Coagulopathy and Thrombocytopenia

Coagulopathy is characterized by abnormalities on tests assessing hemostasis: most commonly manifesting in the prothrombin time (PT), which monitors the tissue factor pathway, the activated partial thromboplastin time (aPTT), which monitors the contact activation and common pathways, and platelet count. The term coagulopathy is often meant to describe abnormalities in the PT and aPTT, while thrombocytopenia is used separately to distinguish a low platelet count. This chapter provides a detailed discussion on the prevention, diagnosis, treatment, and prognosis of coagulopathy and thrombocytopenia. Platelet count, PT, and aPTT are screening tests that detect many coagulopathies and are part of routine testing in critically ill patients. Further diagnostic testing will be based on the pattern of lab abnormalities and clinical context.