Bleeding treatments: Difference between revisions
(Created page with "==Treatments== 1) PRBCs 2) DDAVP (0.3mirog/kq SQ/IV) 3) Platelets 4) FFP 5) Cryopreticipate 6) Vitamin K (10mg SQ/IM) 7) Protamine (Heparin) 8) Estrogen (Renal) 9) PPI/...") |
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==Treatments== | ==Treatments== | ||
# PRBCs | |||
# DDAVP (0.3mirog/kq SQ/IV) | |||
# Platelets | |||
# FFP | |||
# Cryopreticipate | |||
# Vitamin K (10mg SQ/IM) | |||
# Protamine (Heparin) | |||
# Estrogen (Renal) | |||
# PPI/Pepcid/Octreotide (GI) | |||
==Warfarin/Vitamin K Def== | ==Warfarin/Vitamin K Def== | ||
(inc PT/INR) | (inc PT/INR) | ||
#FFP | |||
#Vitamin K (+/- takes 24hrs to affect & 2wk to wear off) | |||
==Heparin/Lovenox== | ==Heparin/Lovenox== | ||
(inc PTT) | (inc PTT) | ||
#Protamie (1mg IV Q100 U of heparin in previous 4hrs) | |||
#Massive bleed --> cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec) | |||
==Liver Disease== | ==Liver Disease== | ||
#Vitamin K | |||
#PPI/pepcid/octreotide (variceal bleed) | |||
#FFP (& platlets if low) | |||
#DDAVP | |||
==Renal Disease== | ==Renal Disease== | ||
#PRBCs (<8 Hb) | |||
#Hemodialysis | |||
#DDAVP | |||
#Conjugated estrogens (unknown mechanism) | |||
#Cyroprecipitate & platelets (in life-threatening bleed only) | |||
==DIC== | ==DIC== | ||
(see also DIC) | (see also DIC) | ||
#IVF | |||
#PRBCs | |||
#Vitamin K | |||
#Folate (1mg IV) | |||
If bleeding predominant DIC: | If bleeding predominant DIC: | ||
#FFP (2 U at a time) | |||
#Cryoprecipitate (10 bags at a time) | |||
#(Heparin is contraversial in thrombosis predominant DIC) | |||
(Heparin is contraversial in thrombosis predominant DIC) | |||
==Factor VIII Inhibitor== | ==Factor VIII Inhibitor== | ||
(PTT does not correct after mixing) | (PTT does not correct after mixing) | ||
#high dose Factor VII, prothrombin, or recombinant factor VIIa | |||
==Lupus Anticoagulant== | ==Lupus Anticoagulant== | ||
(rare) | (rare) | ||
#warfarin or ASA | |||
==Source == | ==Source == | ||
1/22/06 DONALDSON (adapted from Tintinalli's) | 1/22/06 DONALDSON (adapted from Tintinalli's) | ||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Revision as of 14:15, 14 March 2011
Treatments
- PRBCs
- DDAVP (0.3mirog/kq SQ/IV)
- Platelets
- FFP
- Cryopreticipate
- Vitamin K (10mg SQ/IM)
- Protamine (Heparin)
- Estrogen (Renal)
- PPI/Pepcid/Octreotide (GI)
Warfarin/Vitamin K Def
(inc PT/INR)
- FFP
- Vitamin K (+/- takes 24hrs to affect & 2wk to wear off)
Heparin/Lovenox
(inc PTT)
- Protamie (1mg IV Q100 U of heparin in previous 4hrs)
- Massive bleed --> cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec)
Liver Disease
- Vitamin K
- PPI/pepcid/octreotide (variceal bleed)
- FFP (& platlets if low)
- DDAVP
Renal Disease
- PRBCs (<8 Hb)
- Hemodialysis
- DDAVP
- Conjugated estrogens (unknown mechanism)
- Cyroprecipitate & platelets (in life-threatening bleed only)
DIC
(see also DIC)
- IVF
- PRBCs
- Vitamin K
- Folate (1mg IV)
If bleeding predominant DIC:
- FFP (2 U at a time)
- Cryoprecipitate (10 bags at a time)
- (Heparin is contraversial in thrombosis predominant DIC)
Factor VIII Inhibitor
(PTT does not correct after mixing)
- high dose Factor VII, prothrombin, or recombinant factor VIIa
Lupus Anticoagulant
(rare)
- warfarin or ASA
Source
1/22/06 DONALDSON (adapted from Tintinalli's)