Category CCC

The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.

CCC Critical Care compendium 340

Coagulation Profile

OVERVIEW PROTHROMBIN TIME -> warfarin-> vitamin K deficiency-> liver disease-> DIC-> artefact: incorrect sampling or increased haematocrit (> 55%) ACTIVATED PARTIAL THROMBOPLASTIN TIME -> heparin-> DIC-> haemophilia-> liver disease THROMBIN TIME -> heparin-> DIC-> hypofibrinogenaemia-> fibrin degradation products FIBRINOGEN ->…

CCC Critical Care compendium 340

D-dimer

D-dimer specific for fibrin breakdownsensitivity = 95%specificity = 50%

CCC Critical Care compendium 340

Platelet Function Assays

PFA-100 = citrated whole blood placed in a disposable cartridge containing a membrane coated with collagen/adrenaline or collagen/ADP into which a microscopic aperture has been cut -> with high shear rates contact of blood with the membrane causes platelets to aggregate and occlude the aperture.

CCC Critical Care compendium 340

Thromboelastogram (TEG)

Thromboelastography (TEG) is a viscoelastic hemostatic assay that measures the global viscoelastic properties of whole blood clot formation under low shear stress

CCC Critical Care compendium 340

Thrombophilia Screen

Thrombophilia is a predisposition to increased risk of venous and arterial thromboembolism due to haemostatic abnormalities

CCC Critical Care compendium 340

VBG versus ABG

Reviewed and revised 7 January 2016 OVERVIEW Venous blood gases (VBG) are widely used in the emergency setting in preference to arterial blood gases (ABG) as a result of research published since 2001 The weight of data suggests that venous pH…

CCC Critical Care compendium 340

Chloride in Critical Illness

Chloride is the major anion in the extracellular fluid (ECF) and is the second most important contributor to plasma tonicity. The possibility of harm from hyperchloraemia, particularly in the context of fluid resuscitation with chloride-rich solutions such as normal saline, is an area of intense research interest

CCC Critical Care compendium 340

Ammonia and hyperammonaemia

OVERVIEW Hyperammonaemia is easily forgotten as a potential cause of metabolic encephalopathy Ammonia is produced by the hepatic metabolism of amino acids and is primarily degraded via the urea cycle In the absence of obvious liver dysfunction or a drug…