@entity409 results in complex alterations of all 3 phases of hemostasis. It is now recognized that hemostasis is @entity409 . The fall in clotting factor levels is accompanied by a parallel fall in anticoagulant proteins. High @entity2880 factor levels counteract defects in primary hemostasis. Conventional coagulation tests do not fully reflect the derangement in hemostasis and do not accurately predict the risk of @entity548 . Global coagulation assays (thrombin generation, thromboelastography) reflect the interaction between procoagulant factors, anticoagulant factors, platelets, and the fibrinolytic system and show promise for assessing @entity548 risk and guiding therapy. These assays are not yet commercially approved or validated. Prevention of @entity548 should not be aimed at correcting conventional coagulation tests. Thrombopoietin receptor agonists were shown to increase the platelet count in cirrhotic @entity1 undergoing invasive procedures but may increase the risk of @entity715 . Rebalanced hemostasis in @entity409 is precarious and may be tipped toward @entity548 or @entity715 depending on coexisting circumstantial risk factors. @entity2348 may impair hemostasis in @entity82 by triggering the release of endogenous heparinoids. There are no evidence-based guidelines for hemostatic therapy of @entity548 in @entity409 . There is currently inadequate evidence to support the use of recombinant FVIIa, prothrombin complex concentrates, or @entity927 in acute variceal or other @entity548 .

XXXX : a balancing act.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity82 :: ('MESH:D005355', 'Disease') :: ['cirrhosis'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage', 'bleeding', 'acute hemorrhage'] @entity409 :: ('MESH:D008107', 'Disease') :: ['rebalanced in chronic liver disease', 'Liver disease', 'liver disease'] @entity2348 :: ('MESH:D001424', 'Disease') :: ['Bacterial infection'] @entity927 :: ('MESH:D014148', 'Chemical') :: ['tranexamic acid'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity2880 :: ('MESH:D014842', 'Disease') :: ['von Willebrand']
@entity409 :: (MESH:D008107,Disease) :: ['Coagulopathy in liver disease']
