Coagulopatías adquiridas. Deficiencias complejas de la hemostasia

Acquired coagulopathies are very frequent in clinical practice. Usually they result from the overconsumption of coagulation factors, such as in disseminated intravascular coagulation (DIC), factor synthesis defects, liver disease, vitamin K deficit or because of circulating anticoagulants or drugs that impair coagulation (antivitamin K, acenocumarol, warfarin). The intensity of the ensuing hemorrhage can be highly variable and it correlates poorly with the hemostatic defects found in routine coagulation tests (prothrombin time, partial activated partial thromboplastin time, fibrinogen, D-dimer, platelet count). Treatment should be individually managed and requires the correct use of blood derivatives, plasma, platelets, cryoprecipitate along with pharmacologic agents such as prothrombin complex concentrates and antifibrinolytics. Vitamin K should be administered in order to correct a deficit that can be due to treatment with acenocumarol or warfarin.