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Coagulopathy (also called a bleeding disorder) is a condition in which the blood's ability to coagulation (form thrombus) is impaired. This condition can cause a tendency toward prolonged or excessive bleeding (bleeding diathesis), which may occur spontaneously or following an injury or medical and dental procedures.
Coagulopathies are sometimes erroneously referred to as "clotting disorders", but a clotting disorder is the opposite, defined as a predisposition to excessive clot formation (thrombus), also known as a hypercoagulable state or thrombophilia.
Anticoagulants such as warfarin will also prevent clots from forming properly. Coagulopathy may also occur as a result of dysfunction or reduced levels of (small disk-shaped bodies in the bloodstream that aid in the clotting process).
The use of tranexamic acid is the only option that is currently supported by a large, randomized, controlled clinical trial, and is given to people with major bleeding after trauma. There are several possible risks to treating coagulopathies, such as transfusion-related acute lung injury, acute respiratory distress syndrome, multiple organ dysfunction syndrome, major hemorrhage, and venous thromboembolism.
Acute traumatic coagulopathy
In 2003, Karim Brohi, Professor of Traumatology at Queen Mary University of London, first introduced the term Acute Traumatic Coagulopathy (ATC), establishing that coagulopathy induced by trauma results in:
Treatment
If someone has coagulopathy, their health care provider may help them manage their symptoms with medications or replacement therapy. In replacement therapy, the reduced or absent clotting factors are replaced with proteins derived from human blood or created in the laboratory. This therapy may be given either to treat bleeding that has already begun or to prevent bleeding from occurring.
Critical care
One area of treatment is managing people with major bleeding in a critical setting, like an emergency department. In these situations, the common treatment is transfusing a combination of red cells with one of the following options:
+ Laboratory findings in various platelet and coagulation disorders
! Condition
! Prothrombin time
! Partial thromboplastin time
! Bleeding time
! Platelet count Vitamin K deficiency or warfarin Prolonged Normal or mildly prolonged Unaffected Unaffected Disseminated intravascular coagulation Prolonged Prolonged Prolonged Decreased Von Willebrand disease Unaffected Prolonged or unaffected Prolonged Unaffected Hemophilia Unaffected Prolonged Unaffected Unaffected Aspirin Unaffected Unaffected Prolonged Unaffected Thrombocytopenia Unaffected Unaffected Prolonged Decreased Liver failure, early Prolonged Unaffected Unaffected Unaffected Liver failure, end-stage Prolonged Prolonged Prolonged Decreased Uremia Unaffected Unaffected Prolonged Unaffected Congenital afibrinogenemia Prolonged Prolonged Prolonged Unaffected Factor V deficiency Prolonged Prolonged Unaffected Unaffected Factor X deficiency as seen in amyloid purpura Prolonged Prolonged Unaffected Unaffected Glanzmann's thrombasthenia Unaffected Unaffected Prolonged Unaffected Bernard–Soulier syndrome Unaffected Unaffected Prolonged Decreased or unaffected Factor XI deficiency Unaffected Prolonged Unaffected Unaffected C1INH deficiency Unaffected Shortened Unaffected Unaffected
See also
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