Online Lecture Series – Coagulopathy in the ICU - Parts 1 & 2 (Recorded June 2021)

ONLINE LECTURE SERIES CONTENT

Coagulopathy in the ICU - Why Care about Clots & How to Stop Them?

This practical and case-based exploration of coagulopathy will open with a review of human and veterinary data on thrombi, highlighting their common – but often overlooked – occurrence and profound impact on case outcome. From there, we will explore the cell-based model of clot formation, its distinct activation, maturation and fibrinolysis phases, and how the cascade is shifted towards hypercoagulability by trauma, sepsis, tumors, cardiac and autoimmune diseases. Virchow’s triad and clinicopathologic tests (CBC, PT aPTT & thrombo elastogram [TEG]) will be applied to clinical cases to identify patients at risk for thrombus formation. Now equipped to detect hypercoagulability, we will explore established and emerging thromboprophylactic and therapeutic strategies, including antiplatelet and anticoagulant medications, to develop a rational approach to case management. The following conditions will be discussed: Cat with aortic-thromboembolism, dog with pulmonary thromboembolism (PTE) and acute kidney disease/acute neurological disease. Special guests will share novel insights on current literature and emerging therapies.

• Why Care about Clots? Epidemiology of Coagulopathy & How Clots form… (120 minutes including Q&A and case discussions)
• Treating the HYPER-Coagulable State – How can we break down Thrombi? (120 minutes including Q&A and case discussions)

Coagulopathy in the ICU - HYPO-Coagulability Matters!

Though hyper-coagulability can be devastating, equally challenging are patients that can’t form clots. The cell-based model of clot formation and diagnostic tools will be used to separate acquired bleeding disorders into those of platelets, clotting factor deficiencies, and hyperfibrinolysis. Particular attention will be given to trauma, the lethal triad, and how initial stabilization can contribute to development of trauma coagulopathy. From there, we will move into practical treatment decisions: When should you give plasma vs. cryoprecipitate? What are the transfusion triggers and how much blood should you give? What is the best time to give tranexamic vs. aminocaproic acid? Finally, the three stages of disseminated intravascular coagulopathy (DIC) – hypercoagulability, hyperfibrinolysis & hypocoagulability – will be used to review diagnosis and titrated management of coagulopathies. Special guests will share novel insights on current literature and emerging therapies.

• Diagnosis of the HYPO-Coagulable State & Trauma as a Trigger…(120 minutes including Q&A and case discussions)
• The HYPO-Coagulable Patient – Drugs, Blood Products & DIC (120 minutes including Q&A and case discussions)

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