Cargando…
Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease
Over the last decades, individualized approaches and a better understanding of coagulopathy complexity in end-stage liver disease (ESLD) patients has evolved. The risk of both thrombosis and bleeding during minimally invasive interventions or surgery is associated with a worse outcome in this patien...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777026/ https://www.ncbi.nlm.nih.gov/pubmed/36553179 http://dx.doi.org/10.3390/diagnostics12123172 |
_version_ | 1784856003373694976 |
---|---|
author | Tomić Mahečić, Tina Baronica, Robert Mrzljak, Anna Boban, Ana Hanžek, Ivona Karmelić, Dora Babić, Anđela Mihaljević, Slobodan Meier, Jens |
author_facet | Tomić Mahečić, Tina Baronica, Robert Mrzljak, Anna Boban, Ana Hanžek, Ivona Karmelić, Dora Babić, Anđela Mihaljević, Slobodan Meier, Jens |
author_sort | Tomić Mahečić, Tina |
collection | PubMed |
description | Over the last decades, individualized approaches and a better understanding of coagulopathy complexity in end-stage liver disease (ESLD) patients has evolved. The risk of both thrombosis and bleeding during minimally invasive interventions or surgery is associated with a worse outcome in this patient population. Despite deranged quantitative and qualitative coagulation laboratory parameters, prophylactic coagulation management is unnecessary for patients who do not bleed. Transfusion of red blood cells (RBCs) and blood products carries independent risks for morbidity and mortality, including modulation of the immune system with increased risk for nosocomial infections. Optimal coagulation management in these complex patients should be based on the analysis of standard coagulation tests (SCTs) and viscoelastic tests (VETs). VETs represent an individualized approach to patients and can provide information about coagulation dynamics in a concise period of time. This narrative review will deliver the pathophysiology of deranged hemostasis in ESLD, explore the difficulties of evaluating the coagulopathies in liver disease patients, and examine the use of VET assays and management of coagulopathy using coagulation factors. Methods: A selective literature search with PubMed as the central database was performed with the following. |
format | Online Article Text |
id | pubmed-9777026 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97770262022-12-23 Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease Tomić Mahečić, Tina Baronica, Robert Mrzljak, Anna Boban, Ana Hanžek, Ivona Karmelić, Dora Babić, Anđela Mihaljević, Slobodan Meier, Jens Diagnostics (Basel) Review Over the last decades, individualized approaches and a better understanding of coagulopathy complexity in end-stage liver disease (ESLD) patients has evolved. The risk of both thrombosis and bleeding during minimally invasive interventions or surgery is associated with a worse outcome in this patient population. Despite deranged quantitative and qualitative coagulation laboratory parameters, prophylactic coagulation management is unnecessary for patients who do not bleed. Transfusion of red blood cells (RBCs) and blood products carries independent risks for morbidity and mortality, including modulation of the immune system with increased risk for nosocomial infections. Optimal coagulation management in these complex patients should be based on the analysis of standard coagulation tests (SCTs) and viscoelastic tests (VETs). VETs represent an individualized approach to patients and can provide information about coagulation dynamics in a concise period of time. This narrative review will deliver the pathophysiology of deranged hemostasis in ESLD, explore the difficulties of evaluating the coagulopathies in liver disease patients, and examine the use of VET assays and management of coagulopathy using coagulation factors. Methods: A selective literature search with PubMed as the central database was performed with the following. MDPI 2022-12-15 /pmc/articles/PMC9777026/ /pubmed/36553179 http://dx.doi.org/10.3390/diagnostics12123172 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Tomić Mahečić, Tina Baronica, Robert Mrzljak, Anna Boban, Ana Hanžek, Ivona Karmelić, Dora Babić, Anđela Mihaljević, Slobodan Meier, Jens Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease |
title | Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease |
title_full | Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease |
title_fullStr | Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease |
title_full_unstemmed | Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease |
title_short | Individualized Management of Coagulopathy in Patients with End-Stage Liver Disease |
title_sort | individualized management of coagulopathy in patients with end-stage liver disease |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777026/ https://www.ncbi.nlm.nih.gov/pubmed/36553179 http://dx.doi.org/10.3390/diagnostics12123172 |
work_keys_str_mv | AT tomicmahecictina individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT baronicarobert individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT mrzljakanna individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT bobanana individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT hanzekivona individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT karmelicdora individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT babicanđela individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT mihaljevicslobodan individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease AT meierjens individualizedmanagementofcoagulopathyinpatientswithendstageliverdisease |