Core IM | Internal Medicine Podcast #128 Cirrhosis Bleeding Risk, FFP and Indwelling Pleural Catheters: Gray Matters Segments
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Jun 14, 2023 AI Snips
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Paracentesis/Thoracentesis Safety
- Paracentesis and thoracentesis are generally safe procedures, even with abnormal coagulation values.
- A 2004 Hepatology study found no significant bleeding events in 1100 large-volume paracenteses in cirrhotic patients.
FFP Not Recommended
- Current guidelines advise against administering FFP before paracentesis or thoracentesis.
- This is based on the procedures' low bleeding risk, especially when performed by experienced clinicians.
INR and Cirrhosis
- INR in cirrhosis doesn't reflect bleeding risk as it only measures procoagulant factors, not anticoagulant ones.
- Cirrhotic patients have complex coagulation issues like hyperfibrinolysis and low fibrinogen, which FFP doesn't fix.