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Modifying perioperative blood loss.

B J Hunt1

  • 1Department of Research Haematology, Harefield Hospital, Middlesex, UK.

Blood Reviews
|September 1, 1991
PubMed
Summary
This summary is machine-generated.

Concerns about blood transfusions and supply issues drive interest in reducing perioperative bleeding. Pharmacological agents, particularly high-dose aprotinin, show promise in cardiac surgery, though further research on fibrinolysis is needed.

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Area of Science:

  • Anesthesiology
  • Cardiovascular Surgery
  • Pharmacology

Background:

  • Concerns regarding homologous blood transfusion risks, supply, and cost necessitate strategies to minimize perioperative bleeding.
  • Cardiopulmonary bypass significantly impacts hemostasis, making it a primary focus for research on bleeding reduction.

Purpose of the Study:

  • To review the causes of non-surgical perioperative bleeding.
  • To discuss pharmacological agents used to reduce perioperative bleeding, with emphasis on cardiac surgery.

Main Methods:

  • Literature review focusing on pharmacological interventions for perioperative bleeding.
  • Analysis of agents including fibrin sealants, antiplatelet drugs, antifibrinolytics, desmopressin, and aprotinin.
  • Specific examination of the effects of cardiopulmonary bypass on hemostasis.

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Main Results:

  • High-dose aprotinin appears most effective for reducing perioperative bleeding in cardiac surgery, pending full risk-benefit analysis.
  • Aprotinin and tranexamic acid show effectiveness in controlling surgical 'oozing', suggesting fibrinolysis's role requires further evaluation.

Conclusions:

  • Pharmacological agents offer viable strategies for reducing perioperative bleeding.
  • Further research is essential to fully understand and leverage antifibrinolytic agents and the role of fibrinolysis in surgical bleeding.