Practical Hemostasis and Thrombosis (eBook)
John Wiley & Sons (Verlag)
978-1-118-34474-3 (ISBN)
- Provides essential practical management for all those working in the field of hemostasis and thrombosis
- Includes new chapters on direct oral anticoagulants, acquired inhibitors of coagulation, and expanded discussion of thrombotic microangiopathies
- Covers in a clear and succinct format, the diagnosis, treatment and prevention of thrombotic and haemostatic disorders
- Follows templated chapter formats for rapid referral, including key points and summary boxes, and further reading
- Highlights controversial issues and provides advice for everyday questions encountered in the clinic
Nigel S. Key, Harold R. Roberts Distinguished Professor, Division of Hematology and Oncology, Department of Medicine, University of North Carolina School of Medicine, North Carolina, Chapel Hill, USA
Michael Makris, Senior Lecturer in Haematology, Department of Medicine and Pharmacology, University of Sheffield, Sheffield, UK
David Lillicrap, Professor of Hematology, Department of Pathology and Molecular Medicine, Richardson Laboratory, Queen's University, Kingston, Ontario, Canada
Designed as a practical, succinct guide, for quick reference by clinicians with everyday questions, this title guides the reader through the range of approaches available for diagnosis, management, or prevention of hemorrhagic and thrombotic diseases or disorders. Provides essential practical management for all those working in the field of hemostasis and thrombosis Includes new chapters on direct oral anticoagulants, acquired inhibitors of coagulation, and expanded discussion of thrombotic microangiopathies Covers in a clear and succinct format, the diagnosis, treatment and prevention of thrombotic and haemostatic disorders Follows templated chapter formats for rapid referral, including key points and summary boxes, and further reading Highlights controversial issues and provides advice for everyday questions encountered in the clinic
Nigel S. Key, Harold R. Roberts Distinguished Professor, Division of Hematology and Oncology, Department of Medicine, University of North Carolina School of Medicine, North Carolina, Chapel Hill, USA Michael Makris, Senior Lecturer in Haematology, Department of Medicine and Pharmacology, University of Sheffield, Sheffield, UK David Lillicrap, Professor of Hematology, Department of Pathology and Molecular Medicine, Richardson Laboratory, Queen's University, Kingston, Ontario, Canada
Cover 1
Title Page 5
Copyright 6
Contents 7
List of Contributors 11
Chapter 1 Basic Principles Underlying Coagulation 17
Healthy Vasculature 17
Initiation 19
Amplification 20
Propagation 22
Localization 23
Coagulation Assays 24
Summary 25
References 25
Chapter 2 Laboratory Tests of Hemostasis 28
Introduction 28
Sample Collection and Processing 28
Collection 28
Processing and Storage of Samples Prior to Analysis 29
Use of Coagulation Screening Tests 30
Prothrombin Time 31
Activated Partial Thromboplastin Time 31
Mixing Studies 32
Thrombin Time 33
Fibrinogen 33
Screening Tests: Assay Issues 33
Clotting Factor Assay Design 35
One-Stage Assays 35
Factor Assays to Monitor Replacement Therapy in Hemophilia 36
Factor XIII Testing 37
Thrombophilia Testing 37
Sample Collection, Processing, and Assay 38
Clotting Tests in the Presence of Direct Oral Anticoagulants 39
Quality Assurance 39
Internal Quality Control 39
External Quality Assessment 41
References 42
Chapter 3 Molecular Diagnostic Approaches to Hemostasis 43
Introduction 43
Molecular diagnostics of bleeding disorders 44
Hemophilia A 44
Polymorphism linkage analysis in hemophilia A 44
Direct mutation testing for hemophilia A 45
Rationale for direct mutation testing in hemophilia A 45
