title: [Modern coagulation management reduces the transfusion rate of allogenic blood products].
abstract: Evaluating the patient's individual bleeding history with a standardized questionnaire, using "point-of-care" - methods for coagulation analyses and providing autologous transfusion techniques are preconditions of a modern coagulation management. Therapy of coagulopathic patients should be based on structured hemotherapy algorithms. Surgical haemostasis and the maintenance of the basic conditions for haemostasis are elementary requirements for an effective therapy. In cases of diffuse bleeding, early antifibrinolytic therapy should be considered. Coagulation factor deficiencies should be corrected "goal-directed" using coagulation factor concentrates. Transfusion of fresh frozen plasma is only indicated in the clinical setting of massive transfusions. DDAVP and transfusion of platelet concentrates are options to optimize primary haemostasis. In cases of on-going bleeding, recombinant activated coagulation factor VII represents an option for "ultima-ratio" therapy.
authors: Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Klinikums der Goethe-Universität Frankfurt am Main, Germany. Christian.Weber@kgu.de
authors: Christian Friedrich
authors: CF
authors: Weber
mesh_terms: D000465:Algorithms; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001777:Blood Coagulation; D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion / Q000401:mortality; D020147:Coagulation Protein Disorders / Q000628:therapy; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D006487:Hemostasis; D006801:Humans; D007023:Hypotension, Controlled; D007430:Intraoperative Care; D010949:Plasma; D017713:Platelet Transfusion; D019095:Point-of-Care Systems; D065227:Transfusion Reaction
chemical_list: D000933:Antifibrinolytic Agents; D003894:Deamino Arginine Vasopressin