| Abstrakt: |
Purpose/goals: The purpose of this presentation is to heighten awareness of the risk for coagulopathies in the critically ill patient via a discussion surrounding thrombolytic and thrombophilic disease pathologies associated with critical illness. This dialogue will prepare the intensive care unit (ICU) nurse to better care for these patients. Outcome 1: Describe the physiology of the coagulation process Outcome 2: Understand the complexities of coagulopathies in the context of the critically ill patient Outcome 3: Discuss the etiology, pathophysiology, clinical manifestations and treatment of coagulopathies pertinent to the critically ill patient Session description: The critically ill patient is often at risk for alterations in coagulation. Many of the disease pathologies (sepsis, trauma) that bring patients to the intensive care unit (ICU) can result in clotting disorders. Coagulopathies affect patients in the ICU who are already disadvantaged by immobility and medication interactions, which further exacerbate the problem. One study looking at the incidence of venous thromboembolic disease (VTE) found six predominant pre-existing medical conditions that accounted for close to 90% of patients with VTE (Bauer, & Lip, 2018). These include immobility, previous hospital admission, surgery, malignancy, infection and current hospitalization (Bauer, & Lip, 2018). Patients with three or greater of these conditions, such as most ICU patients, accounted for more than 50% of the patients with VTE (Bauer, & Lip, 2018). On the other end of the coagulation spectrum, severe disseminated intravascular coagulopathy (DIC), has mortality rates that can exceed 50% (Schub, & Balderrama, 2018). The predominant causes of DIC are sepsis and trauma, accounting for up to 90% of the cases (Gando, Levi, & Toh, 2016). Understanding the etiology, pathophysiology, clinical manifestations and treatment of coagulopathies in the critical care environment give critical care nurses the tools to prevent and manage these potentially fatal complications. In this session, we will provide a review of the coagulation process followed by an in-depth examination of pertinent coagulopathies such as heparin-induced thrombocytopenia, DIC and thrombophilic coagulopathies leading to deep vein thrombosis and pulmonary embolism. [ABSTRACT FROM AUTHOR] |
