Surgery pp 149-165 | Cite as

Hemostasis and Coagulation

  • Marcel Levi
  • Tom van der Poll


Bleeding is one of the major complications of surgery. Serious intraoperative and postoperative bleeding not only may be caused by a local problem in surgical hemostasis, such as a failed ligature, but also can be caused by a defect in the hemostatic system. Surgical hemostasis and an adequately functioning coagulation system are complementary: In some cases, a patient with a (minor) hemostatic defect may be operated on without any specific perioperative intervention in the coagulation system, whereas in other instances improvement of blood coagulation may be necessary before operation. In this chapter, current insights into the functioning of the coagulation system, and anticoagulant and pro-hemostatic interventions in this system, are discussed. Subsequently, conditions associated with an enhanced risk of perioperative bleeding (including the preoperative use of anticoagulant agents) and strategies to reduce perioperative blood loss are reviewed. Last, the pathogenesis and clinical management of disseminated intravascular coagulation (DIC) are discussed.


Coagulation Factor Disseminate Intravascular Coagulation Tranexamic Acid Disseminate Intravascular Coagulation Tissue Factor Pathway Inhibitor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Marcel Levi
    • 1
  • Tom van der Poll
    • 2
  1. 1.Department of Medicine, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Laboratory of Experimental Medicine, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands

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