ETIOLOGY AND TREATMENT OF ACQUIRED COAGULOPATHIES IN THE CRITICALLY ILL ADULT AND CHILD

Excessive bleeding frequently complicates the care of critically ill p atients. Except in the case of trauma or inpatients with known coagulo pathies, the bleeding is generally not directly related to the illness that results in admission to the intensive care unit. In general, the causes of the bleeding can be divided into three categories: consumpt ive coagulopathies, bleeding related to ''hepatic issues,'' and iatrog enic causes. In most circumstances, the pathogenesis and management of these acquired coagulopathies do not differ between the adult and chi ld patient. However, some differences do exist in regards to the clini cal manifestations and management of some consumptive coagulopathies. This article reviews the more common causes of bleeding in the critica lly ill patient and outlines diagnostic and treatment approaches for t hese patients. Particular emphasis will be placed on the differences i n presentation and management where differences exist.