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Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

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Nội dung chi tiết: Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

SECTION 9Hematologic Problems in the Intensive Care UnitPatrick F. FogartyDisorders of HemostasisAdam Cuker and Suman L. SoodI. THE BLEEDING PATIENT:

Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2 GENERAL PRINCIPLESA.Etiology.1Bleeding disorders (Table 88'1) may Ik- secondary to the following:a.Defects in the activity of platelets.b.Defects in

the activity of one or more coagulation factors (coagulopathy).c.Congenital causes.d.Acquired causes.2Hematology consultation is often necessary if th Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

e cause of bleeding is not immediately apparent and/or if specialized laboratory testing is required for diagnosis.B.Diagnosis.1Clinical presentation.

Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

a.Identify the site of bleeding.i.Platelet disorders tend to cause mucocutaneous bleeding (e.g., epistaxis, oral, gastrointestinal [GI], genitourinary

SECTION 9Hematologic Problems in the Intensive Care UnitPatrick F. FogartyDisorders of HemostasisAdam Cuker and Suman L. SoodI. THE BLEEDING PATIENT:

Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2 and muscles).iii.Bleed in? from a single sire fe.p.. a surgical sire. GĨ trail) warrants638 I SECTION 9 • H E M AT0L0G IC PROBLEMS IN THE ICUSelected

Congenital and Acquired Bleeding DisordersMechanismCongenitalAcquiredDefects in plateletQualitative platelet disordersMedicationsactivity* i. 2 * * 5 Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

von Willebrand disease0Renal disease Myelodysplasia Myeloproliferative disordersDefects in coagulationHemophilia A Hemophilia B Other factor deficienc

Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

iesVitamin K deficiency Liver disease Exposure to anticoagulants Die Trauma Acquired factor inhibitors3Tor defects in platelet function due to thrombo

SECTION 9Hematologic Problems in the Intensive Care UnitPatrick F. FogartyDisorders of HemostasisAdam Cuker and Suman L. SoodI. THE BLEEDING PATIENT:

Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2ie, disseminated intravascular coagulation.b.Obtain the personal and family bleeding history.L Congenital disorders: life-long history of bleeding, po

sitive family history. Exceptions are possible (e.g., mild hemophilia).ii.Acquired disorders: often no previous history of bleeding, no family history Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

.c.Perform a careful physical examination.i.Skin: ecchymosis, petechiae, or nonpalpable purpura.ii.Hemarthrosis: warm, swollen joints.iii.Mucosal surf

Ebook Irwin amp; rippe''s manual of intensive care medicine (6/E): Part 2

ace abnormalities (e.g., nasal or oral pharyngeal mucosa).2Perform tiered laboratory evaluation.a.Initial testing.

SECTION 9Hematologic Problems in the Intensive Care UnitPatrick F. FogartyDisorders of HemostasisAdam Cuker and Suman L. SoodI. THE BLEEDING PATIENT:

SECTION 9Hematologic Problems in the Intensive Care UnitPatrick F. FogartyDisorders of HemostasisAdam Cuker and Suman L. SoodI. THE BLEEDING PATIENT:

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