Antifibrinolytic Therapy and Perioperative Considerations. (March 2018) - Levy, Jerrold H.
Abstract : Fibrinolysis is a physiologic component of hemostasis that functions to limit clot formation. However, after trauma or surgery, excessive fibrinolysis may contribute to coagulopathy, bleeding, and inflammatory responses. Antifibrinolytic agents are increasingly used to reduce bleeding, allogeneic blood administration, and adverse clinical outcomes. Tranexamic acid is the agent most extensively studied and used in most countries. This review will explore the role of fibrinolysis as a pathologic mechanism, review the different pharmacologic agents used to inhibit fibrinolysis, and focus on the role of tranexamic acid as a therapeutic agent to reduce bleeding in patients after surgery and trauma. Abstract : Fibrinolysis is important for hemostatic balance, but after trauma or surgery may contribute to coagulopathy and bleeding. Antifibrinolytic agents reduce bleeding and transfusions, and tranexamic acid is the agent most extensively studied and administered.