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Coagulopathy: Pathophysiology, Evaluation, and Treatment

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Liver Anesthesiology and Critical Care Medicine

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Abstract

For centuries from Hippocrates and Galen to Virchow and Morawitz, the process of hemostasis and its pathways has mystified us, and Roman numerals have comprised our understanding of hemostasis and coagulation. The reassuring “cascade” of events that has represented the process of coagulation and hemostasis has remained dogma until recently. Hemostasis is a dynamic system comprised of “balanced” systems and cannot be explained away by a model of coagulation that is based on “cascades.” As we are forced to understand the “full” picture of hemostasis, we will evaluate coagulation in a more complete way.

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Abbreviations

AT:

Antithrombin

CVP:

Central venous pressure

DDAVP:

Desmopressin

EACA:

Epsilon-aminocaproic acid

EPCR:

Endothelial protein C ­receptor

FFP:

Fresh frozen plasma

INR:

International normalized ration

PAI-1:

Plasminogen activator ­inhibitor

PT:

Prothrombin time

PTT:

Partial thromboplastin time

RBC:

Red blood cell

TACO:

Transfusion-associated ­circulatory overload

TAFI:

Thrombin activatable fibrinolysis inhibitor

TEG:

Thromboelastography

TF:

Tissue factor

TFPI:

Tissue factor pathway ­inhibitor

TM:

Thrombomodulin

tPA:

Tissue plasminogen ­activator

TRALI:

Transfusion-related acute lung injury

TxA:

Tranexamic acid

VWF:

von Willebrand factor

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Authors and Affiliations

  1. Department of Internal Medicine, Virginia Commonwealth University, MCV, 980342, Richmond, VA, 23298-0342, USA

    Matthew R. Kappus

  2. Department of Gastroenterology and Hepatology, Virginia Commonwealth University, MCV, 980342, Richmond, VA, 23298-0342, USA

    Arun J. Sanyal

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  1. , College of Physicians & Surgeons, Departments of Anesthesiology, of Columbia University, New York, 10032, New York, USA

    Gebhard Wagener

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Kappus, M.R., Sanyal, A.J. (2012). Coagulopathy: Pathophysiology, Evaluation, and Treatment. In: Wagener, G. (eds) Liver Anesthesiology and Critical Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5167-9_13

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