Coagulation disorders in the PICU

Abstract

Critically ill patients often have alterations in the hemostatic milieu that require the pediatric intensivist to evaluate and treat clinical changes. Sometimes these alterations may be the primary clinical issue as seen in congenital factor deficiencies but more commonly are acquired and secondary to other systemic illnesses as is the case in disseminated intravascular coagulation. The goal of this chapter is to provide background into the normal components and function (both procoagulant and anticoagulant) of the hemostatic system including coagulation factors, platelets, thrombus formation and fibrinolysis. Using this background information, frequently encountered pathophysiologic clinical scenarios are reviewed including etiology and therapeutic options.