title: Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF).
abstract: In the presented case, the authors describe an obese middle-aged man that presented to the emergency department for persistent oedema, scleral icterus and fatigue. He was admitted to the hospital and diagnosed with liver cirrhosis via transjugular liver biopsy. He continued to bleed from the biopsy site for 5 days from accelerated intravascular coagulation and fibrinolysis (AICF) requiring multiple transfusions of packed red blood cells, fresh-frozen plasma and cryoprecipitate. The authors then used thromboelastography (TEG) to further characterise the patient's coagulopathy, which revealed platelet inhibition. The results of the TEG significantly changed future transfusion management. Finally, the authors conducted a literature review to summarise the current literature available for the use of TEG in the management of liver cirrhosis with AICF.
authors.affiliation: Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, Maryland, USA.
authors.forename: Thomas Joseph
authors.initials: TJ
authors.lastname: Peterson
authors.affiliation: Department of Internal Medicine-Psychiatry, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
authors.forename: Allison Margaret Brown
authors.initials: AM
authors.lastname: Webb
authors.affiliation: Department of Internal Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.
authors.forename: Benjamin Samuel
authors.initials: BS
authors.lastname: Vipler
mesh_terms: D005342:Fibrinolysis; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010949:Plasma; D017713:Platelet Transfusion; D013916:Thrombelastography / Q000379:methods*