Armentarium of topical hemostatic products in cardiovascular surgery: an update

Jessica Forcillo1, Louis P Perrault1

  • 1Cardiac Surgery Department, Montreal Heart Institute, Université de Montréal, Canada.

Insights

Millions of surgeries annually face bleeding complications. This review covers current hemostatic products for cardiovascular surgery and discusses emerging topical agents to improve surgical hemostasis and patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Surgical Complications
  • Hemostasis

Background:

  • Annually, 2.6 million in-hospital surgeries occur in Canada.
  • Significant bleeding is the most common surgical complication, affecting up to 25% of procedures.
  • Bleeding increases mortality, morbidity, transfusion needs, and causes hemodynamic instability.

Purpose of the Study:

  • Review available hemostatic products in cardiovascular surgery.
  • Update on new topical hemostatic agents in development.
  • Optimize hemostasis during surgical procedures.

Main Methods:

  • Literature review of hemostatic products.
  • Analysis of current and emerging topical agents.
  • Focus on cardiovascular surgical applications.

Main Results:

  • Overview of the spectrum of hemostatic products used in cardiovascular surgery.
  • Identification of novel topical hemostatic agents.
  • Discussion of their potential impact on surgical bleeding.

Conclusions:

  • Hemostatic products are crucial for managing surgical bleeding.
  • New topical agents show promise for optimizing hemostasis.
  • Continued innovation in hemostatic products is vital for improving surgical safety.

Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.6K
Introduction to Hemostasis01:05

Introduction to Hemostasis

Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
14.2K
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
Extrinsic and Intrinsic Pathways of Hemostasis01:20

Extrinsic and Intrinsic Pathways of Hemostasis

Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
10.9K
Vascular Spasm01:16

Vascular Spasm

The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
4.9K
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.7K