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Haemostasis management 

Haemostasis management
Chapter:
Haemostasis management
Author(s):

David Royston

DOI:
10.1093/med/9780199653478.003.0017
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date: 19 October 2019

Various laboratory and point-of-care (POC) tests that can be used to guide blood component therapy in order to optimize haemostasis and coagulation are described. The aim of this effort is to minimize bleeding associated with surgery and trauma. In addition to a discussion of the various viscoelastic POC tests of coagulation in whole blood the various commercially available tests of whole blood coagulation used to guide therapy with unfractionated heparin during extracorporeal circulation are compared. The various pharmacological agents that have been and are used to promote haemostasis and reduce bleeding are discussed. Following a brief discussion of drugs acting primarily on platelet functions (such as epoprostenol and DDAVP/desmopressin) drugs that are considered to act on the fibrinolytic system are compared, as well as safety aspects: in particular, the safety concerns and current recommendations on aprotinin use.

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