INR rise after hepatectomy скачать в хорошем качестве

INR rise after hepatectomy

After Hepatectomy: Onset: INR begins to rise on postoperative day 0 Peak: INR peaks between postoperative days 2-3 Elevation: Typically no greater than 2.0 Return to Normal: Between postoperative days 5-7 Underlying Mechanism: Caused by partial liver removal affecting coagulation factor synthesis Remaining liver gradually compensates for the removed portion Interestingly, thromboelastography may initially show a hypercoagulable state Clinical Implications: Important consideration for epidural catheter placement and removal Epidural catheter removal recommended when INR less than 1.5 (typically postoperative days 3-5) Alternative pain management: patient-controlled analgesia Potential for rare coagulation-related complications Takeaway: Despite elevated INR, the liver quickly adapts, with coagulation parameters normalizing within a week after hepatectomy.