ETIOLOGY AND TREATMENT OF ACQUIRED COAGULOPATHIES IN THE CRITICALLY ILL ADULT AND CHILD
Section snippets
CONSUMPTIVE COAGULOPATHIES
These disorders are characterized by the abnormal consumption of clotting factors, and at times platelets, with bleeding occurring as a consequence of this consumption. The classic example of this type of disorder is disseminated intravascular coagulation (DIC), because clotting factors, platelets, and red cells are consumed in this entity. Other examples of consumptive processes in which only some elements are consumed are fibrin(ogen)olysis (fibrinogen); thrombotic thrombocytopenic purpura
IATROGENIC COAGULOPATHIES
Iatrogenic disorders result from prior or ongoing medical intervention. The clearest example of this is an anticoagulant overdose with heparin or warfarin. Such an overdose can occur if concurrent medical therapy results in an enhanced action of the drug through an effect on drug clearance or metabolism. Clinically significant coagulopathies can also occur by drug activation of fibrinolysis20 or through the wash-out of clotting factors and platelets in the course of a patient receiving multiple
CONCLUSION
Bleeding is an uncommon primary, though common secondary, cause of morbidity in critically ill patients. Except in those patients known to have an underlying inherited coagulopathy (e.g., hemophilia), the cause of bleeding in these patients is generally a secondary manifestation of their underlying disease process. As such, it is often multifactorial and the physician caring for these patients must efficiently and accurately determine the cause(s) of the bleeding in order to provide appropriate
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2001, Anesthesiology Clinics of North AmericaCitation Excerpt :The prophylactic use of fresh frozen plasma or platelets is not recommended in the massively transfused patient.2 The transfusion of more than one blood volume is sufficient to dilute clotting factors to 30% normal, which is considered the minimal amount necessary for adequate coagulation.85,95 The need for fresh frozen plasma is nearly zero when transfusing exclusively with whole blood but likely when transfusing with packed red blood cells that contain minimal plasma.
Perioperative anticoagulation and thrombolysis in congenital and acquired coagulopathies
1999, Anesthesiology Clinics of North AmericaPrevalence and Impact of Lupus Anticoagulant in Patients Receiving Extracorporeal Membrane Oxygenation
2023, Clinical and Applied Thrombosis/Hemostasis
Address reprint requests to Robert I. Parker, MD, Department of Pediatrics, HSC T-11 Room 060, S.U.N.Y. at Stony Brook, Stony Brook, NY 11794–8111
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From the Department of Pediatrics, Division of Hematology/Oncology, State University of New York at Stony Brook, Stony Brook, New York