Coagulopathy in Critically Ill Patients

www.chestjournal.org CHEST / 137 / 1 / JANUARY, 2010 185 C about the risk of bleeding in critically ill patients are common. This apprehension may stem from a sense of responsibility for bleeding following procedures or anticoagulant therapy, or perhaps the fact that hemorrhage is often visible externa lly. In addition, the clinical laboratory may raise awareness by offering tests that clinicians think provide information about impaired clotting. Unfortunately, many intensivists are not skilled or trained in carrying out assessments of coagulation testing or disorders. As the second of a two-part series on coagulopathy in critically ill patients, this article reviews soluble clotting factors and the most frequent coagulation disorders seen among adults in the ICU. Although this article does not discuss thrombophilia in detail, it does provide a framework for understanding hemostatic testing and interpreting common coagulation tests. Evaluating Classic Clotting Pathways