COAGULOPATHY IN CRITICALLY ILL PATIENTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 38
Abstract
BACKGROUND Bleeding diathesis and coagulopathies are common in critically ill patients. Patients may have clinical bleeding or only laboratory abnormalities in haemostatic tests. Aims- To determine the incidence and types of bleeding diathesis that commonly occur in our medical ICU. Settings and Design- 50 patients were studied who were admitted in IMCU, IIM, RGGGH. Study Design– Observational study. MATERIALS AND METHODS The patients included in this study were those with any medical illness admitted to the ICU for > 48 hours, who had no primary haematological disease at the time of admission. Patients have their history taken and subjected to clinical examination and investigations. The following tests of haemostasis are done only once: Platelet count and peripheral smear, PT (Prothrombin time), aPTT (activated Partial Thromboplastin Time), Fibrinogen and D-dimer. The results were tabulated and analysed. RESULTS Thrombocytopenia was the most common coagulation abnormality seen in 46% of the study population. More than half of the patients who had abnormal coagulation parameters had clinical bleeding. Melena was the most common bleeding manifestation. No patient had life-threatening bleeding; 10 out of 50 patients studied had aPTT prolongation with 2 patients having combined PT and aPTT prolongation. No patient had hypofibrinogenaemia, but 17 patients had hyperfibrinogenaemia. Sepsis ranks first in causing coagulopathy, followed by liver failure and antithrombotic drugs. CONCLUSION A rationale approach must be developed in treating critical care patients with abnormal coagulation parameters. Too much aggressive transfusions can do more harm than good. A good clinical judgement is required along with the current knowledge for treating such patients.
Authors and Affiliations
Sivaram Kannan S, Damodaran Dhanasekaran
Keywords
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- EP ID EP212923
- DOI 10.14260/Jemds/2017/665
- Views 60
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