In a medical setting, surgery is the most common cause of majorblood loss, defined as a loss of 20% of total blood volume ormore. In particular, cardiovascular procedures, liver transplantationand hepatic resections, and major orthopedic procedures includinghip and knee replacement and spine surgery, are associated withsevere bleeding. Excessive blood loss may also occur for otherreasons, such as trauma. Indeed, bleeding contributes to approximately30% of trauma-related deaths.1 Bleeding in critical locations,such as an intracerebral hemorrhage, may also pose a major clinicalchallenge.
Severe bleeding often requires blood transfusion. Even whenthe benefits of . . . [Full Text of this Article]
Antifibrinolytic Agents
Efficacy of Antifibrinolytic Agents
Safety of Antifibrinolytic Agents
Recombinant Activated Factor VII
Efficacy of rFVIIa
Safety of rFVIIa
Other Interventions
Conclusions
Source Information
From the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and the Department of Medicine and Medical Specialties, University of Milan; the Istituto di Ricovero e Cura a Carattere Scientifico, Maggiore Hospital; and Mangiagalli and Regina Elena Foundation — all in Milan (P.M.M.); and the Department of Medicine and Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam (M.L.).
Address reprint requests to Dr. Mannucci at Via Pace 9, 20122 Milan, Italy, or at pmmannucci@libero.it.
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Prevention and Treatment of Major Blood Loss
Szabo S., Oikonomopoulos T., Hoffmeister H. M., Lange M., Van Aken H., Westphal M., Kumar P. D., Detry O., De Roover A., Honoré P., Mannucci P. M., Levi M.
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N Engl J Med 2007;
357:1260-1261, Sep 20, 2007.
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