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Disorders of Hemostasis01:24

Disorders of Hemostasis

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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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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...
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Extrinsic and Intrinsic Pathways of Hemostasis01:20

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Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
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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,...
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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...
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Microfluidics in Assessing Platelet Function
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Hemostatic Abnormalities in COVID-19: An Update.

Mukul Aggarwal1, Jasmita Dass1, Manoranjan Mahapatra1

  • 1Department of Hematology, All India Institute of Medical Sciences, New Delhi, New Delhi, India.

Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion
|August 25, 2020
PubMed
Summary

COVID-19 causes blood clotting issues, leading to pulmonary intravascular coagulopathy. Early heparin treatment is recommended for hospitalized patients to prevent dangerous blood clots.

Keywords:
COVID associated coagulopathyCOVID-19D-dimerPulmonary intravascular coagulopathyThrombosis

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Area of Science:

  • Pulmonary Medicine
  • Hematology
  • Infectious Diseases

Background:

  • COVID-19 primarily affects the lungs, causing significant hemostatic derangements.
  • A prothrombotic state, termed pulmonary intravascular coagulopathy (PIC), characterizes COVID-19 coagulopathy, differing from disseminated intravascular coagulation.
  • Thrombo-inflammation is a key feature, reflected in elevated D-dimer levels correlating with disease severity.

Purpose of the Study:

  • To review hemostatic abnormalities in COVID-19 patients.
  • To discuss the impact of these abnormalities on patient prognosis.
  • To detail thromboprophylaxis strategies and current guidelines.

Main Methods:

  • Review of scientific literature on COVID-19 and hemostasis.
  • Analysis of coagulation test results in COVID-19 patients.
  • Examination of clinical outcomes related to thrombotic events.

Main Results:

  • COVID-19 is associated with mild prolongation of prothrombin time and activated partial thromboplastin time.
  • Fibrinogen levels are typically normal to increased, with marginal thrombocytopenia.
  • Increased incidence of venous and arterial thrombotic events, particularly in ICU patients, is observed.

Conclusions:

  • Pulmonary intravascular coagulopathy and thrombo-inflammation are critical aspects of COVID-19 pathogenesis.
  • Routine thromboprophylaxis with low molecular weight heparin is advised for hospitalized patients.
  • Bleeding complications are infrequent and manageable with blood product transfusion.