الفهرس 
Physiology of HemostasisOnly 14 pages are availabe for public view
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Abstract
Abstract: Acquired bleeding abnormalities represent one of the major problems commonly encountered in critically ill patients irrespective of age. Although most of these patients have no intrinsic abnormalities of hemostasis, either their underlying disease or the therapy of the disease may produce clinically significant bleeding problems. The intensive care physician must be able to recognize these abnormalities quickly and address them before clinically significant problems arise. Diagnostic information can be obtained from thoughtful review of tests that are routinely available; the complete blood count, peripheral blood smear, PT, and aPTT. Some additional tests that are useful in specific circumstances include functional fibrinogen and d-dimer assays, and specific factor assays. Pursuing structured evaluations of these hematologic problems is essential to their successful management. Certain clinical circumstances of those disorders warrant blood product administration. Platelet transfusion can diminish bleeding in patients who have thrombocytopenia or impaired platelet function, but it is relatively contraindicated in TTP or HUS; in these instances, platelet transfusion can fuel thrombosis and worsen clinical signs and symptoms. FFP infusion in coagulopathy provides portions of all clotting factors that are required for adequate hemostasis. PCC or rFVIIa, that are administered in small volumes, may prove better than FFP when coagulopathies require quick intervention (as in life-threatening bleeding) without risk of volume overload (as in heart failure).