Coagulation abnormalities in critically ill patients

Abstract

Coagulation abnormalities are commonly found in critically ill patients. A myriad of altered coagulation parameters are often detectable, such as thrombocytopenia, prolonged global coagulation times, reduced levels of coagulation inhibitors, or high levels of fibrin split products. Each of these derangements in clotting may derive from a variety of different pathophysiological mechanisms. Proper identification of the underlying causes for these coagulation abnormalities is required, since various coagulation disorders may necessitate different diagnostic and therapeutic management strategies. This chapter reviews the most frequently occurring coagulation abnormalities in critically ill patients with emphasis on the differential diagnosis, the underlying pathogenetic pathways, and the appropriate management strategy.