Strategies for direct mutation detection in hemophilia A 45
Factor VIII inversion mutations 46
Hemophilia B 47
Polymorphism linkage analysis in hemophilia B 47
Direct mutation testing for hemophilia B 48
Hemophilia B mutations of particular clinical significance 48
von Willebrand disease 48
Type 3 von Willebrand disease 49
Type 2 von Willebrand disease 49
Type 2A von Willebrand disease 50
Type 2B von Willebrand disease 50
Type 2M von Willebrand disease 50
Type 2N von Willebrand disease 51
Type 1 von Willebrand disease 51
Less common inherited coagulation factor deficiencies 52
Inherited platelet disorders 52
Molecular diagnostics for thrombotic disease 53
Inherited resistance to activated protein C: factor V Leiden 53
Prothrombin 20210 3? noncoding sequence variant 54
Thermolabile C677T 5,10- methylene-Tetrahydrofolate reductase variant 54
Deficiencies of Antithrombin, protein C, and protein S 55
The role of genetic testing in the clinical management of oral anticoagulation 55
The future for diagnostic molecular hemostasis 55
References 56
Chapter 4 Tests of Platelet Function 58
Structure of Platelets 58
Function 58
Classification of Platelet Defects 60
Platelet Function Testing 62
Global Tests of Platelet Function 66
Bleeding Time 66
Platelet Function Analyzer: PFA-100® / PFA-200® 66
Diagnostic Tests 67
Light Transmission Platelet Aggregometry 67
Whole Blood Aggregometry 69
Electron Microscopy 70
Flow Cytometry 71
Other Common Assays of Platelet Function 74
Conclusion 74
References 75
Chapter 5 Evaluation of the Bleeding Patient 79
The bleeding history 79
Bleeding score 81
The physical examination 81
Laboratory evaluation 82
Introduction to coagulation laboratory testing 82
The prothrombin time and the activated partial thromboplastin time 82
The thrombin clotting time and reptilase time 83
Mixing studies 83
Specific clotting factor assays 83
The Bethesda assay 84
Assays for fibrinogen 84
Factor XIII 84
Testing for von Willebrand disease 84
Assessment of the fibrinolytic system 84
Tests of platelet function 85
Final integration of clinical and laboratory data 86
Patients with bleeding and prolonged PT and normal APTT 86
Patients with bleeding and normal PT and prolonged APTT 86
Patients with bleeding and prolongation of both the PT and APTT 89
Patients with bleeding but normal PT and APTT 91
Patients without bleeding history but with abnormal coagulation testing 92
Conclusion 92
References 92
Chapter 6 Hemophilia A and B 95
Introduction 95
Factor VIII Gene and protein 95
Mutations in F8 gene 96
Factor IX gene and protein 96
Mutations in F9 gene 96
Severity and symptoms 96
Inheritance 97
Females with markedly reduced FVIII/IX levels 97
Carrier testing 97
Prenatal diagnosis 98
Embryo selection: preimplantation genetic diagnosis 98
Delivery of an at?risk pregnancy 98
Making the diagnosis 98
The neonate with hemophilia 99
Clinical manifestations and their treatment 99
Bleeding episodes 99
Pseudotumors 101
Dental treatment 101
Surgery 102
Primary prophylaxis 102
Secondary prophylaxis 102
Hemophilia and aging 103
Treatment 103
Clotting factor replacement 103
Other Hemostatic agents 104
Complications of treatment 104
Acquired hemophilia A 107
The future 108
References 108
Chapter 7 Von Willebrand Disease 110
Introduction: the von Willebrand factor 110
Physiological role of VWF 111
Classification of VWD 111
Genetics and molecular biology of VWD 112
Prevalence and frequency of subtypes of VWD 114
Clinical manifestations 115
Diagnosis of VWD 115
Bleeding history 116
Laboratory evaluation 116
Characterization of the subtype 119
Management of patients with VWD 121
Desmopressin 121
Other nontransfusional therapies for VWD 122
Transfusional therapies 123
Secondary long-term prophylaxis 124
Treatment of women with VWD 125
Conclusions 125
