Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia 30322, USA.
Curr Opin Anaesthesiol. 2013 Feb;26(1):65-70. doi: 10.1097/ACO.0b013e32835b82df.
Coagulopathy in an ICU setting is multifactorial, but newer anticoagulation agents are the potentially contributing causes. Critically ill patients may suffer from disorders because of surgery or trauma, in addition to acquired causes including antiplatelet agents and the new oral anticoagulants. An understanding of the coagulopathy, hemostatic considerations, and therapeutic approaches is important when managing these patients.
All anticoagulation agents may contribute to coagulopathy in critically ill patients. Options for management include hemodialysis, transfusion of blood products, and prohemostatic drugs. Recombinant and purified coagulation therapies are also now available in most countries that provide clinicians with specific agents to treat targeted deficiencies.
Coagulopathy occurs in ICU patients because of multiple factors including anticoagulants, dilution, fibrinolysis, and factor consumption. Therapeutic prohemostatic pharmacologic approaches, in addition to standard transfusion therapy, need to be considered in managing coagulopathy in the ICU setting.
重症监护病房（ICU）中的凝血功能障碍是多因素的，但新型抗凝剂可能是潜在的致病原因。除了因手术或创伤导致的获得性疾病外，危重症患者还可能因抗血小板药物和新型口服抗凝剂而出现凝血功能障碍。了解凝血功能障碍、止血注意事项和治疗方法对于这些患者的管理非常重要。
所有抗凝剂都可能导致 ICU 患者发生凝血功能障碍。管理选项包括血液透析、血液制品输注和促凝药物。重组和纯化的凝血治疗方法现在在大多数国家都有提供，为临床医生提供了治疗特定缺陷的特定药物。
ICU 患者发生凝血功能障碍是由于多种因素引起的，包括抗凝剂、稀释、纤维蛋白溶解和因子消耗。除了标准输血治疗外，还需要考虑在 ICU 环境中进行促凝药理学治疗方法来管理凝血功能障碍。
