The document discusses several hemostasis problems commonly seen in critical illness, including critical illness coagulopathies, uncontrolled bleeding and massive transfusion, anticoagulation-associated problems, and case scenarios. It provides details on acquired hypocoagulable states, the coagulation cascade, disseminated intravascular coagulation, sepsis-associated coagulopathy, heparin-induced thrombocytopenia, immune thrombocytopenic purpura, and pregnancy-related thrombocytopenias. Treatment involves addressing the underlying cause, transfusing blood products, and considering anticoagulants or direct thrombin inhibitors depending on the clinical situation.

1. Hemostasis Problems in Critical Illness Per Thorborg, MD, PhD, FCCM Director, Critical Care Medicine Dept.of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR

6. Normal Hemostasis TF-Bearing Cell Activated Platelet Platelet TF VIIIa Va VIIIa Va Va VIIa TF VIIa X IX V Va II VIII/vWF VIIIa II IXa X IX X IXa IXa VIIa Xa IIa IIa Xa Reproduced with permission from: Hoffman M, et al. Blood Coagul Fibrinolysis. 1998;9(suppl 1):S61-S65. Xa II IIa