Coagulopathy in the ICU Flashcards
CCM 3rd Ed
Chapter 104: Coagulopathy in the ICU
What are the three phases in the cell based co-ag model?
Initiation, amplification, propagation
What is the cell based co-ag model?
Coagulation is initiated through tissue factor (TF) on the surface of TF-bearing cells, leading to the generation of small amounts of thrombin (IIa) from prothrombin (II) (initiation phase). Thrombin amplifies the initial signal by activating platelets and cofactors (fVa, fVIIIa) on the platelet surfaces (amplification phase). Large-scale thrombin generation occurs on the surface of the activated platelet (propagation phase)
Are clinical signs diagnostic for the type of coagulopathy?
No - much overlap
What is a normal BMBT in dogs and cats?
Dogs <3mins
Cats <2mins
What does PT test
Extrinsic and common
What does aPTT test
Intrinsic and common
What are Vit K dependent co-ags?
2, 7, 9, 10
Hemostatic disorders in critically ill animals
What factor is deficient in haemophillia A
Factor 8
What factor is deficient in haemophillia B
9
How does Vit K result in coagulopathy?
These compounds inhibit vitamin K epoxide reductase, an enzyme needed for vitamin K recycling. Hydroquinone (reduced vitamin K) must be present for activation of the vitamin K-dependent coagulation factors (II, VII, IX and X).
What are the 2 consequences of DIC
microthrombosis and consumptive coagulopathy
What is the veterinary definition of DIC
there isn’t one
What haemostatic abnormalities are consistent with DIC
thrombocytopenia, prolongation of PT and aPTT, hypofibrinogenemia, elevated D-dimers, and reduced antithrombin activity.
