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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2004 May;70(5):267-71

SMART 2004 - Milan, May 12-14, 2004 


Critical bleeding in surgery: conventional therapy and new prospects

Levi M.

Department of Vascular Medicine/Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands

Perioperative bleeding is one of the most frequent complications of surgery. Management of bleeding consists of local control (surgical or endoscopic hemostasis), measures to retain adequate circulation and proper transfusion procedures. In this review we will discuss various agents with a prohemostatic potential and their efficacy to reduce perioperative blood loss. Desmopressin increase the plasma concentration of Von Willebrand factor giving an augmentation of primary hemostasis. The use of recombinant activated factor VII is based on the evidence that activation of coagulation in vivo predominantly proceeds by the tissue factor/factor VII (a) pathway. Agents that exerts anti-fibrinolytic activity are aprotinin and the group of lysine analogues. The prohemostatic effect is due to inhibition of fibrinolysis and to a protective effect on platelets.
Prohemostatic therapy may achieve an improvement of hemostasis, by amelioration of primary hemostasis, stimulation of fibrin formation or inhibition of fibrinolysis and seems to be effective in reducing perioperative blood loss and transfusion requirements.

language: English


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