Piotr Czempik: Rethinking Coagulation in Acute Liver Dysfunction
Piotr Czempik, Chair of Department of Anesthesiology and Intensive Care at Medical University of Silesia, shared on LinkedIn:
”Rethinking Coagulation in Acute Liver Dysfunction
Conventional wisdom tells us that a high INR equals high bleeding risk.
But is that always true?
We recently reported a case of a 61‑year‑old ICU patient with acute liver dysfunction, stage 3 AKI, and INR 3.2 who required dialysis catheter insertion.
Despite the alarming lab values, no bleeding occurred.
Why? Because viscoelastic hemostatic assays (ROTEM) revealed preserved clot propagation and firmness, despite impaired initiation.
Guided by these results, we avoided prophylactic FFP transfusion and proceeded safely with catheter placement.
Key takeaways:
- INR alone is not a reliable predictor of bleeding risk in acute liver failure.
- VHAs provide a global, functional view of hemostasis, often uncovering rebalanced or even hypercoagulable states.
- Routine FFP transfusion before invasive procedures may expose patients to unnecessary risks.
- Individualized risk assessment using VHAs can improve safety and reduce inappropriate transfusion.
- This case adds to growing evidence that we need to move beyond conventional coagulation tests in critical care decision‑making.
How do you approach bleeding risk assessment in patients with acute liver dysfunction?
Have VHAs changed your practice?”
Read the full article here.
Article: No bleeding during a dialysis catheter insertion in a patient with INR 3.2 due to acute liver dysfunction
Authors: Piotr Czempik, Tomasz Jaworski
Stay updated on all scientific advances with Hemostasis Today.
-
Oct 10, 2026, 17:58Archo Farzana Batool: Exploring Medical Writing Through an Article on Iron Deficiency Anemia
-
Oct 10, 2026, 17:53Assessing Frailty in Adults With Hemophilia – JTH
-
Oct 10, 2026, 17:52Fatma Sadeghi: Reducing Maternal Health Inequalities Through Nursing Advocacy
-
Oct 10, 2026, 17:50Grzegorz Hensler: How Apheresis Transformed Blood Cell Separation and Collection
-
Oct 10, 2026, 17:47Hemant K Sharma: Japan’s Universal Artificial Blood Research – A Potential Breakthrough in Transfusion Medicine
-
Oct 10, 2026, 17:40John Strouse: Learning About Bleeding Disorders and Sickle Cell Disease at FWGBD
-
Oct 10, 2026, 17:34Mae Caime: Speaking at the Annual Women’s Retreat for the Hemophilia Community in Florida
-
Oct 10, 2026, 17:30Chokri Ben Lamine: PNH beyond the Textbook Triad
-
Oct 10, 2026, 17:29Ruah Alyamany: Thrombosis and Anticoagulation in Hematological Malignancies at SOHO KSA 2026