RT Book, Section
A1 Cotton, Bryan
A1 Holcomb, John B.
A1 Pommerening, Matthew
A1 Jastrow, Kenneth
A1 Kozar, Rosemary A.
A2 Brunicardi, F. Charles
A2 Andersen, Dana K.
A2 Billiar, Timothy R.
A2 Dunn, David L.
A2 Hunter, John G.
A2 Matthews, Jeffrey B.
A2 Pollock, Raphael E.
SR Print(0)
ID 1117740784
T1 Hemostasis, Surgical Bleeding, and Transfusion
T2 Schwartz's Principles of Surgery, 10e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071796743
LK accessmedicine.mhmedical.com/content.aspx?aid=1117740784
RD 2024/04/23
AB The  life  span  of  platelets  ranges  from  7  to  10  days.  Drugs  that  interfere  with  platelet  function  include  aspirin,  clopidogrel,  prasugrel,  dipyridamole,  and  the  glycoprotein  IIb/IIIa  (GP  IIb/IIIa)  inhibitors.  Approximately  5  to  7  days  should  pass  from  the  time  the  drug  is  stopped  until  an  elective  procedure  is  performed.The  acute  coagulopathy  of  trauma  results  from  a  combination  of  activation  of  protein  C  and  hyperfibrinolysis.  It  is  distinct  from  disseminated  intravascular  coagulation,  is  present  on  arrival  to  the  emergency  department,  and  is  associated  with  an  increase  in  mortality.Newer  anticoagulants  like  dabigatran  and  rivaroxaban  have  no  readily  available  method  of  detection  of  the  degree  of  anticoagulation  and  may  not  be  readily  reversible.Therapeutic  anticoagulation  preoperatively  and  postoperatively  is  becoming  increasingly  more  common.  The  patient’s  risk  of  intraoperative  and  postoperative  bleeding  should  guide  the  need  for  reversal  of  anticoagulation  therapy  preoperatively  and  the  timing  of  its  reinstatement  postoperatively.Damage  control  resuscitation  has  three  basic  components:  permissive  hypotension,  minimizing  crystalloid-based  resuscitation,  and  the  administration  of  predefined  blood  products.The  need  for  massive  transfusion  should  be  anticipated,  and  guidelines  should  be  in  place  to  provide  early  and  increased  amounts  of  red  blood  cells,  plasma,  and  platelets.