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- Saskia E M Schols, Johan W M Heemskerk, and Elisabeth C M van Pampus.
- Department of Biochemistry, CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
- Transfus Med Rev. 2010 Jan 1;24(1):44-52.
AbstractThe management of dilutional coagulopathy due to fluid infusion and massive blood loss is a topic that deserves a biochemical approach. In this review article, we provide an overview of current guidelines and recommendations on diagnosis and on management of transfusion in acquired coagulopathy. We discuss the biochemical differences between kinetic clotting assays (clotting times) and new capacitive coagulation measurements that provide time-dependent information on thrombin generation and fibrin clot formation. The available evidence suggests that a combination of assay types is required for evaluating new transfusion protocols aimed to optimize hemostasis and stop bleeding. Although there is current consensus on the application of fresh frozen plasma to revert coagulopathy, factor concentrates may appear to be useful in the future.
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