TY - JOUR
T1 - Recognition and Management of Hemostatic Disorders in Critically Ill Patients Needing to Undergo an Invasive Procedure
AU - Müller, Marcella C. A.
AU - Stanworth, Simon J.
AU - Coppens, Michiel
AU - Juffermans, Nicole P.
PY - 2017
Y1 - 2017
N2 - Abnormal laboratory coagulation test results are frequently documented in critically ill patients, and these patients often also need to undergo invasive procedures. Clinicians have an understandable desire to minimize any perceived heightened risk of bleeding complications in those patients who require invasive procedures. In this setting, prophylactic administration of platelets or plasma is commonplace. This review explores the nature of these sequential statements and the degree to which these statements are supported by evidence. We discuss the complexity of managing the low risk of procedure-related bleeding in a setting where coagulation tests fail to reliably predict this risk. The role of prophylactic transfusion of platelets and plasma and correction of medication-induced coagulopathy is also reviewed. New strategies are required to improve the evidence base, including novel methodological approaches or the use of a clinical scoring system. (C) 2017 Elsevier Inc. All rights reserved
AB - Abnormal laboratory coagulation test results are frequently documented in critically ill patients, and these patients often also need to undergo invasive procedures. Clinicians have an understandable desire to minimize any perceived heightened risk of bleeding complications in those patients who require invasive procedures. In this setting, prophylactic administration of platelets or plasma is commonplace. This review explores the nature of these sequential statements and the degree to which these statements are supported by evidence. We discuss the complexity of managing the low risk of procedure-related bleeding in a setting where coagulation tests fail to reliably predict this risk. The role of prophylactic transfusion of platelets and plasma and correction of medication-induced coagulopathy is also reviewed. New strategies are required to improve the evidence base, including novel methodological approaches or the use of a clinical scoring system. (C) 2017 Elsevier Inc. All rights reserved
U2 - https://doi.org/10.1016/j.tmrv.2017.05.008
DO - https://doi.org/10.1016/j.tmrv.2017.05.008
M3 - Review article
C2 - 28647217
SN - 0887-7963
VL - 31
SP - 223
EP - 229
JO - Transfusion Medicine Reviews
JF - Transfusion Medicine Reviews
IS - 4
ER -