Division of Pediatric Hematology Oncology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Suite 501A, Pittsburgh, PA 15224, USA.
Division of Hematology Oncology, Department of Medicine, Clinical Apheresis and Blood Services, Vitalant Northeast Division, University of Pittsburgh School of Medicine, 3636 Boulevard of the Allies, Pittsburgh, PA 15213, USA.
Crit Care Clin. 2020 Apr;36(2):357-377. doi: 10.1016/j.ccc.2019.12.006. Epub 2020 Feb 6.
Hemostatic abnormalities are common among critically ill patients and are associated with a high risk of bleeding. The abnormalities range from isolated thrombocytopenia or prolongation of global coagulation assays to complex disease states, such as thrombotic microangiopathic syndromes, and can be associated with a wide range of conditions, including trauma, surgery, acute disease processes, cardiopulmonary bypass, and exposure to drugs and blood products. Prompt identification of underlying causes is important because treatment strategies vary. Moreover, prompt initiation of both supportive and specific treatments is vital to decrease the morbidity and mortality in the intensive care unit.
严重疾病患者中常出现止血功能异常，且这些异常与高出血风险相关。这些异常的范围很广，从孤立性血小板减少症或全凝血检测时间延长，到血栓性微血管病综合征等复杂疾病状态，可能与包括创伤、手术、急性疾病过程、体外循环和接触药物和血液制品在内的广泛情况相关。及时确定潜在病因很重要，因为治疗策略有所不同。此外，及时启动支持治疗和特异性治疗对降低重症监护病房的发病率和死亡率至关重要。
