A Misguided Contraindication: International Normalized Ratio in Acute Liver Failure Precluding Thrombolysis for Massive Pulmonary Embolism: A Case Report

We describe a patient with massive pulmonary embolism and new-onset liver failure, who—absent contraindications—warranted thrombolysis. Initial laboratory values, however, revealed an elevated international normalized ratio, which precluded lysis, despite a hypercoagulable Thromboelastogram. We believe that viscoelastic testing of coagulation is essential for evaluating coagulation in liver dysfunction, particularly when considering thrombolysis.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research