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Related Concept Videos

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.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

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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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The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
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Coagulation01:09

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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...
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Introduction to Hemostasis01:05

Introduction to Hemostasis

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Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
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Related Experiment Video

Updated: Jun 27, 2025

Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
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Abnormal coagulation after hepatectomy in patients with normal preoperative coagulation function.

Liting Kuang1, Weibin Lin2, Dahui Wang1

  • 1Department of Anesthesiology, the First Afflicted Hospital of Sun Yet-sen University, Guangzhou, 510080, China.

BMC Surgery
|May 6, 2024
PubMed
Summary

Postoperative abnormal coagulation (PAC) affects over half of patients undergoing hepatectomy. Key risk factors include preoperative international normalized ratio (INR), intraoperative fluid infusion, and major hepatectomy, enabling predictive model development.

Keywords:
INRPostoperative abnormal coagulationRisk factorsSuccinyl gelatin

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Area of Science:

  • Hepatobiliary Surgery
  • Coagulation Medicine
  • Surgical Risk Assessment

Background:

  • Postoperative abnormal coagulation (PAC) is a significant complication following hepatectomy.
  • Identifying risk factors is crucial for patient management and outcomes.
  • Predictive models can aid in early intervention for at-risk patients.

Purpose of the Study:

  • To identify risk factors for postoperative abnormal coagulation (PAC) in patients undergoing hepatectomy.
  • To develop and validate a predictive model for PAC in patients with normal preoperative coagulation.
  • To improve clinical decision-making and patient care after liver surgery.

Main Methods:

  • Retrospective analysis of 661 patients who underwent hepatectomy with normal preoperative coagulation.
  • Univariate and multivariate logistic regression, including LASSO analysis, to identify risk factors.
  • Construction and validation of a nomogram-based predictive model for PAC.

Main Results:

  • The incidence of PAC was 54.8% in the study cohort.
  • Preoperative international normalized ratio (INR), intraoperative succinyl gelatin infusion volume, and major hepatectomy were identified as independent risk factors.
  • The predictive model demonstrated good performance with ROC curves of 0.742 (training) and 0.711 (validation).

Conclusions:

  • PAC is significantly associated with preoperative INR, intraoperative fluid management, and surgical extent.
  • A validated three-factor prediction model can effectively identify patients at risk of PAC after hepatectomy.
  • The model provides a valuable tool for risk stratification and personalized perioperative care.