Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 103-107 |
| Number of pages | 5 |
| Journal | Neurocritical Care |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| State | Published - Aug 2008 |
| Externally published | Yes |
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Keywords
- Cerebral edema
- Clotting
- Coagulopathy
- Factor VII
- Hepatitis
- Hypothermia
- Intracranial pressure
- Liver
- Plasma
ASJC Scopus subject areas
- Clinical Neurology
- Critical Care and Intensive Care Medicine
Cite this
The coagulopathy of acute liver failure and implications for intracranial pressure monitoring. / Munoz, Santiago J.; Rajender Reddy, K.; Lee, William; Lee, W. M.; Larson, Anne; Fix, Oren; Davern, Timothy; Liu, Lawrence; McCashland, Timothy; Hay, J. Eileen; Murray, Natalie; Shaikh, A. Obaid S; Blei, Andres; Ganger, Daniel; Zaman, Atif; Han, Steven; Fontana, Robert; McGuire, Brendan; Chung, Ray; Brown, Robert; Reuben, Adrian; Munoz, Santiago; Reddy, Rajender; Stravitz, R. Todd; Rossaro, Lorenzo; Satyanarayana, Raj; Hassanein, Tarek.
In: Neurocritical Care, Vol. 9, No. 1, 08.2008, p. 103-107.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The coagulopathy of acute liver failure and implications for intracranial pressure monitoring
AU - Munoz, Santiago J.
AU - Rajender Reddy, K.
AU - Lee, William
AU - Lee, W. M.
AU - Larson, Anne
AU - Fix, Oren
AU - Davern, Timothy
AU - Liu, Lawrence
AU - McCashland, Timothy
AU - Hay, J. Eileen
AU - Murray, Natalie
AU - Shaikh, A. Obaid S
AU - Blei, Andres
AU - Ganger, Daniel
AU - Zaman, Atif
AU - Han, Steven
AU - Fontana, Robert
AU - McGuire, Brendan
AU - Chung, Ray
AU - Brown, Robert
AU - Reuben, Adrian
AU - Munoz, Santiago
AU - Reddy, Rajender
AU - Stravitz, R. Todd
AU - Rossaro, Lorenzo
AU - Satyanarayana, Raj
AU - Hassanein, Tarek
PY - 2008/8
Y1 - 2008/8
N2 - 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.
AB - 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.
KW - Cerebral edema
KW - Clotting
KW - Coagulopathy
KW - Factor VII
KW - Hepatitis
KW - Hypothermia
KW - Intracranial pressure
KW - Liver
KW - Plasma
UR - http://www.scopus.com/inward/record.url?scp=54449085722&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=54449085722&partnerID=8YFLogxK
U2 - 10.1007/s12028-008-9087-6
DO - 10.1007/s12028-008-9087-6
M3 - Article
VL - 9
SP - 103
EP - 107
JO - Neurocritical Care
JF - Neurocritical Care
SN - 1541-6933
IS - 1
ER -