| Coagulation biomarkers and laboratory support of critically ill patients Sabrina Racine-Brzostek. |
Abstract
Abnormalities in hemostasis are commonly observed in critically ill patients. Coagulopathies may complicate the patient’s hospital course, leading to potentially adverse outcomes and an increase in mortality. This presentation will review the more commonly known and more readily available coagulation markers such as aPTT, PT/INR, platelets, fibrinogen, fibrin degradation products (e.g. D-dimer). However, these routine coagulation tests may fail to identify or detect clinically significant coagulation defects that contribute to bleeding. During a brief overview of coagulation and fibrinolytic pathophysiology, other less conventional biomarkers will be highlighted including antithrombin (AT), protein C, tissue factor pathway inhibitor (TFPI), tissue plasminogen activator (tPA) and tissue plasminogen activator inhibitor (PAI). Also, the interplay between the coagulation and inflammatory pathways will be touched upon briefly. Finally, nonconventional assays will also be highlighted. As a technology becoming more mainstream in hospital settings, there will be an emphasis on viscoelastic testing which provides a comprehensive evaluation of the overall hemostatic process and may fill diagnostical gaps that standard coagulation testing may lack.
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