Clinical Considerations of Coagulopathy in Acute Liver Failure.
Clinical Considerations of Coagulopathy in Acute Liver Failure.
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DOI：
10.14218/jcth.2020.00058
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发表时间：
2020-12-28
影响因子：
3.6
通讯作者：
Chen PH
中科院分区：
文献类型：
--
作者：
Kim A;Niu B;Woreta T;Chen PH
急性肝功能衰竭（ALF）是指在无基础肝病的情况下出现肝性脑病和合成功能受损（国际标准化比值≥1.5）的严重肝功能障碍的快速发作。ALF的国际标准化比值升高通常被误解为出血倾向增加，这可能导致不适当的预防性输血。然而，通过粘弹性试验或凝血酶生成试验对凝血病进行的总体评估表明，ALF患者的止血状态或甚至高凝状态已重新确立。尽管目前的全球检测方法并不完美，但与凝血功能障碍的常规检测方法相比，它们可以为ALF的止血系统提供更细致的见解。
Acute liver failure (ALF) is the rapid onset of severe liver dysfunction, defined by the presence of hepatic encephalopathy and impaired synthetic function (international normalized ratio of ≥1.5) in the absence of underlying liver disease. The elevated international normalized ratio value in ALF is often misinterpreted as an increased hemorrhagic tendency, which can lead to inappropriate, prophylactic transfusions of blood products. However, global assessments of coagulopathy via viscoelastic tests or thrombin generation assay suggest a reestablished hemostatic, or even hypercoagulable, status in patients with ALF. Although the current versions of global assays are not perfect, they can provide more nuanced insights into the hemostatic system in ALF than the conventional measures of coagulopathy.