References 125
Chapter 8 The Rarer Inherited Coagulation Disorders 129
Introduction 129
Genetics 130
Clinical Features 130
Pregnancy 131
Investigation 131
Individual Deficiencies 131
Fibrinogen 131
Prothrombin 132
Factor V Deficiency 132
Combined Deficiency of Factors V and VIII 132
Factor VII Deficiency 132
Factor X Deficiency 133
Factor XI Deficiency 133
Factor XIII Deficiency 134
Combined Deficiencies of the Vitamin K?dependent Factors: II, VII, IX, and X 135
Illustrative Case Histories 135
Case 1 135
Case 2 135
Case 3 136
Case 4 136
Case 5 136
Conclusion 137
Acknowledgments 137
References 137
Chapter 9 Acquired Inhibitors of Coagulation 140
Introduction 140
Pathophysiology of Acquired Hemophilia, Acquired Von Willebrand Syndrome, and Other Acquired Coagulation Factor Deficiencies 140
Epidemiology 141
Acquired Hemophilia 141
Acquired von Willebrand Syndrome 142
Other Acquired Coagulation Inhibitors 143
Signs and Symptoms 143
Acquired Hemophilia 144
Acquired von Willebrand Syndrome 144
Other Coagulation Factor Deficiencies 144
Diagnosis – Laboratory Measures to be Complemented with Clinical Findings 145
Differential Diagnosis 145
Management of Coagulation Inhibitors 146
Control of Bleeding Episodes 146
Immunomodulation 147
Clinical Follow up 148
Chapter 10 Quantitative Platelet Disorders 150
Introduction 150
Platelet Production 150
Mechanisms of Thrombocytopenia in Children and Adults 151
Platelet Sequestration 151
Decreased Platelet Production 151
Increased Platelet Destruction 153
Evaluating a Thrombocytopenic Patient 153
Patient History 153
Family History 154
Medication History 154
Medical History 154
Physical Examination 158
Laboratory Evaluation 158
Specific Conditions 161
Immune Thrombocytopenia 161
Evan Syndrome 164
Drug-induced Thrombocytopenia 164
Heparin-induced Thrombocytopenia 165
Pregnancy-associated Thrombocytopenia 165
Post-Transfusion Purpura 166
HIV-associated Thrombocytopenia 167
HCV-associated Thrombocytopenia 167
Microangiopathies 167
Hypersplenism 168
Thrombocytopenia in the Newborn Infant 168
Neonatal Alloimmune Thrombocytopenia 169
Neonatal Autoimmune Thrombocytopenia 170
Congenital Thrombocytopenia 170
Thrombocytosis 172
Acknowledgement 173
References 173
Chapter 11 Qualitative Platelet Disorders 176
Introduction 176
Congenital Qualitative Platelet Defects 176
Abnormalities of the Platelet Receptors for Adhesive Proteins 177
Abnormalities of GPIb?V?IX Complex (VWF Binding Site) 177
Abnormalities of GPllb/llla (?IIb/?3) 178
Abnormalities of GPla/IIa (?2/?1) 178
Abnormalities of GPVI 178
Abnormalities of the Platelet Receptors for Soluble Agonists 179
Thromboxane A2 Receptor 179
?2?Adrenergic Receptors 179
P2Y12 Receptor for ADP 179
Abnormalities of the Platelet Granules 180
Abnormalities of the ??Granules (??Storage Pool Deficiency) 180
Abnormalities of the ??Granules 181
Abnormalities of the ?? and ??Granules 181
Abnormalities of the Platelet Signal?Transduction Pathways 182
Abnormalities of Membrane Phospholipids 182
Scott Syndrome 182
Stormorken Syndrome 182
Miscellaneous Abnormalities of Platelet Function 182
Primary Secretion Defects 182
Other Platelet Abnormalities 183
Acquired Platelet Defects 183
Uremia 183
Acute Leukemia and Myelodysplastic Syndromes 183
Myeloproliferative Disorders 183
Cardiopulmonary Bypass 184
Medications 184
Liver Disease 184
Therapy 185
References 185
Chapter 12 Disseminated Intravascular Coagulation 188
Introduction 188
Etiology 188
Pathogenesis 189
Excessive Activation of Coagulation 189
Downregulation of Physiological Anticoagulation Pathways 190
Dysregulation of Fibrinolysis 190
DIC Versus Trauma-Induced Coagulopathy 191
Clinical Manifestations 191
Diagnosis 192
Scoring Systems for the Diagnosis of DIC 192
Treatment 194
Management of the Underlying Disease 194
