The Management of Postoperative Bleeding

Dagi, T. Forcht

doi:10.1016/j.suc.2005.10.013

Cited by 27 publications

(26 citation statements)

References 18 publications

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“…For example, the risk of bleeding is increased in patients taking anticoagulants or antiplatelet agents, those with underlying intrinsic bleeding disorders, or those with specific comorbidities, including diabetes mellitus, hypertension, and renal insufficiency. 1,2 Further, primary complications of surgery, such as infection, can lead to the development of disseminated intravascular coagulation and widespread diffuse bleeding. 1 Iatrogenic factors, including poor surgical technique, hypothermia, acidosis, and hemodilution (infusion of large volumes of plasma-poor fluids) also contribute to the risk of perioperative bleeding.…”

mentioning

confidence: 99%

Achieving Hemostasis in the Surgical Field

Boucher

Traub

2009

Pharmacotherapy

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Hemostatic mechanisms are an integral part of the human physiology. Traditionally divided into intrinsic and extrinsic arms, the coagulation cascade converges, through the interactions of many different factors, at a common element-thrombin. As a consequence, a number of different agents have been developed to supplement this common, critical step to aid surgical hemostasis. Intraoperative interventions most commonly include sutures and heat-generating cautery devices; however, these methods are sometimes insufficient or inappropriate for a specific procedure or anatomic location, leading to the development of other adjunctive therapies, including topical hemostats. Topical hemostatic agents generally act as active, passive, and combinations therapies, depending on their individual composition and mode of action. We provide a brief review of the normal coagulation cascade, including critical points, followed by a discussion of surgical strategies and adjuctive therapies used to achieve surgical hemostasis and concluding with a discussion of topical thrombins.

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confidence: 99%

Achieving Hemostasis in the Surgical Field

Boucher

Traub

2009

Pharmacotherapy

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“…Patients who have high Child-Pugh class may have severe varicose collateral vessels, poor preoperative condition, severely enlarged spleen, and coagulation dysfunction, and these factors may cause massive intraoperative blood loss and necessitate blood product transfusion. 15 Other studies have shown that higher preoperative Child-Pugh class is an independent risk factor associated with massive intraoperative transfusion, and that Child-Pugh class A may be a protective factor for massive intraoperative bleeding after liver transplant. [25][26][27] In addition, preoperative international normalized ratio and presence of ascites may correlate independently with the amount of blood transfusion after liver transplant.…”

Section: Discussionmentioning

confidence: 98%

“…Massive blood loss during liver transplant may be associated with poor preoperative coagulation status, varicose collateral vessels, technical difficulties, or low preoperative platelet count. 15 Intraoperative massive blood loss may cause consumption of clotting factors, further compromising coagulation function in recipients. 16,17 This may explain the finding that massive intraoperative blood loss was a risk factor for postoperative bleeding after living-donor liver transplant (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Untitled

Wen²,

Yan³

et al. 2014

Exp Clin Transplant

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“…A search of published peer-reviewed and grey literature was conducted, 18,[21][22][23][24][25][26][27] and combined with local prescribing and treatment protocols in the development of the first iteration of Post-Operative Surgical Checklist for Hospital care (POSCH), for each of the 6 complications.…”

Section: Checklist Developmentmentioning

confidence: 99%