Resumen de Acquired disorders of coagulation
Normal coagulation is a balance between pro- and anti-thrombotic mechanisms. Haemorrhage occurs when factors that promote thrombus formation are dysfunctional/absent and may be due to inherited or acquired factors. The most common acquired abnormalities seen in the clinical setting are covered in this article including vitamin K deficiency and warfarin therapy, liver disease, disseminated intravascular coagulation, platelet disorders and vascular disorders. Patients bleeding on warfarin therapy need urgent INR testing and reversal with vitamin K and/or prothrombin complex concentrate. Patients with liver disease have complex haemostatic changes and the management of bleeding depends on the site and severity of bleeding. Disseminated intravascular coagulation may complicate many clinical situations and needs prompt action when patients are bleeding. Acquired dysfunction of platelets is commonly encountered in clinical practice, often in association with drug therapy such as aspirin.
