Abstract
Cardiac surgical patients represent a unique group of patients where coagulopathy
occurs due to multiple causes besides simple hemorrhagic blood loss. Hemodilution,
inflammation, and hemostatic activation while on cardiopulmonary bypass all contribute
to this problem and provide targets for therapeutic intervention. Current pharmacological
strategies to reduce the need for allogeneic transfusions include both preemptive
agents to decrease the potential for bleeding as well as prohemostatic agents to promote
the coagulation process. This article will discuss pharmacological agents including
antifibrinolytics, protamine, desmopressin, fibrinogen, purified protein concentrates,
recombinant factor VIIa, factor XIII, and topical agents used in cardiac surgery.
Keywords
antifibrinolytics - protamine - desmopressin - fibrinogen - purified protein concentrates
- recombinant factor VIIa - factor XIII