[Medical hemostasis. II. Systemic hemostatics, a critical evaluation].
The control of spontaneous and traumatic haemorrhage is a matter of constant concern to veterinary practitioners. In some instances, the control of bleeding may be relatively simple using some topical therapeutic procedure, but when haemostatic defects are present, treatment with topical agents alone might not be sufficient, and more radical and life-saving procedures are indicated: replacement therapy with blood or blood products. As this is not easy to perform in most veterinary clinical situations, any therapeutic agent, which facilitates control of haemorrhage is a welcome addition to the therapeutic armament. Besides vitamin K, blood products and agents for topical use, there are only a few agents having a well-defined action on the mechanism of haemostasis. On the other hand several drugs are propagated in the Netherlands as systemic haemostatics in the treatment of bleeding disorders and prevention of haemorrhage during operation. None of these is of proven clinical value in veterinary practice. The only agent, which possibly showed some clinical effect: ethamsylate, has recently been withdrawn from the Dutch market by the manufacturers. Double-blind prospective trials with quantitation of loss of blood showed that antifibrinolytic agents such as tranexamic acid are clinically effective in certain conditions in humans. Because of their mode of action, it might reasonably be expected that these drugs might have positive results in veterinary medicine. Therefore, clinical trials with antifibrinolytic agents are urgently indicated to evaluate the effectiveness and side-effects of these drugs in animals showing severe bleeding or in the prevention of peroperative haemorrhage.
van den Bogaard
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Centrale Proefdier Voorzieningen Medische Faculteit Maastricht, Biomedisch Centrum RL.
D000818:Animals; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects; D001792:Blood Platelets / Q000187:drug effects; D002196:Capillaries / Q000187:drug effects; D006470:Hemorrhage / Q000188:drug therapy / Q000662:veterinary*; D006474:Hemorrhagic Disorders / Q000188:drug therapy / Q000662:veterinary; D006490:Hemostatics / Q000145:classification / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D006490:Hemostatics
Medicamenteuze haemostase. II. Systemische haemostatica, een kritische evaluatie.