Subscribe to RSS
DOI: 10.1055/s-0040-1712855
Perioperative Coagulopathy in Patients with Normal Preoperative Coagulation Screen: A Couple of Coagulopathic Clinical Case Conundrums
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 inhibitorPublication History
Article published online:
01 June 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/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Mya T, Heng N. An approach to the patient with non-surgical bleeding and a normal coagulation screen. Proceedings of Singapore Healthcare. 2014; 23 (01) 21-27
- 2 Simmons JW, Powell MF. Acute traumatic coagulopathy: pathophysiology and resuscitation. Br J Anaesth 2016; 117 (suppl 3) iii31-iii43
- 3 Gerlach R, Krause M, Seifert V, Goerlinger K. Hemostatic and hemorrhagic problems in neurosurgical patients. Acta Neurochir (Wien) 2009; 151 (08) 873-900
- 4 Goh KY, Poon WS, Chan DT, Ip CP. Tissue plasminogen activator expression in meningiomas and glioblastomas. Clin Neurol Neurosurg 2005; 107 (04) 296-300
- 5 D’Asti E, Fang Y, Rak J. Brain neoplasms and coagulation-lessons from heterogeneity. Rambam Maimonides Med J 2014; 5 (04) e0030
- 6 del GJ Zoppo, Izawa Y, Hawkins BT. Hemostasis and alterations of the central nervous system. Semin Thromb Hemost 2013; 39 (08) 856-875
- 7 Roose SP, Rutherford BR. Selective serotonin reuptake inhibitors and operative bleeding: a review of literature. J Clin Psychopharmacol 2016; 36 (06) 704-709
- 8 Salem AM, Roh D, Kitagava RS, Choi HA, Chang TR. Assessment and management of coagulopathy in neurocritical care. Journal of NeuroCritical Care 2019; 12 (01) 9-19