[Drugs to reduce transfusion needs during surgery]

Blood components are a limited and expensive resource, and transfusions may cause serious side effects. Drug treatment is an option to reduce the need for transfusions related to surgery. Tranexamic acid reduces transfusion requirements after total hip and knee arthroplasty, and after various cardiac surgical procedures. Desmopressin does not reduce the need for transfusions after surgery in patients with normal preoperative hemostasis. Treatment with recombinant factor VIIa may be considered in patients with massive hemorrhage caused by blunt trauma, post-partum hemorrhage, cardiac surgery, and in uncontrolled bleeding in surgery in general.