Supportive Care and Blood Products 195
Systemic Anticoagulation 195
Antifibrinolytic Therapy 196
Specific Inhibitors of Coagulation 196
References 197
Chapter 13 Thrombotic Microangiopathies 199
Introduction 199
Confirmation of Diagnosis 199
Pathophysiology 200
Thrombotic Thrombocytopenic Purpura 200
Shiga-like Toxin-associated Hemolytic Uremic Syndrome 200
Atypical Hemolytic Uremic Syndrome 201
Streptococcus Pneumonia-associated HUS 203
Diagnosis 204
Diagnosis of TTP 204
Diagnosis of STEC-HUS 204
Diagnosis of aHUS 204
Diagnosis of Pneumococcal HUS 205
Treatment 205
Treatment of TTP 205
Treatment of STEC-HUS 206
Treatment of Atypical HUS 207
Outcomes 207
STEC-HUS Outcomes 207
Renal Transplantation in aHUS 208
TTP Outcomes 208
References 208
Chapter 14 Venous Thromboembolism 211
Pathogenesis of Venous Thromboembolism 211
Inherited Predisposition to VTE 211
Acquired Predisposition to VTE 212
Prevalence and Natural History of VTE 212
Management of VTE 212
Diagnosis of VTE 212
Diagnosis of DVT 212
Diagnosis of PE 216
Advice to Patients After Negative Testing for Supected DVT or PE 220
Treatment of VTE 220
Initiation of Anticoagulant Therapy 220
Long?term Therapy with Vitamin K Antagonists 220
Novel Oral Anticoagulants 220
Duration of Anticoagulant Therapy 220
Major Transient Risk Factors 221
Minor Transient Risk Factors 221
Unprovoked VTE 221
Active Malignancy 221
Hypercoagulable States 221
Risk of Bleeding on Anticoagulant Therapy 222
Treatment of VTE During Pregnancy 222
Thrombolytic Therapy 222
Surgical Treatment 223
Prevention of VTE 223
VTE Prophylaxis Following Surgery 223
VTE prophylaxis in Medical Patients 224
Chapter 15 Myeloproliferative Neoplasms: Thrombosis and Hemorrhage 226
Introduction 226
Clinical Manifestations 226
Polycythemia Vera 226
Essential Thrombocythemia 227
Primary Myelofibrosis 228
Diagnosis 228
Diagnostic Criteria 228
Molecular Testing 228
Which Patients Presenting with Thrombosis should be Tested for an MPN? 231
Pathophysiology of Thrombotic and Hemorrhagic Complications 231
Treatment – General Approach 231
Polycythemia Vera 233
Essential Thrombocythemia 236
Primary Myelofibrosis 237
Treatment – Specifics 238
Treatment of Established Thrombosis 238
Hemorrhage: Prevention and Management 239
Special Situations 239
Patient Resources 241
References 241
Chapter 16 Arterial Thrombosis 245
Introduction 245
Risk Factors 246
Cardiovascular Disease 246
Atrial Fibrillation 246
Laboratory Investigations 248
Routine Laboratory Investigations 248
Specialized Laboratory Investigations 248
Coagulation Factors 249
Treatment 250
Primary Prevention of Arterial Thrombosis 250
Secondary Prevention of Arterial Thrombosis 251
Atrial Fibrillation 251
Combination Therapy with Vitamin K Antagonists and Antiplatelet Agents 252
Conclusions 252
References 252
Chapter 17 Anticoagulation: Heparins and Vitamin K Antagonists 256
Heparins 256
Prophylaxis of Venous Thromboembolism 258
Therapy of Venous Thromboembolism 258
Treatment of Arterial Diseases 259
Oral Anticoagulants: Vitamin K Antagonists 260
Initiation and Dosing of Warfarin Anticoagulation 261
Patients with Highly Unstable Response to VKAs 262
Complications of Anticoagulation with VKAs: Bleeding 262
Management of Overanticoagulation and Bleeding 264
Management of Patients Treated with VKAs Who Require Surgery or Invasive Procedures 265
Chapter 18 The Direct Oral Anticoagulants 269
Pharmacology (Table 18.1) 269
Direct Thrombin Inhibitors 269
Direct Factor Xa Inhibitors 270
Evidence-Based Clinical Indications 272
VTE Prevention in Joint Replacement Surgery (Tables 18.3 and 18.4) 272
VTE Prevention in Medically Ill Patients 275
Treatment of Acute VTE (Table 18.5) 275
Extended Treatment of VTE (Table 18.6) 277
Stroke Prevention in Atrial Fibrillation (Table 18.7) 279
