Objectives: To provide a concise review of the medical management of coagulopathy related to hepatic insufficiency. This review will focus on prevention and management of bleeding episodes in patients with hepatic insufficiency. The treatment and prevention of thromboembolic complications will also be addressed. Data Sources: Electronic search of PubMed database using relevant search terms, including hepatic coagulopathy, hemorrhage, liver diseases, blood coagulation disorders, blood transfusion, disseminated intravascular coagulation, and liver failure. Subsequent searches were done on specific issues. Study Selection: Articles considered include original articles, review articles, guidelines, consensus statements, and conference proceedings. Data Extraction: A detailed review of scientific, peer-reviewed data was performed. Relevant publications were included and summarized. Data Synthesis: Available evidence is used to describe and summarize currently available tests of hemostasis, utilization of prohemostatic agents, transfusion strategies, use of prophylactic anticoagulation and treatment of thromboembolic events in patients with hepatic insufficiency. Conclusions: Dynamic changes to hemostasis occur in patients with hepatic insufficiency. Routine laboratory tests of hemostasis are unable to reflect these changes and should not be used exclusively to evaluate coagulopathy. Newer testing methods are available to provide data on the entire spectrum of clotting but are not validated in acute bleeding. Prohemostatic agents utilized to prevent bleeding should only be considered when the risk of bleeding outweighs the risk of thrombotic complications. Restrictive transfusion strategies may avoid exacerbation of acute bleeding. Prophylaxis against and treatment of thromboembolic events are necessary and should consider patient specific factors. Copyright (C) by 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2a8TdNY
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Champion EMS is currently seeking a Communications Center Manager. Champion EMS is based out of Longview, Texas, serving the East Texas area...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
The name of the second author of this article was incorrectly presented as "Riccardo Scarpa Cosimo" this should have been "Co...
-
Abstract Given shifting sex work criminalization and enforcement in Canada, this study examined worrying about workplace inspections by au...
-
Abstract Introduction In recent years, platelet-rich plasma (PRP) has emerged as a promising autologous biological treatment modality fo...
-
Abstract Background Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation ...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
While the psychiatric disorders are conditions frequently encountered in hospitalized patients, there are little or no data regarding the ch...
-
No abstract available from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2Tlj4K7
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου