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How do we transfuse blood components in cirrhotic patients undergoing gastrointestinal procedures?
- Source :
- Transfusion. 56:791-798
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- The liver plays a pivotal role in hemostasis. Consequently, patients with cirrhosis frequently demonstrate abnormal coagulation profiles on routine laboratory tests. These tests mainly reflect decreased procoagulant proteins. However, in cirrhosis, complex changes also occur in anticoagulant and fibrinolytic pathways. Recent evidence demonstrates that patients with cirrhosis exist in a state of hemostatic rebalance. Accordingly, routine tests inadequately represent hemostatic alterations in these patients. Unfortunately, these tests are regularly used to guide the transfusion of blood components with the assumption that they will correct laboratory abnormalities and improve hemostasis in a bleeding patient or prevent excessive bleeding following a procedure. With an absence of both accurate laboratory testing to assess hemostasis and evidence-based guidelines to direct the transfusion of blood components, management of patients with cirrhosis poses a significant challenge to clinicians. Therefore, we developed multidisciplinary guidelines for the periprocedural transfusion of blood components in patients with cirrhosis based on concurrent evidence and personal experience at our medical center.
- Subjects :
- Excessive Bleeding
medicine.medical_specialty
Cirrhosis
medicine.drug_class
business.industry
Immunology
Anticoagulant
Routine laboratory
Hematology
030204 cardiovascular system & hematology
medicine.disease
Gastrointestinal procedures
Surgery
03 medical and health sciences
0302 clinical medicine
Coagulation
Hemostasis
medicine
Immunology and Allergy
030211 gastroenterology & hepatology
In patient
Intensive care medicine
business
Subjects
Details
- ISSN :
- 00411132
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Transfusion
- Accession number :
- edsair.doi...........04dbd6d4e1860446d5f1e0fb7645ff2c