Bleeding complications are frequently associated with fibrinolytic therapy. Which of the following statement(s) concerning complications of fibrinolytic therapy is/are true?
A. Careful monitoring of prothrombin time and aPTT time are necessary to avoid bleeding complications B. A level of serum fibrinogen less than 100 mg/dl is associated with an increased risk of bleeding C. Recent (less than 10 days) major surgery is a contraindication to systemic but not regional fibrinolytic therapy D. A patient with a cerebrovascular event occurring less than two months ago can be treated with fibrinolytic therapy if head CT scan is normal
A level of serum fibrinogen less than 100 mg/dl is associated with an increased risk of bleeding-fibrinolytic therapy induces a hemostatic defect through a combination of factors. hypofibrinogenemia and fibrin degradation products inhibit fibrin polymerization and, in combination with a decrease in the clotting factors v and viii, prolong the ability of blood to clot. however, coagulation tests in general do not correlate well with bleeding complications. a level of fibrinogen less than 100 mg/dl is associated with an increased risk of bleeding. absolute contraindications to thrombolytic therapy include active internal bleeding, recent (less than 2 months) cerebral vascular accident, and documented left heart thrombosis. recent (less than 10 days) major surgery, obstetric delivery, organ biopsy, or major trauma is considered a major relative contraindication to either regional or systemic thrombolytic therapy.