Prevention and treatment of bleeding by pro-hemostatic treatment strategies.
Pro-hemostatic therapy may achieve an improvement of hemostasis, by amelioration of primary hemostasis, stimulation of fibrin formation or inhibition of fibrinolysis. Pro-hemostatic interventions appear to be effective in reducing peri-operative blood loss and reducing transfusion requirements in specific situations and may be helpful adjuncts in the management of severe spontaneous and post-operative bleeding. The risk of a higher incidence of thrombotic complications associated with the use of pro-hemostatic therapy is unknown but seems not to be very high in clinical practice. There is a need for more systematic and adequately controlled clinical observations to better establish the efficacy and safety of pro-hemostatic interventions.
Levi
Marcel
M
Department of Vascular Medicine/Internal Medicine, University of Amsterdam, The Netherlands. m.m.levi@amc.uva.nl
Vink
Roel
R
de Jonge
Evert
E
D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001803:Blood Transfusion; D003029:Coagulants / Q000627:therapeutic use*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D015942:Factor VIIa / Q000627:therapeutic use*; D006488:Hemostasis, Surgical; D006801:Humans; D019106:Postoperative Hemorrhage / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
D000933:Antifibrinolytic Agents; D003029:Coagulants; D015942:Factor VIIa; D003894:Deamino Arginine Vasopressin