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8 - Correction of Coagulopathy

Published online by Cambridge University Press:  19 May 2022

By
Ahmed M Salem  and
Tiffany R Chang
Edited by
Andrew M. Naidech
Andrew M. Naidech
Affiliation:
Northwestern University, Illinois
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Summary

Coagulopathy is the loss of balance between hemostatic and fibrinolytic processes resulting in excessive bleeding, intravascular thrombosis, or abnormalities in coagulation testing. It is frequently encountered in the neurocritical care unit and can contribute to poor outcomes. Coagulopathies present unique challenges to the neurointensivist, where early recognition and appropriate management are key. In this chapter, we will discuss techniques to assess coagulopathies as well as treatment strategies for the brain-injured patient.

Type
Chapter
Information
Neurocritical Care , pp. 147 - 163
Publisher: Cambridge University Press
Print publication year: 2022

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References

Hemphill, JC 3rd, Greenberg, SM, Anderson, CS, Becker, K, Bendok, BR, Cushman, M, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. July 2015;46(7):2032–60.Google Scholar
Frontera, JA, Lewin, JJ 3rd, Rabinstein, AA, Aisiku, IP, Alexandrov, AW, Cook, AM, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: a statement for healthcare professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Neurocrit Care. February 2016;24(1):6–46.CrossRefGoogle ScholarPubMed
Holcomb, JB, Minei, KM, Scerbo, ML, Radwan, ZA, Wade, CE, Kozar, RA, et al. Admission rapid thrombelastography can replace conventional coagulation tests in the emergency department [Internet]. Ann Surg. 2012;256:476–86. Available from: http://dx.doi.org/10.1097/sla.0b013e3182658180Google Scholar
Gonzalez, E, Moore, EE, Moore, HB, Chapman, MP, Chin, TL, Ghasabyan, A, et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg. June 2016;263(6):1051–59.Google Scholar
Tapia, NM, Chang, A, Norman, M, Welsh, F, Scott, B, Wall, MJ, et al. TEG-guided resuscitation is superior to standardized MTP resuscitation in massively transfused penetrating trauma patients [Internet]. J Trauma Acute Care Surg. 2013;74:378–86. Available from: http://dx.doi.org/10.1097/ta.0b013e31827e20e0CrossRefGoogle ScholarPubMed
Khan, NI, Siddiqui, FM, Goldstein, JN, Cox, M, Xian, Y, Matsouaka, RA, et al. Association between previous use of antiplatelet therapy and intracerebral hemorrhage outcomes [Internet]. Stroke. 2017;48:1810–17. Available from: http://dx.doi.org/10.1161/strokeaha.117.016290Google Scholar
Baharoglu, MI, Irem Baharoglu, M, Cordonnier, C, Salman, RA-S, de Gans, K, Koopman, MM, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial [Internet]. Lancet. 2016;387:2605–13. Available from: http://dx.doi.org/10.1016/s0140-6736(16)30392-0CrossRefGoogle Scholar
Choi, PA, Parry, PV, Bauer, JS, Zusman, BE, Panczykowski, DM, Puccio, AM, et al. Use of aspirin and P2Y12 response assays in detecting reversal of platelet inhibition with platelet transfusion in patients with traumatic brain injury on antiplatelet therapy. Neurosurgery. January 1, 2017;80(1):98–104.Google Scholar
Naidech, AM, Liebling, SM, Rosenberg, NF, Lindholm, PF, Bernstein, RA, Batjer, HH, et al. Early platelet transfusion improves platelet activity and may improve outcomes after intracerebral hemorrhage. Neurocrit Care. February 2012;16(1):82–87.CrossRefGoogle ScholarPubMed
Furay, E, Daley, M, Teixeira, PG, Coopwood, TB, Aydelotte, JD, Malesa, N, et al. Goal-directed platelet transfusions correct platelet dysfunction and may improve survival in patients with severe traumatic brain injury. J Trauma Acute Care Surg. November 2018;85(5):881–87.CrossRefGoogle ScholarPubMed
Steiner, T, Poli, S, Griebe, M, Hüsing, J, Hajda, J, Freiberger, A, et al. Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial. Lancet Neurol. May 2016;15(6):566–73.Google Scholar
Dias, JD, Norem, K, Doorneweerd, DD, Thurer, RL, Popovsky, MA, Omert, LA. Use of thromboelastography (TEG) for detection of new oral anticoagulants. Arch Pathol Lab Med. May 2015;139(5):665–73.CrossRefGoogle ScholarPubMed
Chan, K-H, Mann, KS, Chan, TK. The significance of thrombocytopenia in the development of postoperative intracranial hematoma [Internet]. J Neurosurg. 1989;71:38–41. Available from: http://dx.doi.org/10.3171/jns.1989.71.1.0038CrossRefGoogle ScholarPubMed
Salem, AM, Roh, D, Kitagawa, RS, Choi, HA, Chang, TR. Assessment and management of coagulopathy in neurocritical care [Internet]. J Neurocrit Care. 2019;12:9–19. Available from: http://dx.doi.org/10.18700/jnc.190086CrossRefGoogle Scholar

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