Procedures in patients with coagulopathies: Difference between revisions

No edit summary
Line 14: Line 14:


==Central Line==
==Central Line==
*No benefit FFP if artery isn't hit (Am J Surg '01)
*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)

Revision as of 22:26, 24 June 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

  • Tranfuse if platelets <50,000[1][2] or INR >1.4[3]
  • If hemophiliac, replace factor before LP

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)
  1. ↑ Roberts, Clin Proc Emer Med 2004
  2. ↑ Johnson KS, et al. Lumbar puncture: Technique, indications, contradindications, and complications in adults. Sept 18, 2013. UpToDate.
  3. ↑ Johnson KS, et al. Lumbar puncture: Technique, indications, contradindications, and complications in adults. Sept 18, 2013. UpToDate.
  4. ↑ Am J Surg '01
Retrieved from "https://www.wikem.org/w/index.php?title=Procedures_in_patients_with_coagulopathies&oldid=22027"