This study attempts to clarify the pathophysiology of haemostasis in relation to the evidence of sepsis in liver disease, and compares the accuracy of various available laboratory tests in assessment of these patients. Further research is needed for proper understanding of the influence of sepsis on coagulation disorders in acute variceal bleeding in cirrhosis, to correctly identify the type and optimal quantity of blood product requirement in at risk patients. Thromboelastography (TEG) /Sonoclot has been proposed as a superior tool to rapidly diagnose and help guide resuscitation with blood products. Secondly, the study of derangement in coagulopathy after the onset of sepsis is of paramount importance because of increased mortality after the onset of sepsis. In the present study, patients with cirrhosis who present with acute variceal bleeding, will be included in the study cohort, and will undergo a baseline diagnostic workup as described. They will be followed for development of any signs of infection after hospitalization. Then the effect of sepsis on their coagulation and thrombin generation response swill be assessed. Thus the effect of sepsis on the progression and outcome of coagulopathy in patients with acute variceal bleeding will be studied.
Study Type
OBSERVATIONAL
Enrollment
75
Coagulation assessment using heparinase treated SONOCLOT
Postgraduate Institute of Medical Education and Research
Chandigarh, Choose Any State/Province, India
RECRUITINGGeneration of Endogenous Heparinoids
Change in SONOCLOT values- global and heparinase treated
Time frame: 7 days
Change in plasma levels of Specific Coagulation Factors -VIII, X, XIII, TPA and PAI
Specific factor assessment
Time frame: 7 days
Correlation of sonoclot parameters- ACT, PF and Peak amplitude in predicting blood product utilization
blood transfusion requirements
Time frame: 7 Days
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