Acute Coronary Syndromes 280
Practical Considerations 281
Laboratory Assessment 281
Interruption for Elective Procedures 282
Reversal for Surgery or Major Bleeding 282
Future Directions 282
References 282
Chapter 19 Antiphospholipid Syndrome 285
Introduction 285
Definition of Antiphospholipid Syndrome 285
Antiphospholipid Antibodies and the Pathology of the Antiphospholipid Syndrome 286
Clinical Features of APS 289
Diagnosis of Antiphospholipid Syndrome 290
Transient and Nonpathological Antiphospholipid Antibodies 290
Laboratory Assays 291
Treatment of APS 292
Primary Prevention of Thrombosis 292
Treatment of Thrombosis 293
Treatment Failures 294
Prevention of Obstetric Complications 294
Catastrophic Antiphospholipid Syndrome 295
Antiphospholipid Syndrome with Bleeding 295
Practical Approach to Diagnosis 295
References 295
Chapter 20 Cardiovascular Medicine 298
Introduction 298
Acute Coronary Syndromes 298
Epidemiology 298
Pathophysiology 299
Therapies for Acute Coronary Syndromes 299
Bleeding and Outcomes in Acute Coronary Syndromes 303
Peripheral Arterial Disease 304
Epidemiology 304
Peripheral Arterial Disease and Cardiovascular Risk 304
Antiplatelet and Anticoagulant Therapy for Cardiovascular Risk Reduction 305
Ventricular Assist Devices 306
Bleeding in Continuous-Flow Ventricular Assist Devices 307
Management of Bleeding in Continuous-flow Ventricular Assist Devices 307
Management of Ventricular Assist Device Thrombosis 308
Balancing Ventricular Assist Device-Related Thromboembolic and Bleeding Risk 308
Electrophysiological Catheter Ablation 309
Atrial Fibrillation Ablation 309
Transcatheter Aortic Valve Replacement 310
Clinical Experience 310
Stroke in Transcatheter Aortic Valve Replacement 310
Bleeding in Transcatheter Aortic Valve Replacement 310
Surgical Heart Valve Replacement and Repair 310
Conclusion 311
References 311
Chapter 21 Cardiothoracic Surgery 315
Introduction 315
Cardiac Surgery without Cardiopulmonary Bypass 315
Minimally Invasive Direct Coronary Artery Bypass 316
Off-pump Coronary Artery Bypass 316
Robot-assisted Coronary Artery Bypass 316
Anticoagulation during CPB 316
CPB technical Aspects 317
The cardiopulmonary Bypass Circuit 317
Hemostasis in Cardiopulmonary Bypass 318
Conventional Tests of Coagulation 318
Inappropriateness of Component Transfusion 319
The Need for Near-patient Testing 319
Early Attempts at Near-patient Testing 319
Standard Laboratory Tests (see chapter 2) 320
Nonstandard Laboratory Tests 321
Near-patient Testing-based Transfusion Algorithms 321
Extended Uses of ROTEM and TEG 323
Blood and Hemostatic Component Management: Future Development 323
Clinical Indications to Reduce Exposure 324
Logistical Indications to Reduce Exposure 324
Preoperative Preparation 324
Pharmacological Methods 324
Preoperative Assessment Clinics 326
Diagnosis of a Bleeding Disorder 327
Assessment of Current Medication 327
References 328
Chapter 22 Neurology 330
Ischemic Stroke 331
Venous Sinus Thrombosis 332
Intracerebral Hemorrhage 333
Subarachnoid Hemorrhage 336
Diseases Associated with Ischemic Strokes 337
Hereditary and Acquired HypercoagulableSstates 337
Activated Protein C Resistance/ Factor V Leiden 337
Antiphospholipid Antibody Syndrome 337
Hyperhomocystinemia 338
Sickle Cell Disease 338
Diseases Associated with Hemorrhagic Strokes 340
Hemophilia A 340
Novel Anticoagulant Agents 340
Direct Thrombin Inhibitors 341
Factor Xa Inhibitors 341
Reversal of Agents 341
References 342
Chapter 23 Hepatology 345
Introduction 345
Pathophysiology of Coagulopathy 346
Impaired Coagulation Factor Synthesis 346
Thrombocytopenia and Platelet Dysfunction 346
Disseminated Intravascular Coagulation 347
Vitamin K Deficiency 347
Dysfibrinogenemia 348
Hyperfibrinolysis 348
