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3.10.1 - Disorders of Haemostasis in Intensive Care

from Section 3.10 - Haematological and Oncological Disorders

Published online by Cambridge University Press:  27 July 2023

Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Abnormal coagulation results are not uncommon in critically unwell patients.

  2. 2. In vitro tests do not always fully correlate with events in vivo, and so all results should be interpreted with reference to the clinical history, particularly any bleeding or thrombosis history.

  3. 3. The clinical severity of disseminated intravascular coagulation may not necessarily correlate with abnormalities seen in the laboratory tests, and an individualised plan should be made depending on the clinical scenario.

  4. 4. Patients with cirrhosis are at risk of thrombosis, as well as bleeding.

  5. 5. In a stable, non-bleeding patient with liver disease, there is no need for ‘prophylactic’ blood components unless procedures are required.

Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
, pp. 327 - 330
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Baker, P, Platton, S, Gibson, C, et al.; British Society for Haematology, Haemostasis and Thrombosis Task Force. Guidelines on the laboratory aspects of assays used in haemostasis and thrombosis. Br J Haematol 2020;191:347–62.CrossRefGoogle ScholarPubMed
Curry, NS, Davenport, R, Pavord, S, et al. The use of viscoelastic haemostatic assays in the management of major bleeding: a British Society for Haematology Guideline. Br J Haematol 2018;182:789806.CrossRefGoogle ScholarPubMed
Levi, M, Toh, CH, Thachil, J, Watson, HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol 2009;145:2433.CrossRefGoogle ScholarPubMed
Thachil, J, Hill, Q (eds). Haematology in Critical Care: A Practical Handbook. Chichester: John Wiley & Sons; 2014.CrossRefGoogle Scholar

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