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Fisiología de la Hemostasia

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by

Miguel Rosas

on 4 November 2016

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Transcript of Fisiología de la Hemostasia

Fisiopatología del sangrado
Monitoreo de la Coagulación
Dinámica de la Hemostasia
Fisiología de la Hemostasia
Fisiología de la Hemostasia
Monitoreo
Fisiopatología del Sangrado

5% del potencial hemostático
El recuento plaquetario, el TP, el RIN y el Kptt dan una idea del nivel de factores con los que se cuenta, pero no reflejan la complejidad de la hemostasia in vivo.

Los estudios basados en la viscoelasticidad de la sangre entera, como la Tromboelastografía (TEG) o Tromboelastometría (ROTEM), miden el estado hemostático completo y en forma dinámica.
Clotting Time:
Time until initiation of fibrin formation, taken as a period to 2 mm amplitude on the tracing
Indicates concentration of soluble clotting factors in the plasma
Clot Formation Time:
Time period for the amplitude of the tracing to increase from 2 to 20 mm
Measurement of clot kinetics
Alfa Angle:
Rapidity of fibrin build up and cross-linking
Maximum Clot Firmness:
Number and function of platelets and fibrinogen concentration
Lysis Index:
Per cent reduction of clot firmness 30 min and 1 h after MCF
Clot stability and fibrinolysis
Mediciones
Reactivos
Miguel Rosas
Coágulo normal
Coágulo diluído al 65% con HES
Tratamiento con Concentrado de Fibrinógeno
1 molécula de trombina puede activar 1680 moléculas de fibrinógeno
Cada plaqueta tiene 40.000-50.000 receptores GP IIb/IIIa
Concentrado de Fibrinógeno
"Proceso por el cual la sangre pasa de un estado líquido a un gel"
Existe alguna condición fisiológica en la cual el organismo se prepare para sufrir un sangrado importante?
Hemodilución
FIBRINÓGENO aumenta 100%, (4-6g/l vs 2-4g/l)
FIBRINOLISIS disminuye (baja el tPA)
miguel.rosas@hotmail.com
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