Sam's Journal Jam

Relevant Articles:The Coagulopathy of Chronic Liver Disease: this is the article Brian used for his researchHow I Treated Disseminated Coagulopathy of Liver Disease: This article contains a great review of DIC and a very useful scoring tool TEG for Cirrhotic Coagulopathy: Time for Implementation? this is a great review on the concept of thromboelastograms (TEG studies)Bleeding and Coagulopathies in Critical Care: this is a great review article on coagulopathies in general and our history of using blood products Take-Home Points:INR correlates poorly with bleeding risk in cirrhosis.While an increased tendency to bleed is certainly present, it may have more to do with altered hemodynamics (elevated portal pressures), endothelial dysfunction, uremia, platelet count/dysfunction, and bacterial infections rather than elevations in traditional markers of coagulation (PT/INR, aPTT) Distinguishing between DIC and Accelerated Intra-vascular Coagulation and Fibrinolysis (AICF) is difficult. Some helpful adjuncts include