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Abnormal laboratory coagulation test results are frequently documented in critically ill patients, and these patients often also need to undergo invasive procedures. Clinicians have an understandable desire to minimize any perceived heightened risk of bleeding complications in those patients who require invasive procedures. In this setting, prophylactic administration of platelets or plasma is commonplace. This review explores the nature of these sequential statements and the degree to which these statements are supported by evidence. We discuss the complexity of managing the low risk of procedure-related bleeding in a setting where coagulation tests fail to reliably predict this risk. The role of prophylactic transfusion of platelets and plasma and correction of medication-induced coagulopathy is also reviewed. New strategies are required to improve the evidence base, including novel methodological approaches or the use of a clinical scoring system.

Original publication

DOI

10.1016/j.tmrv.2017.05.008

Type

Journal article

Journal

Transfus Med Rev

Publication Date

10/2017

Volume

31

Pages

223 - 229

Keywords

Coagulopathy, Critical illness, Fresh-frozen plasma, Interventions, Platelet transfusion, Blood Transfusion, Critical Illness, Hemostatic Disorders, Humans, Preventive Medicine, Surgical Procedures, Operative