• Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2012

    Review

    [Modern coagulation management reduces the transfusion rate of allogenic blood products].

    • Christian Friedrich Weber.
    • Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Klinikums der Goethe-Universität Frankfurt am Main, Germany. Christian.Weber@kgu.de
    • Anasthesiol Intensivmed Notfallmed Schmerzther. 2012 Jun 1;47(6):418-24; quiz 425.

    AbstractEvaluating the patient's individual bleeding history with a standardized questionnaire, using "point-of-care" - methods for coagulation analyses and providing autologous transfusion techniques are preconditions of a modern coagulation management. Therapy of coagulopathic patients should be based on structured hemotherapy algorithms. Surgical haemostasis and the maintenance of the basic conditions for haemostasis are elementary requirements for an effective therapy. In cases of diffuse bleeding, early antifibrinolytic therapy should be considered. Coagulation factor deficiencies should be corrected "goal-directed" using coagulation factor concentrates. Transfusion of fresh frozen plasma is only indicated in the clinical setting of massive transfusions. DDAVP and transfusion of platelet concentrates are options to optimize primary haemostasis. In cases of on-going bleeding, recombinant activated coagulation factor VII represents an option for "ultima-ratio" therapy.© Georg Thieme Verlag Stuttgart · New York.

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