What can ex vivo experiments contribute to clinical haemostasis management?

Keyvan Karkouti; Peter L Gross

doi:10.1016/j.bja.2023.06.041

What can ex vivo experiments contribute to clinical haemostasis management?

Br J Anaesth. 2023 Sep;131(3):424-425. doi: 10.1016/j.bja.2023.06.041. Epub 2023 Jul 10.

Authors

Keyvan Karkouti¹, Peter L Gross²

Affiliations

¹ Department of Anesthesia and Pain Management, University Health Network, Sinai Health, and Women's College Hospital, University of Toronto, Toronto, ON, Canada. Electronic address: Keyvan.karkouti@uhn.ca.
² Department of Medicine, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.

PMID: 37438219
DOI: 10.1016/j.bja.2023.06.041

Abstract

A recent ex vivo study found that post-cardiopulmonary bypass platelet defects can be restored with supplemental fibrinogen, but the clinical significance of this finding will require further study. We propose that the best management strategy for achieving haemostasis in bleeding surgical patients is to identify individualised coagulation defects and then use a targeted therapeutic approach that addresses each identified defect systematically.

Keywords: cardiac surgery; cardiopulmonary bypass; coagulopathy; haemostasis; platelet dysfunction.

Publication types

Editorial
Comment

MeSH terms

Blood Coagulation*
Cardiopulmonary Bypass
Fibrinogen / analysis
Fibrinogen / therapeutic use
Hemorrhage / drug therapy
Hemostasis
Hemostatics* / therapeutic use
Humans

Substances

Hemostatics
Fibrinogen