Perioperative systemic haemostatic agents.
Skilful surgery combined with blood-saving methods and careful management of blood coagulation will all help reduce unnecessary blood loss and transfusion requirements. Excessive surgical bleeding causes hypovolaemia, haemodynamic instability, anaemia and reduced oxygen delivery to tissues, with a subsequent increase in postoperative morbidity and mortality. The role of anaesthetists in managing surgical blood loss has increased greatly in the last decade. Position of the patient during surgery and the provision of a hypotensive anaesthetic regimen were once considered the most important contributions of the anaesthetist to decreasing blood loss. Now, several pharmacological haemostatic agents are being used by anaesthetists as blood-saving agents. After a brief discussion of the physiology of haemostasis, this article will review the evidence for the role of such agents in reducing perioperative blood loss and transfusion requirements.
Academic Unit of Anaesthesia and Intensive Care, University of Aberdeen, Aberdeen, UK.
A M
AM
Mahdy
N R
NR
Webster
D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D007611:Aprotinin / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use; D006487:Hemostasis / Q000502:physiology; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D011994:Recombinant Proteins / Q000627:therapeutic use
D000933:Antifibrinolytic Agents; D006490:Hemostatics; D011994:Recombinant Proteins; D007611:Aprotinin; D015942:Factor VIIa; D003894:Deamino Arginine Vasopressin