Procedures in patients with coagulopathies: Difference between revisions
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*Paracentesis: Kaji Questions, Thomsen TW. Paracentesis. N Engl J Med 2006; 355: e21. | *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; Yu (Clin Liv Dz '01) | ||
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[[Category:Procedures]] | [[Category:Procedures]] | ||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Revision as of 20:56, 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, or INR >1.4[1]
- If hemophiliac, replace factor before LP
Central Line
- No benefit FFP if artery isn't hit (Am J Surg '01)
- 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)
- ↑ Johnson KS, et al. Lumbar puncture: Technique, indications, contradindications, and complications in adults. Sept 18, 2013. UpToDate.