Correction of Severe Coagulopathy and Hyperfibrinolysis by Tranexamic Acid and Recombinant Factor VIIa in a Cirrhotic Patient After Trauma: A Case Report

A & a Case Reports
Jack LouroRoman Dudaryk

Abstract

Coagulopathy induced by trauma or cirrhosis is a well-recognized entity. Viscoelastic testing has been used in either condition for goal-directed transfusion and detection of fibrinolysis since conventional coagulation tests do not correlate with clinical risk of bleeding. Hemostatic resuscitation may not be adequate for a trauma patient with liver disease due to complex alterations in coagulation systems and occasionally require adjuvant therapy. We report a case of trauma-induced coagulopathy presenting as severe hyperfibrinolysis in a cirrhotic patient who was refractory to hemostatic resuscitation but was rapidly corrected by the administration of tranexamic acid and recombinant Factor VIIa.

References

Sep 30, 2004·Journal of the American College of Surgeons·Demetrios DemetriadesLinda Chan
Nov 5, 2010·The New England Journal of Medicine·Marcel LeviDavid Truloff
Apr 20, 2011·Annals of Internal Medicine·Veronica YankRandall S Stafford
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Feb 3, 2016·Current Opinion in Anaesthesiology·Christopher T StephensJohn B Holcomb

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Citations

Jul 12, 2019·Research and Practice in Thrombosis and Haemostasis·Saranya KodaliMary Cushman
Sep 18, 2017·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·M J MadurskaJ J Morrison

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