凝血病
消耗性凝血病
重症监护医学
医学
弥漫性血管内凝血
止血
体外膜肺氧合
体外
血栓形成
凝结
外科
内科学
作者
Andrew Retter,Beverley J. Hunt
出处
期刊:Hematology
[American Society of Hematology]
日期:2023-12-08
卷期号:2023 (1): 754-760
被引量:2
标识
DOI:10.1182/hematology.2023000502
摘要
Abstract A consumptive coagulopathy describes a situation where there is a loss of hemostatic factors, which leads to an increased risk of bleeding. Some recent studies have used the term interchangeably with disseminated intravascular coagulation (DIC), but we have reverted to the older definition, which covers a broader range of issues where there is loss of hemostatic factors due to multiple causes, which includes systemic activation of coagulation as seen in DIC. Therefore, the term consumptive coagulopathy covers conditions from the hemostatic effects of major hemorrhage to the use of extracorporeal circuits to true DIC. We review the current understanding of the pathophysiology, diagnosis, and management of common consumptive coagulopathy in critical care patients, focusing on recent advances and controversies. Particular emphasis is given to DIC because it is a common and often life-threatening condition in critical care patients and is characterized by the simultaneous occurrence of widespread microvascular thrombosis and bleeding. Second, we focus on the effect of modern medical technology, such as extracorporeal membrane oxygenation, on hemostasis.
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