Clinical aspects of coagulation

Haemostasis is a complex physiological cascade that results in cessation of bleeding following injury. Point-of-care tests now run alongside conventional tests of coagulation and allow closer, patient-specific tailoring of necessary intervention with reduced turn-around times. Inherited bleeding diathesis and hypercoagulable diseases remain a source of patient morbidity that should be recognized and managed. Liver disease should be seen as a heterogeneous group of disorders with unpredictable coagulation effects. We describe trauma, dilution and transfusion-induced coagulopathy; the pathophysiological aetiology and the rationale for treatment.