Bleeding and Clotting: Blood and Drugs
Pp. 120-148 (29)
Monica B. Pagano, Aaron S. Hess and John R. Hess
Uncontrolled hemorrhage from trauma, surgery, or post-partum is a major
cause of death, but more people die from clotting, as heart attacks, strokes, or
thromboembolism. The coagulation system underlies this complex interaction between
bleeding and clotting. There are numerous blood components, biologicals, and drugs
that affect bleeding and clotting; a basic understanding is requisite for successful
perioperative care. This chapter provides an essential review of primary and secondary
hemostasis and fibrinolysis, conventionally available tests of coagulation, common
causes of hemorrhage, and commonly used anticoagulant drugs and platelet inhibitors.
Finally, it discusses current concepts of the use of blood components to reverse
coagulopathy and the transfusion reactions that can complicate blood therapy.
Anticoagulants, Antiplatelet agents, ACT, Clotting, Coagulation
testing, Congenital clotting disorders, Fibrinolysis, Hemorrhage, Primary
hemostasis, Secondary hemostasis, Thrombosis, Von Willibrands Disease.
Transfusion Medicine, Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.