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Inr normal range for surgery driver#

The study is intriguing and should be reproduced utilizing a primary cohort of emergency department specific disease entities and in particular traumatic injuries. The study is however predicated upon the TEG as the gold standard of bleeding homeostasis, and this is far from established. Following the established recommendations likely exposed these patients to harm via the unnecessary transfusions based upon a surrogate marker that does not directly assess actual bleeding risk. LDL cholesterol), the INR in these patients not taking vitamin K antagonists did not reflect patient-oriented disease specifics– in particular the need for FFP transfusions.

Despite the change in slight decrease in INR (1.83 to 1.53), the pre- and post-FFP CI’s (-0.1 to 0.4) were all in the normal range.Īs with various other indirect measurements of patient disease burden (e.g.

After transfusion of FFP, patients average CI = 0.4.

Before transfusion of FFP, patients average CI= -0.1.

After transfusion of FFP (range of 1-4 units FFP/patient), patients’ average INR = 1.53.

Before transfusion of FFP, patients’ average INR = 1.83.

A total of 106 patients (35% traumatic, 65% surgical) were included in the final analysis.

Patient had ingested an antiplatelet agent within 10 days.

Patients undergoing massive transfusions.

Single center prospective observational study of trauma and surgical patients who were > 16 years of age, hemodynamically stable, and received FFP transfusions.

To compare INR versus TEG prior to and after the administration of FFP in trauma and surgical patients.

The International Normalized Ratio overestimates coagulopathy in stable trauma and surgical patients. Values 3 represent a thrombotic risk (hypercoagulable state).

After the calculation of multiple data points, the final reading is provided as a coagulation index (CI), or overall state of coagulation. TEG is a point of care test that measures multiple parameters of bleeding hemostasis from blood clot initiation to lysis at a given patient body temperature (more on TEG on LIFTL). Is there a better marker for bleeding risk? Thromboelastography (TEG) In spite of this, indications for FFP transfusions in surgical and traumatically injured patients center on the assessment and subsequent normalization of the INR. As a corollary, patients with chronic liver disease frequently have elevations in their INR due to insufficient protein synthesis but are still at increased risk for clotting. It is not clear, due to the limited scope of the INR to measure actual bleeding/clotting homeostasis as opposed to the extrinsic pathway, that the INR directly reflects the underlying bleeding risk of acutely ill patients. In patients NOT taking vitamin K antagonists, an elevated international normalized ratio (INR) is presumed to represent bleeding risk and therefore be a useful measurement in traumatic and surgical patients. Seems reasonable… or is it? What is the logic? Background

The surgeons admit her to the hospital to observe for a potential hollow viscus injury and requests that you order 2 units of FFP for her. She has moderate abdominal tenderness diffusely and a seat belt sign, but has a negative abdominal/pelvis CT.

Inr normal range for surgery driver#

A 55 year old woman presents as the driver of a motor vehicle collision.