Hyperfibrinolysis and the risk of hemorrhage in stable cirrhotic patients

Surawong, Anoree; Rojnuckarin, Ponlapat; Juntiang, Jumlong; Akkawat, Benjaporn; Komolmit, Piyawat; Intragumtornchai, Tanin

doi:10.2478/abm-2010-0027

Cited by 5 publications

(7 citation statements)

References 23 publications

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“…3 APTT prolongation is a significant risk factor of death. 1 Alcoholic cirrhosis is the most common etiology found in hyperfibrinolysis with liver disease.…”

Section: Discussionmentioning

confidence: 99%

Sudden Onset Abdominal Wall Swellings in Patient of Liver Cirrhosis

Patil

Sheth

Prasanna

et al. 2012

Journal of Clinical and Experimental Hepatology

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Spontaneous hematomas in cirrhotic patients are uncommon. Severe coagulopathy in advanced hepatic disease is characterized by both coagulation factor deficiencies and accelerated fibrinolysis. Hyperfibrinolysis in cirrhosis is a result of excess fibrin breakdown leading to defective hemostasis. We present a case of spontaneous hematomas with an acute drop in hemoglobin level, in a patient with cirrhosis which was due to primary hyperfibrinolysis.

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“…3 APTT prolongation is a significant risk factor of death. 1 Alcoholic cirrhosis is the most common etiology found in hyperfibrinolysis with liver disease.…”

Section: Discussionmentioning

confidence: 99%

Sudden Onset Abdominal Wall Swellings in Patient of Liver Cirrhosis

Patil

Sheth

Prasanna

et al. 2012

Journal of Clinical and Experimental Hepatology

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“…It is not necessarily accompanied by hemorrhagic tendency, although there are many risk factors that can cause hyperfibrinolysis, even hyperfibrinolysis occurred in severe hepatitis [ 91 ]. In addition, FDPs inhibit fibrin monomer polymerize function, and also block platelet aggregation, then further worse the deficiency of hemostasis and coagulation, finally leading to the aggravation of bleeding tendency [ 92 ].…”

Section: Mechanismsmentioning

confidence: 99%

“…There are many assay methods including immunization Fi test (namely latex particle agglutination test, normal titer<1:8), FDPs flocculation test, radial immunodiffusion staphylococcal clumping test, indirect hemagglutination inhibition test, enzyme-linked immunosorbent assay (ELISA) and so on. If the serum levels of FDPs elevate, it indicates acute DIC may occur [ 92 ].…”

Section: Laboratory Testsmentioning

confidence: 99%

Main Complications of AECHB and Severe Hepatitis B (Liver Failure)

Song

Zhu

et al. 2019

Acute Exacerbation of Chronic Hepatitis B

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This chapter describes the clinical features, and diagnosis of complications in AECHB including secondary bacterial infections, coagulation disorder, water electrolyte disorder, hepatorenal syndrome, hepatic encephalopathy, hepatopulmonary syndrome and endotoxemia Patients with severe hepatitis have impaired immunity and are therefore vulnerable to all kinds of infections. After infection, these patients may experience shock, DIC and multiple organ failure, all of which seriously affect their prognosis and are major causes of death. Concurrent infections consist primarily of infections of the lungs, intestines, biliary tract, and urinary tract, as well as spontaneous bacterial peritonitis and sepsis. Severe hepatitis may reduce the synthesis of coagulation factors and enhance their dysfunction and increase anticoagulants and platelet abnormalities, leading to coagulopathy. Infection, hepatorenal syndrome and complications can further aggravate coagulopathy, resulting in DIC and seriously affecting patient prognosis. Hepatorenal syndrome, which is characterized by renal failure, hemodynamic changes in arterial circulation and abnormalities in the endogenous vascular system, is a common clinical complication of end-stage liver disease, and one of the important indicators for the prognosis of patients with severe hepatitis. Water electrolyte disorder (water retention, hyponatremia, hypokalemia, hyperkalaemia) and acid-base imbalance are common in patients with severe hepatitis. These internal environment disorders can lead to exacerbation and complication of the illness. Hepatic encephalopathy is a neurological and psychiatric anomaly syndrome based on metabolic disorder, and an important prognostic indicator for patients with severe hepatitis. The hepatopulmonary syndrome is an important vascular complication in lungs due to systemic hypoxemia in patients with cirrhosis and portal hypertension. The majority of patients with HPS are asymptomatic. Long-term oxygen therapy remains the most frequently recommended therapy for symptoms in patients with severe hypoxemia. Endotoxemia, an important complication of severe hepatitis, is not only a second hit to the liver, but also leads to other complications including SIRS and MODS.

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“…Maximum observation time was 300 min. Hyperfibrinolysis was defined as an ELT ≤ 100 min (11)(12)(13).…”

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confidence: 99%

“…Child-Pugh score for the 42 patients with a cirrhosis was A, B or C in 9, 11 and 22 cases, respectively. MELD score was 15 [10][11][12][13][14][15][16][17][18][19][20][21][22]. Median peroperative blood loss was 5.…”

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confidence: 99%