PMID: 8957438Dec 1, 1996Paper

Reduction in requirements for allogeneic blood products: pharmacologic methods

The Annals of Thoracic Surgery
M JanssensJ L David

Abstract

Numerous articles describe the reduction of perioperative bleeding by the therapeutic or prophylactic administration of drugs such as prostacyclin, desmopressin, and natural or synthetic antifibrinolytics. A review of the literature was carried out to help the reader define the indications of these drugs during cardiopulmonary bypass operations, highlight the questions that remain concerning their indications and modes of action, and suggest future studies to answer these remaining questions. Prostacyclin reduces platelet trauma induced by extracorporeal circulation but does not effectively reduce postoperative bleeding and transfusion requirements. Desmopressin acts as a "glue," improving platelet adhesion, and may be effective when postoperative bleeding is excessive, but its routine use in cardiac operations cannot be recommended. Natural and synthetic antifibrinolytics inhibit plasmin and plasmin-induced platelet dysfunction. These agents have been shown to decrease bleeding and the need for allogeneic transfusions after open heart operations. However, with antifibrinolytic drugs, the risk of thromboembolic phenomena cannot be neglected. With aprotinin, this risk appears to be minimal when the drug is used at concentrations...Continue Reading

References

Dec 1, 1992·The Annals of Thoracic Surgery·D M CosgroveF D Loop
Dec 1, 1992·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·B D RoystonJ D Pearson
Feb 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·D Royston
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Dec 1, 1987·The Annals of Thoracic Surgery·W van OeverenC R Wildevuur
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Dec 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·D J GoldsteinC R Smith

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Citations

Sep 26, 1997·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J F Hardy, S Bélisle
Apr 19, 2000·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·H KiyamaT Imazeki
Dec 10, 1999·The Annals of Thoracic Surgery·H KiyamaT Yamada
Jun 24, 2003·Blood Reviews·M B C Koh, Beverley J Hunt
Mar 24, 2005·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Fahad Al-ShammariRiyad Tarazi
Dec 1, 1996·The Annals of Thoracic Surgery·J F HardyM Samama
May 25, 2002·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Yahya UnlüO Akbulut
Jun 24, 2004·Asian Cardiovascular & Thoracic Annals·Sandeep ChauhanPanangipalli Venugopal
Dec 25, 2009·Circulation. Cardiovascular Quality and Outcomes·Rajendra H MehtaUNKNOWN Society of Thoracic Surgeons National Cardiac Surgery Database Investigators
Apr 17, 2001·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·M J RayN Marsh
Oct 12, 2000·The Journal of Surgical Research·G DickneiteU Nicolay

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