凝血病
医学
重症监护医学
神经重症监护
止血
器官功能障碍
脑出血
重症监护室
消耗性凝血病
血肿
自发性脑出血
血栓弹性测定
凝血酶原复合物浓缩物
蛛网膜下腔出血
颅内出血
麻醉
格拉斯哥昏迷指数
内科学
败血症
作者
Joshua VanDerWerf,Monisha A. Kumar
出处
期刊:Seminars in Neurology
[Georg Thieme Verlag KG]
日期:2016-05-23
被引量:1
标识
DOI:10.1055/s-0036-1582133
摘要
Coagulopathy, defined as impaired clot formation, is common in intensive care units (ICUs). Many physiological derangements lead to dysfunctional hemostasis in the ICU; most of these are acquired rather than congenital. Coagulopathies in the ICU are often related to systemic diseases, autoimmune dysfunction, acute infection, organ dysfunction, therapeutic medications, and/or other medical treatments. A significant complication of coagulopathy in the critically ill is major bleeding, defined as fatal hemorrhage, hemodynamic instability, transfusion requirement, or intracranial hematomas. Coagulopathy in the ICU often poses complex management dilemmas, especially when coagulopathy coexists with a thrombotic state. Coagulopathy associated with intracerebral hemorrhage (ICH) bears directly on neurologic prognosis and functional outcome. There is a paucity of high-quality evidence for the management of coagulopathies in neurocritical care; however, data derived from studies of patients with ICH may inform treatment decisions. This article focuses on acquired conditions such as pharmacological therapies, organ failure, and platelet dysfunction that are often associated with defective clot formation in the ICU that result in or exacerbate ICH.
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