Clinical manifestations of Liver Disease Coagulopathy 348
Hemorrhage 348
Thrombosis (Table 23.3) 348
Progression of Fibrosis due to Parenchymal Extinction 350
Extracorporeal Circuits 350
Laboratory Investigation of Hemostasis in Liver Disease 350
Clotting Screen 350
Fibrinogen Level 351
Emerging Evidence for Rebalanced Coagulation in Liver Disease 351
Invasive Procedures and Liver Disease 352
Liver Biopsy 352
Shunt Insertion in Liver Disease 352
Liver Transplantation 352
Treatment of Liver Transplant Coagulopathy 353
Treatment of Liver Disease Coagulopathy 353
Chapter 24 Nephrology 356
Bleeding in Renal Disease 356
Clinical Presentation 356
Etiology 356
Prevention and Treatment 357
Kidney Biopsy 358
Bleeding Risk 358
Prevention of Bleeding 359
Chronic Kidney Disease and Thrombosis 359
Clinical Presentation 359
Etiology 359
Prevention and Treatment 360
Thrombosis in Nephrotic Syndrome 360
Etiology 361
Treatment 361
ANCA Vasculitis and Venous Thromboembolism 362
Clinical Presentation 362
Etiology 362
Treatment 362
Renal Vein Thrombosis 363
Clinical Presentation 363
Etiology 363
Diagnosis, Treatment, and Prognosis 363
Renal Transplant and Thrombosis 364
Incidence and Clinical Presentation of Thromboembolic Events 364
Etiology 364
Diagnosis and Prevention 365
Anticoagulant Use in Kidney Disease 365
Anticoagulants 365
Guidelines for Mild to Moderate Renal Insufficiency 365
Guidelines for Severe Renal Insufficiency 366
Oral Anticoagulants 366
Acknowledgment 367
References 367
Chapter 25 Oncology 371
Introduction 371
Clinical Aspects: Thrombosis and Bleeding 372
Thrombosis 372
Bleeding 374
Occult Malignancy 374
The hypercoagulable State of Patients with Malignancy 375
Routine Laboratory Tests 375
Specialized Tests 375
Pathogenic Mechanisms 378
Clinical Factors 379
Biological Factors 379
Prevention and Treatment of Thrombosis and Bleeding in Cancer 384
Primary Thromboprophylaxis 384
Treatment of Thrombosis 386
Novel Anticoagulants 386
Prophylaxis and Treatment of Bleeding 386
Anticoagulation and Cancer Survival 387
References 388
Chapter 26 Obstetrics, Contraception, and Estrogen Replacement 395
Physiological Changes in Pregnancy 395
Venous Thromboembolism 395
Risk Factors for VTE in Pregnancy 396
Superficial Thrombophlebitis 398
Prevention of Gestational VTE 398
Diagnosis of Acute VTE 399
Treatment of Acute VTE 401
Post-Thrombotic Syndrome 402
Warfarin in Pregnancy 402
Management of Delivery on Full Anticoagulation 402
Obstetric Antiphospholipid Syndrome 403
Contraception, HRT, and in Vitro Fertilization 404
Contraception 404
Progesterone Only Pills 405
Hormone Replacement Therapy 405
In Vitro Fertilization 406
References 406
Chapter 27 Pediatrics 409
Quaternary Care Pediatrics: Trading One Problem for Another 409
Hemostasis in Children 409
Developmental Hemostasis 409
The Differences in Children 410
Cohorts of Children at Risk for Thrombosis 410
Indications for Anticoagulation 412
Congenital Heart Disease 412
Deep venous and Arterial Thrombosis and Pulmonary Embolism 412
Long-term Anticoagulation in Children 412
Diagnosis of Thrombosis in Children 412
Epidemiology of Thrombosis in Children 413
Outcomes of Thrombosis in Children 413
Post-thrombotic Syndrome in Children 413
Outcomes of Systemic Arterial Thrombosis in Children 413
The Importance of Antithrombotic Therapy 413
Therapeutic Agents and Metabolism 413
Health-related Quality of Life 414
Antithrombotic Therapy in Children 414
Heparin 414
Unfractionated Heparin in Children 414
Low Molecular Weight Heparin 418
Oral Vitamin K Antagonists 419
New Agents 422
Thrombolytic Therapy 423
Antiplatelet Therapy 423
Thrombophilia Testing in Children 424
Difficulties in Performing Clinical Trials in Children 425
Future Perspectives 425
References 425
Chapter 28 Intensive and Critical Care 430
