Coagulation abnormalities in the cirrhotic patient



Título del documento: Coagulation abnormalities in the cirrhotic patient
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000415635
ISSN: 1665-2681
Autores: 1
1
2
2
Instituciones: 1Fundación Clínica Médica Sur, Unidad de Cuidados Intensivos, México, Distrito Federal. México
2Fundación Clínica Médica Sur, Unidad de Investigación de Hígado, México, Distrito Federal. México
Año:
Periodo: Sep-Oct
Volumen: 12
Número: 5
Paginación: 713-724
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés The clotting process is a dynamic array of multiple processes which can be described in four phases: platelet plug initiation and formation, clotting process propagation by the coagulation cascade, clotting termination by antithrombotic mechanisms and clot removal by fibrinolysis. The liver plays a central role in each of these phases of clotting process, as it synthesizes the majority of coagulation factors and proteins involved in fibrinolysis as well as thrombopoeitin, which is responsible for platelet production from megakaryocytes. Many pathological processes associated with cirrhosis, such as portal hypertension and endothelial dysfunction, as well as co-morbid conditions, may also alter the coagulation process. Consequently, patients with liver disease have a disturbed balance of procoagulant and anti-coagulant factors which deviates from the normal coagulation cascade. This situation poses an additional problem in the diagnostic and therapeutic approach to this group of patients, since traditional coagulation test may not be reliable for assessing bleeding or thrombotic risk and traditional transfusional strategies may not be applicable in cirrhotic patients. In this article, we review the pathophysiological bases of coagulation abnormalities, in cirrhotic patients, the diagnostic therapeutic strategies to be followed and its impact on the clinical outcome in the cirrhotic patient
Disciplinas: Medicina
Palabras clave: Gastroenterología,
Hematología,
Enfermedad hepática,
Cirrosis hepática,
Coagulopatía
Keyword: Medicine,
Gastroenterology,
Hematology,
Liver diseases,
Liver cirrhosis,
Coagulopathy
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