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Improved outcome with individualised antifibrinolytic therapy: what is the evidence?

Daniel Bolliger1, Marco Ranucci2

  • 1Clinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, University of Basel, Basel, Switzerland.

British Journal of Anaesthesia
|May 10, 2024
PubMed

Viscoelastic haemostatic testing (VHT) has been used to determine hyperfibrinolysis and hypofibrinolysis. When modified by addition of tissue plasminogen activator (tPA), VHT has been suggested to assess responses to antifibrinolytic therapy and to estimate the concentration of tranexamic acid in patients undergoing cardiac surgery. Despite some evidence that tPA-modified VHT might allow individualisation of antifibrinolytic therapy, further studies are warranted to prove its clinical benefit for postsurgical bleeding, transfusion of blood products, and thromboembolic events.

Keywords:
cardiac surgerycoagulationfibrinolysistranexamic acidviscoelastic testing

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