The Nature of Changes in the Hemostatic System in Liver Cirrhosis

Tugushev Aliy Saitovich; Cherkovska Olga Stepanivna

doi:doi:10.11648/j.ejcbs.20210706.13

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The Nature of Changes in the Hemostatic System in Liver Cirrhosis

Tugushev Aliy Saitovich, Cherkovska Olga Stepanivna

Published in European Journal of Clinical and Biomedical Sciences (Volume 7, Issue 6)

Received: 31 August 2021 Accepted: 8 October 2021 Published: 23 November 2021

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Abstract

The nature of violations of the hemostatic system in liver cirrhosis is complex, often unpredictable and concerns all its links – vascular-platelet, coagulation and fibrinolysis. It is now well established that patients with cirrhosis may experience both bleeding and thrombosis. The mechanisms of blood clotting disorders in this case are very complex, since defects simultaneously occur both in the procoagulant system and in the anticoagulation system. Aim to study the factors and mechanism of the development of hemostasis imbalance in patients with liver cirrhosis based on the analysis of scientific literature, to determine the information content of existing laboratory tests for the study of hemostasis and the features of correction of hemostasis disorders depending on hyper- or hypocoagulation. It is generally accepted that cirrhosis results in a state of hypocoagulation with an increased tendency to bleeding. However, a number of publications do not support this opinion, and the interpretation of laboratory parameters is explained by the standard methodology, where the procoagulant and antifibrinolytic systems of hemostasis are insufficiently studied. Many researchers have established a state of hypercoagulability in liver cirrhosis, leading to intra- and extrahepatic thrombosis. The cause of bleeding, primarily from varicose veins of the esophagus and stomach, is not hypocoagulation as such, but rupture of varices due to hemodynamic disturbances with increased portal pressure, one of which is thrombosis. Accordingly, therapeutic tactics should be aimed, first of all, not at normalizing laboratory tests, but at eliminating the pathogenetic mechanisms of hemostatic imbalance that occur in liver cirrhosis. At the same time, drug correction should be directed not at individual links of the hemostasis system - pro or anticoagulant, but at the correction of hemostatic imbalance as a whole. Conclusions. To date questions about the nature of changes in the hemostasis system in liver cirrhosis, their relationship with hemorrhagic complications or thrombosis, the principles of drug correction remain open, requiring further research in this direction.

Published in	European Journal of Clinical and Biomedical Sciences (Volume 7, Issue 6)
DOI	10.11648/j.ejcbs.20210706.13
Page(s)	99-110
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Liver Cirrhosis, Hemostasis System, Bleeding, Thrombosis, Diagnosis, Treatment

References

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Tugushev Aliy Saitovich, Cherkovska Olga Stepanivna. (2021). The Nature of Changes in the Hemostatic System in Liver Cirrhosis. European Journal of Clinical and Biomedical Sciences, 7(6), 99-110. https://doi.org/10.11648/j.ejcbs.20210706.13

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Tugushev Aliy Saitovich; Cherkovska Olga Stepanivna. The Nature of Changes in the Hemostatic System in Liver Cirrhosis. Eur. J. Clin. Biomed. Sci. 2021, 7(6), 99-110. doi: 10.11648/j.ejcbs.20210706.13

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Tugushev Aliy Saitovich, Cherkovska Olga Stepanivna. The Nature of Changes in the Hemostatic System in Liver Cirrhosis. Eur J Clin Biomed Sci. 2021;7(6):99-110. doi: 10.11648/j.ejcbs.20210706.13

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@article{10.11648/j.ejcbs.20210706.13,
  author = {Tugushev Aliy Saitovich and Cherkovska Olga Stepanivna},
  title = {The Nature of Changes in the Hemostatic System in Liver Cirrhosis},
  journal = {European Journal of Clinical and Biomedical Sciences},
  volume = {7},
  number = {6},
  pages = {99-110},
  doi = {10.11648/j.ejcbs.20210706.13},
  url = {https://doi.org/10.11648/j.ejcbs.20210706.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20210706.13},
  abstract = {The nature of violations of the hemostatic system in liver cirrhosis is complex, often unpredictable and concerns all its links – vascular-platelet, coagulation and fibrinolysis. It is now well established that patients with cirrhosis may experience both bleeding and thrombosis. The mechanisms of blood clotting disorders in this case are very complex, since defects simultaneously occur both in the procoagulant system and in the anticoagulation system. Aim to study the factors and mechanism of the development of hemostasis imbalance in patients with liver cirrhosis based on the analysis of scientific literature, to determine the information content of existing laboratory tests for the study of hemostasis and the features of correction of hemostasis disorders depending on hyper- or hypocoagulation. It is generally accepted that cirrhosis results in a state of hypocoagulation with an increased tendency to bleeding. However, a number of publications do not support this opinion, and the interpretation of laboratory parameters is explained by the standard methodology, where the procoagulant and antifibrinolytic systems of hemostasis are insufficiently studied. Many researchers have established a state of hypercoagulability in liver cirrhosis, leading to intra- and extrahepatic thrombosis. The cause of bleeding, primarily from varicose veins of the esophagus and stomach, is not hypocoagulation as such, but rupture of varices due to hemodynamic disturbances with increased portal pressure, one of which is thrombosis. Accordingly, therapeutic tactics should be aimed, first of all, not at normalizing laboratory tests, but at eliminating the pathogenetic mechanisms of hemostatic imbalance that occur in liver cirrhosis. At the same time, drug correction should be directed not at individual links of the hemostasis system - pro or anticoagulant, but at the correction of hemostatic imbalance as a whole. Conclusions. To date questions about the nature of changes in the hemostasis system in liver cirrhosis, their relationship with hemorrhagic complications or thrombosis, the principles of drug correction remain open, requiring further research in this direction.},
 year = {2021}
}

