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Anticoagulants and antithrombotics in critical illness 

Anticoagulants and antithrombotics in critical illness
Chapter:
Anticoagulants and antithrombotics in critical illness
Author(s):

Vickie McDonald

and Marie Scully

DOI:
10.1093/med/9780199600830.003.0051
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date: 20 February 2020

Coagulation is best thought of using the cell-based model of coagulation. Patients commenced on heparin therapy should have their platelet count monitored early because of the risk of heparin-induced thrombocytopenia, which can occur on any type or dose of heparin. Emergency reversal of warfarin should be with prothrombin complex concentrate (containing factors II, VII, IX, and X) and not fresh frozen plasma. New oral anticoagulants have the advantage of predictable pharmacokinetics and do not require routine monitoring, but optimal reversal strategies for these agents are not clear. Thrombolytic agents lead to variable degrees of systemic lysis, which may cause haemorrhage, including intracerebral haemorrhage

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