Perioperative systemic haemostatic agents

A M Mahdy, Nigel Robert Webster

Research output: Contribution to journalLiterature review

105 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)842-858
Number of pages17
JournalBritish Journal of Anaesthesia
Volume93
Issue number6
DOIs
Publication statusPublished - 2004

Keywords

  • blood, factor VIIa
  • blood, haemostasis
  • blood, loss
  • polypeptides, aprotinin
  • recombitant factor VIIA
  • reduces blood loss
  • Oorthotropic liver transplantation
  • activated factor VII
  • high-dose aprotinin
  • epsilon aminocaproic acid
  • open heart surgery
  • placebo controlled trial
  • total hip arthroplasty
  • cardiopulmonary bypass surgery

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