title: Perioperative coagulation management in the intensive care unit.
abstract: OBJECTIVE
  Coagulopathy in an ICU setting is multifactorial, but newer anticoagulation agents are the potentially contributing causes. Critically ill patients may suffer from disorders because of surgery or trauma, in addition to acquired causes including antiplatelet agents and the new oral anticoagulants. An understanding of the coagulopathy, hemostatic considerations, and therapeutic approaches is important when managing these patients.
  
  
  RESULTS
  All anticoagulation agents may contribute to coagulopathy in critically ill patients. Options for management include hemodialysis, transfusion of blood products, and prohemostatic drugs. Recombinant and purified coagulation therapies are also now available in most countries that provide clinicians with specific agents to treat targeted deficiencies.
  
  
  CONCLUSIONS
  Coagulopathy occurs in ICU patients because of multiple factors including anticoagulants, dilution, fibrinolysis, and factor consumption. Therapeutic prohemostatic pharmacologic approaches, in addition to standard transfusion therapy, need to be considered in managing coagulopathy in the ICU setting.
authors.affiliation: Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia 30322, USA. Jlevy01@emory.edu
authors.forename: Jerrold H
authors.initials: JH
authors.lastname: Levy
authors.forename: David
authors.initials: D
authors.lastname: Faraoni
authors.forename: Roman M
authors.initials: RM
authors.lastname: Sniecinski
mesh_terms: D001777:Blood Coagulation / Q000187:drug effects*; D001778:Blood Coagulation Disorders / Q000188:drug therapy*; D001803:Blood Transfusion; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007362:Intensive Care Units; D019990:Perioperative Care / Q000379:methods*; D006435:Renal Dialysis
chemical_list: D006490:Hemostatics