Management of Hemostatic Disorders in Patients With Advanced Liver Disease Admitted to an Intensive Care Unit

Ton Lisman*, William Bernal

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)

Abstract

Patients with liver diseases frequently acquire complex changes in their hemostatic system. Traditionally, bleeding complications in patients with liver disease were ascribed to these hemostatic changes, and liver diseases were considered as an acquired bleeding disorder. Nowadays, it is increasingly acknowledged that patients with liver diseases are in "hemostatic rebalance" due to a commensurate decline in pro- and anticoagulant drivers. Indeed, both thrombosis and bleeding may complicate liver disease. Such complications may be particularly worrisome in critically ill patients with liver disease. This review will outline knowns and unknowns in prediction, prevention, and treatment of bleeding and thrombosis in patients with liver disease admitted to an intensive care unit.

Original languageEnglish
Pages (from-to)245-251
Number of pages7
JournalTransfusion medicine reviews
Volume31
Issue number4
DOIs
Publication statusPublished - Oct-2017

Keywords

  • Bleeding
  • Thrombosis
  • Liver
  • Cirrhosis
  • Acute-on-chronic liver failure
  • Intensive care
  • Anticoagulants
  • Fresh frozen plasma
  • Prothrombin time
  • Thromboelastography
  • CRITICALLY-ILL PATIENTS
  • VON-WILLEBRAND-FACTOR
  • THROMBIN GENERATION
  • PLATELET TRANSFUSION
  • RISK-FACTORS
  • REBALANCED HEMOSTASIS
  • HYPERCOAGULABLE STATE
  • HOSPITALIZED-PATIENTS
  • RETROSPECTIVE COHORT
  • ARTERIAL THROMBOSIS

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