Current concepts of hemostasis: implications for therapy.
The revised model of coagulation has implications for therapy of both hemorrhagic and thrombotic disorders. Of particular interest to anesthesiologists is the management of clotting abnormalities before, during, and after surgery. Most hereditary and acquired coagulation factor deficiencies can be managed by specific replacement therapy using clotting factor concentrates. Specific guidelines have also been developed for perioperative management of patients using anticoagulant agents that inhibit platelet or coagulation factor functions. Finally, recombinant factor VIIa has been used off-label as a hemostatic agent in some surgical situations associated with excessive bleeding that is not responsive to conventional therapy.
Roberts
Harold R
HR
Division of Hematology/Oncology, Carolina Cardiovascular Biology Center, University of North Carolina School of Medicine, Chapel Hill 27599-7035, USA. hrr@med.unc.edu
Monroe
Dougald M
DM
Escobar
Miguel A
MA
D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology*; D003029:Coagulants / Q000627:therapeutic use; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans
D000925:Anticoagulants; D003029:Coagulants