229. Clotting Disorders


Activation of blood coagulation system. Fibrin consumption, leading to thrombosis of small and medium vessels. Eventually leading to organ dysfunction. Fibrin production leads to microthombin, red cell lysis, and diffuse bleeding due to no more clotting factor. Bleeding type usually with OB and leukemic patients. Organ failure with infection and sepsis. Massive bleeding with major surgery and OB procedures. DIC never primary process, likely ARDS. Clinically look for it when bleeding from atypical sites.

Labs: thrombocytopenia (<100), elevated PTT/INR, low fibrinogen (<100), and elevated d-dimer.

Tx: Treat underlying disease. When bleeding, target blood component therapy. If active bleeding and platelets <50, give platelets. If hgb < 7. If INR > 1.6, give FFP. If fibrinogen < 100, give cryoprecipitate. Don’t give PCCs. Only give TXA in recent surgery or acute leukemia. (USC Rounds, 10/12/17).

229. Clotting Disorders

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