Updates in perioperative coagulation: physiology and management of thromboembolism and haemorrhage

Understanding of blood coagulation has evolved significantlyin recent years. Both new coagulation proteins and inhibitorshave been found and new interactions among previously knowncomponents of the coagulation system have been discovered. Thisincreased knowledge has led to the development of various newdiagnostic coagulation tests and promising antithrombotic andhaemostatic drugs. Several such agents are currently being introducedinto clinical medicine for both the treatment or prophylaxisof thromboembolic disease and for the treatment of bleeding.This review aims to elucidate these new concepts and to outlinesome consequences for clinical anaesthesia and perioperativemedicine.