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ISSN 2448-8909 (Print)

2004, Number 1

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Med Crit 2004; 18 (1)

Breaking a paradigm: of the humoral model at the cellular model of coagulation: Its clinical application in the critically ill patient

Carrillo ER, Salmerón NP, Carvajal RR, Contreras DV, Hernández AC

Language: Spanish
References: 57
Page: 17-23
PDF size: 74.85 Kb.


ABSTRACT

The traditional model of coagulation includes two pathways with sequential humoral activation that result in the generation of thrombin. The cellular model establishes that the complex tissue factor – activated factor VII (FT-FVIIa), in a close relation with the surface of the platelet, activates the rest of the coagulation factors to generate thrombin. The sequence initiation, amplification and propagation are characteristics of this model. The use of the recombinant activated factor VII (rFVIIa) is sustained in the cellular model activation of coagulation. In this model the haemostasia is induced by the activated platelet and the coagulation factors in its surface. The primary indication for rFVIIa was hemophilia with inhibitors; it has recently been also used in critically children and adults with microvascular hemorrhage and uncontrollable bleeding as in trauma patients, liver transplantation, cardiopulmonar surgery, renal and hepatic failure, neurosurgery, intoxication with oral anticoagulants and platelet dysfunction.


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