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Perioperative Bleeding - Dilutional Coagulopathy

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During excessive bleeding, the number of platelets or coagulation factors may be too low to stop bleeding. Products used to treat patients in these situations may not contain the necessary coagulation factors (e.g. red blood cell concentrates or plasma substitutes/expanders) to stop further bleeding, and so need to be replenished. This condition is known as dilutational coagulopathy, which means that a patient’s blood is so diluted that it cannot clot or form a stable plug. 13


Volume replacement with substitutes and/or
red blood cell concentrates can lead to
dilutional coagulopathy 
Colloid plasma expanders are believed to impair coagulation more than simple dilution with saline. Impairments that develop as a result of colloid expanders are thought to be caused by an acquired dysfunctional fibrinogen defect that results in abnormal fibrin polymerization. 15

CSL Behring products used in the treatment of bleeding associated with dilutional coagulopathy include:

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