Related Experiment Videos
Management of bleeding disorders by prohemostatic therapy
Marcel M Levi1, Roel Vink, Evert de Jonge
1Department of Vascular Medicine/Internal Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
International Journal of Hematology
|November 15, 2002
Summary
Pro-hemostatic therapies enhance blood clotting by improving primary hemostasis, boosting fibrin formation, or inhibiting fibrinolysis. These treatments are effective for specific defects and also reduce bleeding in patients without primary coagulation issues.
Area of Science:
- Hematology
- Pharmacology
Background:
- Pro-hemostatic therapy aims to improve hemostasis through various strategies.
- These strategies include enhancing primary hemostasis, stimulating fibrin formation, or inhibiting fibrinolysis.
- Treatments can correct specific coagulation defects or reduce bleeding in patients without them.
Purpose of the Study:
- To review current pro-hemostatic therapies.
- To discuss pharmacological agents like desmopressin and recombinant factor VIIa.
- To explore anti-fibrinolytic agents and their mechanisms.
Main Methods:
- Review of pharmacological agents for hemostasis.
- Discussion of desmopressin (DDAVP) and its effects on Von Willebrand factor and factor VIII.
- Analysis of recombinant factor VIIa and anti-fibrinolytic agents like aprotinin and lysine analogues.
Main Results:
- Desmopressin (DDAVP) increases plasma Von Willebrand factor and factor VIII, enhancing primary hemostasis.
- Recombinant factor VIIa shows potent procoagulant activity, effective in bleeding prevention and treatment.
- Anti-fibrinolytic agents inhibit fibrinolysis and may protect platelets, shifting the balance towards procoagulation.
Conclusions:
- Pro-hemostatic therapies offer diverse strategies for managing bleeding.
- Desmopressin and recombinant factor VIIa are key pharmacological agents.
- Anti-fibrinolytic agents provide another avenue, though thromboembolic risks require ongoing evaluation.