Pharmacologic Approaches to Bleeding
Pharmacologic approaches are an important part of bleeding management beyond the use of transfusional therapies. In addition to antifibrinolytic agents, that have an increasing role in managing traumatic, surgical, and medical bleeding, procoagulant factor concentrates, such as prothrombin complex and fibrinogen concentrates, are also considered part of a multimodal strategy. With ongoing sporadic blood supply interruptions, the role of pharmacologic nontransfusional therapies continues to evolve. Factor concentrate advantages include being readily available and lower volume, not requiring crossmatching, and potential storage at room temperature. Based on the increasing use of coagulation testing algorithms, including viscoelastic testing for bleeding management, nontransfusional therapies are increasingly considered in addition to transfusional therapies to treat bleeding.
