Correction of coagulopathy in the setting of acute liver failure

Crit Care Nurs Clin North Am. 2010 Sep;22(3):315-21. doi: 10.1016/j.ccell.2010.02.001. Epub 2010 Jun 25.

Abstract

The depletion of vital coagulation factors and proteins in the setting of acute liver failure (ALF) is common and multifactorial. The management of critically ill patients with ALF is difficult and requires a multidisciplinary approach to effective treatment. Critical care nurses are essential in identifying potential sources of bleeding, monitoring for transfusion reactions, and staying vigilant for medication-related adverse reactions. Prevention and treatment of bleeding disorders is a priority because ineffective therapy can lead to hazardous consequences. Correction of coagulopathy for treatment of bleeding and reversal for invasive procedures should include a multifactorial therapeutic plan emphasizing the correction of all coagulation factors. The limitations of current knowledge in effective correction should serve as a stimulus for future research.

Publication types

  • Review

MeSH terms

  • Arteriovenous Shunt, Surgical
  • Blood Coagulation Disorders / etiology*
  • Blood Coagulation Disorders / physiopathology
  • Blood Coagulation Disorders / therapy*
  • Catheterization, Central Venous
  • Critical Care
  • Factor VIIa / therapeutic use
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemodynamics
  • Humans
  • Intracranial Hemorrhages / etiology
  • Intracranial Hemorrhages / therapy
  • Liver Failure, Acute / complications*
  • Liver Failure, Acute / physiopathology*
  • Monitoring, Physiologic
  • Recombinant Proteins / therapeutic use
  • Renal Replacement Therapy

Substances

  • Recombinant Proteins
  • recombinant FVIIa
  • Factor VIIa