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TY  - JOUR
T1  - The Nature of Changes in the Hemostatic System in Liver Cirrhosis
AU  - Tugushev Aliy Saitovich
AU  - Cherkovska Olga Stepanivna
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ejcbs.20210706.13
DO  - 10.11648/j.ejcbs.20210706.13
T2  - European Journal of Clinical and Biomedical Sciences
JF  - European Journal of Clinical and Biomedical Sciences
JO  - European Journal of Clinical and Biomedical Sciences
SP  - 99
EP  - 110
PB  - Science Publishing Group
SN  - 2575-5005
UR  - https://doi.org/10.11648/j.ejcbs.20210706.13
AB  - The nature of violations of the hemostatic system in liver cirrhosis is complex, often unpredictable and concerns all its links – vascular-platelet, coagulation and fibrinolysis. It is now well established that patients with cirrhosis may experience both bleeding and thrombosis. The mechanisms of blood clotting disorders in this case are very complex, since defects simultaneously occur both in the procoagulant system and in the anticoagulation system. Aim to study the factors and mechanism of the development of hemostasis imbalance in patients with liver cirrhosis based on the analysis of scientific literature, to determine the information content of existing laboratory tests for the study of hemostasis and the features of correction of hemostasis disorders depending on hyper- or hypocoagulation. It is generally accepted that cirrhosis results in a state of hypocoagulation with an increased tendency to bleeding. However, a number of publications do not support this opinion, and the interpretation of laboratory parameters is explained by the standard methodology, where the procoagulant and antifibrinolytic systems of hemostasis are insufficiently studied. Many researchers have established a state of hypercoagulability in liver cirrhosis, leading to intra- and extrahepatic thrombosis. The cause of bleeding, primarily from varicose veins of the esophagus and stomach, is not hypocoagulation as such, but rupture of varices due to hemodynamic disturbances with increased portal pressure, one of which is thrombosis. Accordingly, therapeutic tactics should be aimed, first of all, not at normalizing laboratory tests, but at eliminating the pathogenetic mechanisms of hemostatic imbalance that occur in liver cirrhosis. At the same time, drug correction should be directed not at individual links of the hemostasis system - pro or anticoagulant, but at the correction of hemostatic imbalance as a whole. Conclusions. To date questions about the nature of changes in the hemostasis system in liver cirrhosis, their relationship with hemorrhagic complications or thrombosis, the principles of drug correction remain open, requiring further research in this direction.
VL  - 7
IS  - 6
ER  -

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Tugushev Aliy Saitovich

Department of Faculty Surgery, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
Cherkovska Olga Stepanivna

Department of Faculty Surgery, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine

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Tugushev Aliy Saitovich, Cherkovska Olga Stepanivna. (2021). The Nature of Changes in the Hemostatic System in Liver Cirrhosis. European Journal of Clinical and Biomedical Sciences, 7(6), 99-110. https://doi.org/10.11648/j.ejcbs.20210706.13

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ACS Style

Tugushev Aliy Saitovich; Cherkovska Olga Stepanivna. The Nature of Changes in the Hemostatic System in Liver Cirrhosis. Eur. J. Clin. Biomed. Sci. 2021, 7(6), 99-110. doi: 10.11648/j.ejcbs.20210706.13

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AMA Style

Tugushev Aliy Saitovich, Cherkovska Olga Stepanivna. The Nature of Changes in the Hemostatic System in Liver Cirrhosis. Eur J Clin Biomed Sci. 2021;7(6):99-110. doi: 10.11648/j.ejcbs.20210706.13

