| The coagulopathy of acute liver failure and implications for intracranial pressure monitoring. | |
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MedLine Citation:
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PMID: 18379899 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The development of coagulopathy in acute liver failure (ALF) is universal. The severity of the coagulopathy is often assessed by determination of the prothrombin time and International Normalized Ratio (INR). DISCUSSION: In more than 1,000 ALF cases, the severity of the coagulopathy was moderate in 81% (INR 1.5-5.0), severe in 14% (INR 5.0-10.0), and very severe in 5% (INR > 10.0). Certain etiologies were associated with more severe coagulopathy, whereas ALF caused by fatty liver of pregnancy had the least severe coagulopathy. METHODS: Management consisted of transfusions of FFP in 92%. Overall, FFP administered during the first week of admission amounted to 13.7 +/- 15 units. RESULTS: Patients who received an ICP monitor had significantly more FFP transfused than those managed without ICP monitor (22.7 +/- 2.4 vs. 12.3 +/- 0.8 units FFP; P < 0.001). Only a minority of patients developed gastrointestinal bleeding or had an intracranial pressure monitor installed. CONCLUSION: Further research is necessary to explore the reasons clinicians transfuse ALF patients with large amounts of FFP in the absence of active bleeding or invasive procedures. |
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Authors:
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Santiago J Munoz; K Rajender Reddy; William Lee; |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Neurocritical care Volume: 9 ISSN: 1541-6933 ISO Abbreviation: Neurocrit Care Publication Date: 2008 |
Date Detail:
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Created Date: 2008-08-21 Completed Date: 2008-10-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 103-7 Citation Subset: IM |
Affiliation:
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Division of Hepatology, Albert Einstein Medical Center, 5401 Old York Road, Klein Bldg., Suite 509, Philadelphia, PA 19141, USA. orolonco@comcast.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Coagulation Disorders
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etiology*,
therapy* Cohort Studies Humans Intensive Care / methods Intracranial Pressure* Liver Failure, Acute / complications*, etiology Monitoring, Physiologic* Plasma* Prothrombin Time Registries Severity of Illness Index |
| Investigator | |
Investigator/Affiliation:
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W M Lee / ; Anne Larson / ; Oren Fix / ; Timothy Davern / ; Lawrence Liu / ; Timothy McCashland / ; J Eileen Hay / ; Natalie Murray / ; A Obaid S Shaikh / ; Andres Blei / ; Daniel Ganger / ; Atif Zaman / ; Steven Han / ; Robert Fontana / ; Brendan McGuire / ; Ray Chung / ; Robert Brown / ; Adrian Reuben / ; Santiago Munoz / ; Rajender Reddy / ; R Todd Stravitz / ; Lorenzo Rossaro / ; Raj Satyanarayana / ; Tarek Hassanein / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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