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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2021; 08(02): 144-146
DOI: 10.1055/s-0040-1712855
Case Report

Perioperative Coagulopathy in Patients with Normal Preoperative Coagulation Screen: A Couple of Coagulopathic Clinical Case Conundrums

Joseph N. Monteiro
1   Department of Anaesthesiology, P. D. Hinduja Hospital and Medical Research Centre. Mumbai, Maharashtra, India
,
Shwetal Goraksha
1   Department of Anaesthesiology, P. D. Hinduja Hospital and Medical Research Centre. Mumbai, Maharashtra, India
,
Ninad S. Dhokte
1   Department of Anaesthesiology, P. D. Hinduja Hospital and Medical Research Centre. Mumbai, Maharashtra, India
,
Balkrishna Padate
2   Department of Hematology, P. D. Hinduja Hospital and Medical Research Centre. Mumbai, Maharashtra, India
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Abstract

Perioperative coagulopathy impacts patient outcome by influencing intraoperative hemodynamics and blood loss. We present two cases which despite having normal preoperative coagulation profiles and normotension during the surgery had intraoperative coagulopathy and unusual bleeding. These cases required a multidisciplinary approach to manage them successfully. A thorough knowledge of the coagulation cascade along with a high-degree of suspicion and early recognition of coagulation is required. Abnormalities are critical for a timely intervention. Point-of-care tests like thromboelastography (TEG) as well as platelet function studies helped us arrive at an early diagnosis and initiate prompt treatment.

Keywords

thromboelastography - thrombin activatable fibrinolysis inhibitor - selective serotonin reuptake inhibitor


Publikationsverlauf

Artikel online veröffentlicht:
01. Juni 2020

© 2020. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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