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@article{10.11648/j.ejcbs.20210706.13,
  author = {Tugushev Aliy Saitovich and Cherkovska Olga Stepanivna},
  title = {The Nature of Changes in the Hemostatic System in Liver Cirrhosis},
  journal = {European Journal of Clinical and Biomedical Sciences},
  volume = {7},
  number = {6},
  pages = {99-110},
  doi = {10.11648/j.ejcbs.20210706.13},
  url = {https://doi.org/10.11648/j.ejcbs.20210706.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20210706.13},
  abstract = {The nature of violations of the hemostatic system in liver cirrhosis is complex, often unpredictable and concerns all its links – vascular-platelet, coagulation and fibrinolysis. It is now well established that patients with cirrhosis may experience both bleeding and thrombosis. The mechanisms of blood clotting disorders in this case are very complex, since defects simultaneously occur both in the procoagulant system and in the anticoagulation system. Aim to study the factors and mechanism of the development of hemostasis imbalance in patients with liver cirrhosis based on the analysis of scientific literature, to determine the information content of existing laboratory tests for the study of hemostasis and the features of correction of hemostasis disorders depending on hyper- or hypocoagulation. It is generally accepted that cirrhosis results in a state of hypocoagulation with an increased tendency to bleeding. However, a number of publications do not support this opinion, and the interpretation of laboratory parameters is explained by the standard methodology, where the procoagulant and antifibrinolytic systems of hemostasis are insufficiently studied. Many researchers have established a state of hypercoagulability in liver cirrhosis, leading to intra- and extrahepatic thrombosis. The cause of bleeding, primarily from varicose veins of the esophagus and stomach, is not hypocoagulation as such, but rupture of varices due to hemodynamic disturbances with increased portal pressure, one of which is thrombosis. Accordingly, therapeutic tactics should be aimed, first of all, not at normalizing laboratory tests, but at eliminating the pathogenetic mechanisms of hemostatic imbalance that occur in liver cirrhosis. At the same time, drug correction should be directed not at individual links of the hemostasis system - pro or anticoagulant, but at the correction of hemostatic imbalance as a whole. Conclusions. To date questions about the nature of changes in the hemostasis system in liver cirrhosis, their relationship with hemorrhagic complications or thrombosis, the principles of drug correction remain open, requiring further research in this direction.},
 year = {2021}
}

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TY  - JOUR
T1  - The Nature of Changes in the Hemostatic System in Liver Cirrhosis
AU  - Tugushev Aliy Saitovich
AU  - Cherkovska Olga Stepanivna
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ejcbs.20210706.13
DO  - 10.11648/j.ejcbs.20210706.13
T2  - European Journal of Clinical and Biomedical Sciences
JF  - European Journal of Clinical and Biomedical Sciences
JO  - European Journal of Clinical and Biomedical Sciences
SP  - 99
EP  - 110
PB  - Science Publishing Group
SN  - 2575-5005
UR  - https://doi.org/10.11648/j.ejcbs.20210706.13
AB  - The nature of violations of the hemostatic system in liver cirrhosis is complex, often unpredictable and concerns all its links – vascular-platelet, coagulation and fibrinolysis. It is now well established that patients with cirrhosis may experience both bleeding and thrombosis. The mechanisms of blood clotting disorders in this case are very complex, since defects simultaneously occur both in the procoagulant system and in the anticoagulation system. Aim to study the factors and mechanism of the development of hemostasis imbalance in patients with liver cirrhosis based on the analysis of scientific literature, to determine the information content of existing laboratory tests for the study of hemostasis and the features of correction of hemostasis disorders depending on hyper- or hypocoagulation. It is generally accepted that cirrhosis results in a state of hypocoagulation with an increased tendency to bleeding. However, a number of publications do not support this opinion, and the interpretation of laboratory parameters is explained by the standard methodology, where the procoagulant and antifibrinolytic systems of hemostasis are insufficiently studied. Many researchers have established a state of hypercoagulability in liver cirrhosis, leading to intra- and extrahepatic thrombosis. The cause of bleeding, primarily from varicose veins of the esophagus and stomach, is not hypocoagulation as such, but rupture of varices due to hemodynamic disturbances with increased portal pressure, one of which is thrombosis. Accordingly, therapeutic tactics should be aimed, first of all, not at normalizing laboratory tests, but at eliminating the pathogenetic mechanisms of hemostatic imbalance that occur in liver cirrhosis. At the same time, drug correction should be directed not at individual links of the hemostasis system - pro or anticoagulant, but at the correction of hemostatic imbalance as a whole. Conclusions. To date questions about the nature of changes in the hemostasis system in liver cirrhosis, their relationship with hemorrhagic complications or thrombosis, the principles of drug correction remain open, requiring further research in this direction.
VL  - 7
IS  - 6
ER  -

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