Diferencia entre revisiones de «Procedures in patients with coagulopathies»
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| Línea 14: | Línea 14: | ||
==Central Line== | ==Central Line== | ||
*No benefit FFP if artery isn't hit | *No benefit FFP if artery isn't hit<ref>Am J Surg '01</ref> | ||
*Consider transfuse if plat <50,000 | *Consider transfuse if plat <50,000 | ||
*Use compressible site if coagulopathic (jury is still out) | *Use compressible site if coagulopathic (jury is still out) | ||
Revisión del 22:26 24 jun 2014
Paracentesis
- no data supporting cutoff values for coags/platelets beyond which paracent should be avoided/prophylactically transfused
- routine use of FFP and platelets is not recommended
- contraindicated only if DIC or fibrinolysis
- incidence of clinically significant bleeding complications low even in liver failure (< 0.2%)
- Greatly increased serum creatinine levels --> consider post-procedure observation
Thoracentesis
- Transfuse if plat <50,000, or PT/PTT twice nl range (Mcvay)
Lumbar Puncture
Central Line
- No benefit FFP if artery isn't hit[4]
- Consider transfuse if plat <50,000
- Use compressible site if coagulopathic (jury is still out)
See Also
Sources
- Paracentesis: Kaji Questions, Thomsen TW. Paracentesis. N Engl J Med 2006; 355: e21.
- Roberts, Clin Proc Emer Med 2004; Yu (Clin Liv Dz '01)
- ↑ Roberts, Clin Proc Emer Med 2004
- ↑ Johnson KS, et al. Lumbar puncture: Technique, indications, contradindications, and complications in adults. Sept 18, 2013. UpToDate.
- ↑ Johnson KS, et al. Lumbar puncture: Technique, indications, contradindications, and complications in adults. Sept 18, 2013. UpToDate.
- ↑ Am J Surg '01