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• W4381954845 abstract "Bleeding in the ICU patient is a significant problem that may contribute to patient morbidity and mortality. A patient-centered approach can optimize therapies and patient outcomes. A thorough history and physical exam are essential to pinpointing the etiology of bleeding to develop the best diagnostic and therapeutic plan. Etiologies of bleeding in the ICU patient are numerous and can include disorders of primary or secondary hemostasis, hyperfibrinolysis, vascular abnormalities, surgical bleeding, or rupture of mass lesions. Rapid identification of the source of bleeding is essential to early control of hemostasis. A thorough diagnostic investigation is multimodal and can include laboratory testing as well as imaging. Bloodwork should comprise testing of primary hemostasis, such as platelet number and function, and secondary hemostasis, such as standard tests of coagulation and viscoelastic testing. Focused assessment with ultrasound in trauma is a particularly useful bedside diagnostic test that can aid in identifying and quantifying hemorrhage. For significant hemorrhage, a surgical intervention should be considered early on to minimize morbidity and achieve hemostasis in a timely manner, if clinically applicable. Intravascular volume restoration may be accomplished with conservative crystalloid therapy and blood products. High ratios of fresh frozen plasma to packed red blood cells have been beneficial in humans and should be considered in veterinary patients. Pharmacological management of hemorrhage may involve vitamin K1, desmopressin, and lysine analogs aminocaproic and tranexamic acid. The latter have been an important adjunct to therapy in bleeding patients from a variety of etiologies and have been shown to reduce blood loss, the need for transfusions and possibly reduce mortality. Timely aggressive management of the hemorrhaging patient will augment patient outcomes in the ICU." @default.
• W4381954845 created "2023-06-26" @default.
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• W4381954845 date "2023-01-01" @default.
• W4381954845 modified "2023-09-23" @default.
• W4381954845 title "Management of the bleeding patient in the ICU" @default.
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• W4381954845 doi "https://doi.org/10.1016/b978-0-323-76469-8.00114-3" @default.
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