Abstract Number: PB0482
Meeting: ISTH 2020 Congress
Background: Yellow fever is a viral sepsis which most commonly clinical manifestations include since sudden onset of fever and prostration to more serious illness associated with multiorgan dysfunction, worse outcome and high mortality. The severe form of the disease can be complicated by acute fulminant hepatitis, rapid deterioration of liver function and jaundice. Hepatic-induced coagulopathy may be associated with severe hemorrhagic manifestations. Liver failure and disseminated intravascular coagulation (DIC) are the main causes of bleeding. TEM score is a highly desirable goal designed to detect a hypocoagulable state in the advanced stages of DIC.
Thromboelastometry has been used for early diagnosis of coagulopathy guiding therapy by goals. Factor concentrates and hemostatic drugs can prevent the unnecessary use of blood components.
Aims: This a case report of a patient admitted to the ICU with diagnoses of yellow fever complicated by liver failure and DIC, in which thromboelastometry identified coagulopathy guiding hemostatic therapy with fibrinogen concentrate and vitamin K. No blood components transfusion was required, even in presence of thrombocytopenia.
Methods: Case report description.
Results: We report the case of a 23-year-old male admitted to the department of critical care with diagnosis of yellow fever associated with liver failure, and DIC. Laboratory tests showed thrombocytopenia and a tendency of hypofibringenemia, suggesting higher risk of bleeding. Unlike CLT, TEM identified specific coagulation disorder and thereby guided hemostatic therapy by goals. Both Fibrinogen concentrate and Vitamin K were administered, no blood components transfusion was required, even in presence of thrombocytopenia.
Conclusions: Thromboelatometry allowed early identification of coagulopathy, guiding hemostatic therapy by goals. Administration of hemostatic drugs including fibrinogen concentrate and vitamin K could improve thromboelastometric parameters, correcting the complex coagulation disorder. Blood components transfusion were not performed, and there was no bleeding as well.
To cite this abstract in AMA style:Crochemore T, Savioli F. Thromboelastometry Identifies Coagulopathy Associated with Liver Failure and DIC Caused by Yellow Fever, Guiding Specific Hemostatic Therapy: A Case Report [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/thromboelastometry-identifies-coagulopathy-associated-with-liver-failure-and-dic-caused-by-yellow-fever-guiding-specific-hemostatic-therapy-a-case-report/. Accessed March 4, 2024.
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