Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

607
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...
607
Extrinsic and Intrinsic Pathways of Hemostasis01:20

Extrinsic and Intrinsic Pathways of Hemostasis

5.3K
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...
5.3K
Coagulation01:09

Coagulation

4.5K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
4.5K
Clot Retraction and Fibrinolysis01:16

Clot Retraction and Fibrinolysis

3.8K
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
3.8K
Introduction to Hemostasis01:05

Introduction to Hemostasis

5.4K
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,...
5.4K

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Risk-Stratified Venous Thromboembolism Chemoprophylaxis After Total Joint Arthroplasty: Evaluation of an Institutional Approach.

Journal of clinical medicine·2025
Same author

Pharmacotherapy of acute ST-elevation myocardial infarction and the pharmacist's role, part 2: Complications, post-revascularization care, and quality improvement.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists·2024
Same author

Pharmacotherapy of acute ST-elevation myocardial infarction and the pharmacist's role, part 1: Patient presentation through revascularization.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists·2024
Same author

Blood Management for the Orthopaedic Surgical Patient.

Orthopedic nursing·2023
Same author

Carbon Capture, Employment, and Coming Home from Prison.

Deviant behavior·2023
Same author

Acute Pain Management Pearls: A Focused Review for the Hospital Clinician.

Healthcare (Basel, Switzerland)·2023

Related Experiment Video

Updated: Jun 3, 2025

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
08:13

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice

Published on: September 30, 2021

6.0K

Prothrombin Complex Concentrate vs Factor VII for Refractory Bleeding in Cardiac Surgery.

Sara J Hyland1, Daniel C James1, Erin M Gordon2

  • 1Department of Pharmacy, OhioHealth Grant Medical Center, Columbus, Ohio.

Annals of Thoracic Surgery Short Reports
|January 10, 2025
PubMed
Summary

Four-factor prothrombin complex concentrate (4F-PCC) use in cardiac surgery bleeding reduced cryoprecipitate transfusions and costs. While not statistically significant, mortality and transfusion trends favored 4F-PCC, warranting further investigation.

More Related Videos

Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
13:08

Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay

Published on: September 9, 2012

18.9K
In Vitro Thrombosis Test for Ventricular Assist Devices
09:15

In Vitro Thrombosis Test for Ventricular Assist Devices

Published on: March 21, 2025

456

Related Experiment Videos

Last Updated: Jun 3, 2025

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
08:13

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice

Published on: September 30, 2021

6.0K
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
13:08

Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay

Published on: September 9, 2012

18.9K
In Vitro Thrombosis Test for Ventricular Assist Devices
09:15

In Vitro Thrombosis Test for Ventricular Assist Devices

Published on: March 21, 2025

456

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Pharmacology

Background:

  • Perioperative bleeding is a significant complication in cardiac surgery.
  • Current guidelines recommend goal-directed use of coagulation factors for refractory bleeding, but optimal strategies remain unclear.
  • Four-factor prothrombin complex concentrate (4F-PCC) offers theoretical advantages over recombinant activated factor VII (rFVIIa) due to broader targets and a better safety profile, yet comparative data are scarce.

Purpose of the Study:

  • To assess the impact of implementing an institutional algorithm favoring 4F-PCC over rFVIIa for refractory bleeding in cardiac surgery.
  • To compare patient outcomes and costs associated with 4F-PCC versus rFVIIa use.

Main Methods:

  • Retrospective cohort study involving cardiac surgery patients who received either 4F-PCC or rFVIIa for refractory bleeding between 2019-2020 at two community hospitals.
  • Primary outcome was all-cause in-hospital mortality.
  • Secondary outcomes included blood product transfusion volumes and medication costs.

Main Results:

  • A total of 42 patients were included in the study.
  • Mortality was nonsignificantly lower in the 4F-PCC group (7.1% vs. 28.6%, P = .16).
  • The 4F-PCC group showed significantly lower cryoprecipitate transfusions (0.5 vs. 2 units, P = .01) and medication costs ($9,772 vs. $50,293, P < .001).

Conclusions:

  • A 4F-PCC-based strategy for refractory cardiac surgery bleeding is associated with reduced cryoprecipitate use and lower medication costs.
  • No significant differences in inpatient mortality or overall transfusion requirements were observed between the groups.
  • Observed trends towards decreased mortality and transfusions suggest the need for larger prospective trials to validate these findings.