Introduction 430
Managing Coagulopathies in Critical Care 430
Thrombocytopenia 432
Platelet Clumping 432
Patients with Sepsis 432
Immune Mechanisms 432
Nonimmune Mechanisms 433
Thresholds for Platelet Transfusion 433
Procedures 434
Antiplatelet Therapy 434
Massive Transfusion 434
Disseminated Intravascular Coagulopathy 434
Immune Thrombocytopenia 434
Post-Transfusion Purpura 434
The Thrombotic Microangiopathies 434
Sepsis and the Systemic Inflammatory Response Syndrome (SIRS) 435
Treatment of SIRS 435
Sequential Organ Failure Assessment Score 435
Heparin Induced Thrombocytopenia 435
Laboratory Diagnosis 437
Clinical Diagnosis 437
Treatment of HIT 437
Thrombocytosis 439
Management of Thromboembolism in ICU 439
Massive Pulmonary Embolism 439
Treatment of PE 439
Thromboprophylaxis in the ICU 440
Mechanical Measures of Thromboprophylaxis 441
Pharmacological Studies 442
Special Situations in Critical Care 443
Inherited and Acquired Von Willebrand Disease 443
Fibrinolytic Bleeding 443
Renal Failure 443
Renal Transplantation and Thrombosis 443
Jehovah’s Witnesses 444
References 445
Chapter 29 Transfusion 449
Introduction 449
Blood Transfusion as a Form of Transplantation 449
The ABO Group 449
The Rhesus System 450
Red Cell Cross-Matching 450
Use of O-Negative Blood 450
Risks of Transfusion 451
Infective Risks 451
Transfusion Reactions 451
Immediate Hemolytic Reactions 451
Delayed Hemolytic Reactions 452
Febrile Transfusion Reactions 452
Transfusion-Related Acute Lung Injury 452
Immunization 452
Post?Transfusion Purpura 452
Blood Products Available 452
Red Cells 452
Platelets 453
Fresh Frozen Plasma 453
Cryoprecipitate and Methylene Blue-Treated Cryosupernatant 454
Cyrosupernatant and Methylene Blue-Treated Cryosupernatant 454
Human Albumin Solution 454
Intravenous Immunoglobulin 454
Coagulation Factor Concentrates 454
Fibrin Sealants 454
Autologous Blood 454
Drugs that Reduce the Need for Transfusion 455
Desmopressin 455
Tranexamic Acid and Other Fibrinolytic Inhibitors 455
Iron 455
Vitamins 455
Erythropoietin 455
Recombinant Activated Factor VII 455
Use of Blood Products 456
How Much to Give? 456
Assessment of Hemorrhage 456
Importance of Good Communication 457
Special Situations 457
Disseminated Intravascular Coagulation 457
Massive Transfusion 457
Cardiac Surgery 457
Obstetrics 457
Pediatrics 457
Jehovah’s Witnesses 458
Hemovigilance and Regulation of Transfusion 458
Conclusions 459
Web Sites of Interest 459
References 459
Appendix 1 Reference Ranges 460
Index 468
EULA 486
"I would heartily recommend this attractively presented book to every coagulation laboratory and every haematologist." (Royal College of Pathologists, 1 April 2011)
| Erscheint lt. Verlag | 8.11.2016 |
|---|---|
| Sprache | englisch |
| Themenwelt | Medizinische Fachgebiete ► Innere Medizin ► Hämatologie |
| Schlagworte | anticoagulation using vitamin K antagonists and direct oral anticoagulants • Antiphospholipid Syndrome • arterial thrombosis • Bleeding • coagulation • coagulation inhibitors • David Lillicrap • DVT • Hämatologie • Hämatologie • Hematology • Hemophilia • Hemostasis • Heparin • inherited coagulation disorders • Medical Science • Medizin • Michael Makris • myeloproliferative neoplasms • Nigel S. Key • platelet disorders • Platelet function • Practical Hemostasis and Thrombosis • Thrombose u. Hämostase • Thrombose u. Hämostase • thrombosis • Thrombosis & Hemostasis • thrombotic microangiopathies • Transfusion Medicine • Venous Thromboembolism • Von Willebrand disease • VTE |
| ISBN-10 | 1-118-34474-X / 111834474X |
| ISBN-13 | 978-1-118-34474-3 / 9781118344743 |
| Informationen gemäß Produktsicherheitsverordnung (GPSR) | |
| Haben Sie eine Frage zum Produkt? |
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