Related Experiment Video
Updated: May 17, 2026
06:23
Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
Published on: August 4, 2018
Perioperative coagulation management in the intensive care unit
Jerrold H Levy1, David Faraoni, Roman M Sniecinski
1Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia 30322, USA. Jlevy01@emory.edu
Current Opinion in Anaesthesiology
|November 13, 2012
Summary
Newer anticoagulants can cause coagulopathy in critically ill patients. Management involves blood products, prohemostatic drugs, and specific coagulation therapies to address deficiencies.
Area of Science:
- Critical Care Medicine
- Hematology
- Pharmacology
Background:
- Coagulopathy in intensive care unit (ICU) patients is complex, stemming from surgery, trauma, and medications.
- Newer anticoagulation agents, including new oral anticoagulants (NOACs) and antiplatelet agents, are increasingly recognized as contributors.
- Understanding these multifactorial causes is crucial for effective patient management.
Purpose of the Study:
- To review the causes of coagulopathy in ICU patients.
- To discuss hemostatic considerations and therapeutic strategies.
- To highlight the role of newer anticoagulants in ICU coagulopathy.
Main Methods:
- Review of current literature on ICU coagulopathy.
- Analysis of contributing factors, including anticoagulation therapies.
- Evaluation of available management options.
Main Results:
- All anticoagulation agents can potentially induce coagulopathy in critically ill patients.
- Management strategies include hemodialysis, blood product transfusion, and prohemostatic drugs.
- Recombinant and purified coagulation therapies offer targeted treatment for specific deficiencies.
Conclusions:
- ICU coagulopathy results from multiple factors: anticoagulants, dilution, fibrinolysis, and factor consumption.
- Therapeutic prohemostatic pharmacologic approaches are essential alongside standard transfusion therapy.
- A comprehensive understanding and tailored approach are vital for managing ICU coagulopathy.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...