Bleeding treatments: Difference between revisions
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==Treatments== | ==Treatments== | ||
# | #pRBCs | ||
# DDAVP | #DDAVP 0.3mg/kg subQ or IV (max 20mg) | ||
# Platelets | #Platelets | ||
# FFP | #FFP | ||
# Cryopreticipate | #Cryopreticipate | ||
# Vitamin K (10mg SQ/IM) | #Vitamin K (10mg SQ/IM) | ||
# Protamine (Heparin) | #Protamine (Heparin) | ||
# Estrogen ( | #Estrogen (Uterine, renal) | ||
# PPI/Pepcid/Octreotide (GI | #PPI/Pepcid/Octreotide (GI) | ||
==Warfarin/Vitamin K Deficiency== | |||
#FFP | #FFP | ||
#Vitamin K (+/- takes 24hrs to affect & 2wk to wear off) | #Vitamin K (+/- takes 24hrs to affect & 2wk to wear off) | ||
==Heparin/Lovenox== | ==Heparin/Lovenox== | ||
#Protamie (1mg IV Q100 U of heparin in previous 4hrs) | #Protamie (1mg IV Q100 U of heparin in previous 4hrs) | ||
#Massive bleed --> cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec) | #Massive bleed --> cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec) | ||
| Line 25: | Line 21: | ||
#Vitamin K | #Vitamin K | ||
#PPI/pepcid/octreotide (variceal bleed) | #PPI/pepcid/octreotide (variceal bleed) | ||
#FFP | #FFP | ||
#Plts | |||
#DDAVP | #DDAVP | ||
==Renal Disease== | ==Renal Disease== | ||
# | #pRBCs (<8 Hb) | ||
#Hemodialysis | #Hemodialysis | ||
#DDAVP | #DDAVP | ||
#Conjugated estrogens (unknown mechanism) | #Conjugated estrogens (unknown mechanism) | ||
#Cyroprecipitate & platelets (in life-threatening bleed only) | #Cyroprecipitate & platelets (in life-threatening bleed only) | ||
==DIC== | ==DIC== | ||
Revision as of 09:38, 12 October 2011
Treatments
- pRBCs
- DDAVP 0.3mg/kg subQ or IV (max 20mg)
- Platelets
- FFP
- Cryopreticipate
- Vitamin K (10mg SQ/IM)
- Protamine (Heparin)
- Estrogen (Uterine, renal)
- PPI/Pepcid/Octreotide (GI)
Warfarin/Vitamin K Deficiency
- FFP
- Vitamin K (+/- takes 24hrs to affect & 2wk to wear off)
Heparin/Lovenox
- 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
- Plts
- 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)