title: Management of the clotting system:  a European perspective.
abstract: OBJECTIVE
  Coagulation management remains a challenge for anesthesiologists involved in cardiovascular surgery as the population undergoing surgery becomes older and presents with more comorbidities. These patients are frequently treated with one or more agents that directly affect coagulation. This review will discuss what is known and the treatments available to manage coagulation in the perioperative setting of cardiac surgery.
  
  
  RESULTS
  New antithrombotics will be discussed as well as their proposed substitution in the preoperative period. The review will also describe the different products available in Europe for the treatment of bleeding and coagulopathy. Finally, the use of new monitoring devices will be discussed.
  
  
  CONCLUSIONS
  The introduction of new drugs with different mechanisms of action adds to the complexity of coagulation management during cardiovascular surgery. Monitoring needs to be developed and improved, especially for evaluating platelet function.
authors.affiliation: Department of Anesthesiology, Hôpital Universitaire Erasme, Brussels, Belgium. brigitte.ickx@erasme.ulb.ac.be
authors.forename: Brigitte E
authors.initials: BE
authors.lastname: Ickx
authors.forename: David
authors.initials: D
authors.lastname: Faraoni
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000628:therapy*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006348:Cardiac Surgical Procedures; D002318:Cardiovascular Diseases / Q000628:therapy; D017707:Erythrocyte Transfusion; D005060:Europe; D006470:Hemorrhage / Q000628:therapy*; D006487:Hemostasis; D006801:Humans; D010949:Plasma; D011300:Preoperative Care
chemical_list: D000925:Anticoagulants