單一純麥_MadsMikkelsen

肝硬化,血小板,fibrinogen,CVC

給肝硬化病人打CVC或tapping腹水胸水前不必因為INR延長而預先輸FFP。反而要注意的是病人的血小板及fibrinogen的數值是多少。

Management of Coagulopathy in Liver Disease


Should a prolonged INR in liver cirrhosis be routinely corrected with FFP prior to invasive procedure?

No. PT or INR is not a reliable predictor of bleeding tendency in cirrhotic patients.

Platelet < 50,000/uL or fibrinogen < 120 mg/dL is more reliable than PT or INR in predicting bleeding risk in cirrhotic patients. Targeting INR or PT alone leads to overuse of FFP. 

Vitamin K replacement usually has a minimal effect. The thinking has been that “it does not hurt and may help,” so there is no harm in adding vitamin K supplementation to the treatment program.


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