- Anticoagulant Induced Bleeding:
- Coags
- Coag Pathway
- Platlet abnormalities:
- Transfusion Rx
- Dilution Coagulopathy:
- may result from massive transfusions;
- rarely occurs w/ < 12 units of transfused pRBC, but occurs in nearly all pts that have received > 20 units of pRBC;
- note: coagulopathy associated with pelvic fractures may have a mortality rate of greater than 85 %;
- thrombocytopenia and platlet dysfunction;
- Bleeding due to Platlet abnormalities:
- most common caused by thrombocytopenia, but decreased platelet function & rapid dilution of plasma clotting factors are also common;
- DIC:
- Anticoagulant Induced Bleeding
- Platlet abnormalities:
- Diagnosis: - prolongation of PT, PTT; - decrease in serum Fibrinogen to < 100 mg/dl (norm 160 mg/dl); - rise in fibrin degradation products to > 40 mg/dl;
- Treatment:
- treat underlying cause (eg. sepsis, incompatible blood transfusion)
- support platlets/coags;
- consider Fresh Frozen Plasma/Cyroprecipitate/platlets
- ? whether HEPARIN Rx is effective in oncology
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Extracorporeal hemolysis in orthopedic patients. Report of two cases.
Concepts in Emergency and Critical Care: Pathogenesis of Disseminated Intravascular Coagulation in Sepsis.