Related Experiment Video
Updated: Aug 20, 2025
04:56
Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
Published on: August 4, 2023
831
Hypercoagulability in critically ill patients with COVID 19, an observational prospective study
Laure Calvet1, François Thouy1, Olivier Mascle1
1Service de Médecine Intensive et Réanimation, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
Plos One
|November 23, 2022
Summary
Most intensive care unit (ICU) patients with COVID-19 pneumonia exhibit hypercoagulability. However, specific hypercoagulability markers on admission did not predict thromboembolic events or adverse outcomes, though later markers indicated risk.
Area of Science:
- Critical Care Medicine
- Hematology
- Infectious Diseases
Background:
- COVID-19 is frequently linked to hypercoagulability and thromboembolic (TE) events.
- Understanding hypercoagulability's role in COVID-19 ICU patients is crucial for predicting outcomes.
Purpose of the Study:
- To assess hypercoagulability characteristics in intensive care unit (ICU) patients with COVID-19 pneumonia.
- To investigate the relationship between hypercoagulability and new-onset TE events.
- To determine the association with the composite outcome of intubation and/or death in the ICU.
Main Methods:
- A prospective observational monocentric study was conducted at a University Hospital.
- 133 ICU patients admitted for COVID-19 pneumonia were included between January 2020 and May 2021.
- Standard hemostatic tests and rotational thromboelastometry (ROTEM) were performed on admission and day 4.
Main Results:
- Hypercoagulability was prevalent on admission (86.4%) and day 4 (nearly all patients).
- No hypercoagulability indices on day 1 or 4 predicted new-onset TE events or the composite outcome.
- Hyperfibrinogenemia (>8 g/L), elevated D-dimers, and higher EXTEM Li 60 on day 4 predicted the need for intubation and/or ICU death.
Conclusions:
- The study confirms high rates of hypercoagulability in COVID-19 ICU patients.
- Hyperfibrinogenemia or fibrinolysis shutdown on day 4 are associated with unfavorable outcomes in these patients.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
834
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...
834
01:09Coagulation
7.2K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
7.2K
01:24Disorders of Hemostasis
1.0K
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.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
1.0K
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
31
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
31
01:29Pulmonary Embolism I: Introduction
32
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
32
01:29Venous Thrombosis III: Interprofessional Care
16
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...
16