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Review
. 2023 Dec 8;2023(1):754-760.
doi: 10.1182/hematology.2023000502.

Consumptive coagulopathy in the ICU

Andrew Retter  1 , Beverley J Hunt  2
Affiliations
Review

Consumptive coagulopathy in the ICU

Andrew Retter et al. Hematology Am Soc Hematol Educ Program. .

Abstract

A consumptive coagulopathy describes a situation where there is a loss of hemostatic factors, which leads to an increased risk of bleeding. Some recent studies have used the term interchangeably with disseminated intravascular coagulation (DIC), but we have reverted to the older definition, which covers a broader range of issues where there is loss of hemostatic factors due to multiple causes, which includes systemic activation of coagulation as seen in DIC. Therefore, the term consumptive coagulopathy covers conditions from the hemostatic effects of major hemorrhage to the use of extracorporeal circuits to true DIC. We review the current understanding of the pathophysiology, diagnosis, and management of common consumptive coagulopathy in critical care patients, focusing on recent advances and controversies. Particular emphasis is given to DIC because it is a common and often life-threatening condition in critical care patients and is characterized by the simultaneous occurrence of widespread microvascular thrombosis and bleeding. Second, we focus on the effect of modern medical technology, such as extracorporeal membrane oxygenation, on hemostasis.

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Conflict of interest statement

Andrew Retter consults for Volition Diagnostics UK. He has received fees for presentations and reimbursement for travel to conferences. Volition Diagnostics was not involved with this article in any way.

Beverley J. Hunt: no competing financial interests to declare.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Suggested simple algorithm for the hemostatic management of major bleeding.
See this image and copyright information in PMC

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