Patients With Liver Disease Often Have Blood Results That Give An Appearance Of A Significant Bleeding Risk

12 Mar, 2021

Dr. Rajesh Bollam

#liverdisease #hemostasis

Patients with liver disease often have blood results that give an appearance of a significant bleeding risk;

- Low platelets

- Prolonged PT/APTT

- Low fibrinogen

However...patients with liver disease often have a 'rebalancing' of haemostasis...

This occurs because when procoagulant factors reduce, so do natural anticoagulants

Some more considerations;

- Spontaneous bleeding & bleeding post minimally invasive procedures are both low

- FFP transfusion often leads to minimal improvement in PT (no impact if under 19s)

-FFP transfusion could also increase portal pressures, and this is a known risk for variceal haemorrhage

- The American association for the study of liver disease guidelines advise against checking INR or giving FFP in variceal haemorrhage

A study of ICU patients with liver disease identified that a fibrinogen of under 0.6g/L and platelet count of <30 x 10^9/L were most predictive of bleeding suggesting that these should be relied upon more than PT results.

SO...treating the numbers with FFP transfusion is unlikely to give benefit in most pts. & mayharm. A v. low platelet count or fibrinogen are more likely to be predictive of bleeding

See @BritSocHaem FFP guideline for more https://t.co/HPoJLeni8m

#DrRajeshBollam #Hematology #HematoOncologist #oncologist #cancerdoctor #Hyderabad #Secundrabad

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Patients With Liver Disease Often Have Blood Results That Give An Appearance Of A Significant Bleeding Risk

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