic inhibitors such as epsilon-aminocaproic acid or aprotinin.
D. Plasma fibrinogen concentration recovers spontaneously within 2 hours after discontinuing plasminogen activator treatment, so if possible, delay the surgery for this duration.
Answer: D
Plasma fibrinogen concentration does not recover spontaneously until 24 to 36 hours after discontinuing plasminogen activator treatment. This pertains for both the long- and short-acting agents and also for those that induce a potent or a mild fibrinolytic state.
Reference
Hoffman: Hematology: Basic Principles and Practice, 3rd ed., Copyright ? 2000 Churchill Livingstone, Inc.