Best Practice & Research Clinical Anaesthesiology
Volume 24, Issue 1 , Pages 133-144, March 2010

Hypercoagulability in the perioperative period

  • Vance G. Nielsen, MD, Professor, Director of Anesthesiology Research,

      Affiliations

    • Drexel University College of Medicine, Department of Anesthesiology, Philadelphia, Pennsylvania 19102, USA
    • Corresponding Author InformationCorresponding author.
  • ,
  • Lars M. Asmis, MD, Head, Coagulation Laboratory,

      Affiliations

    • Department of Internal Medicine, Division of Hematology, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland

One of the greatest disappointments associated with a successful surgical procedure is a thrombotic or thrombo-embolic complication in the postoperative period. Morbidity and mortality of the perioperative period are related, to a relevant degree, to perioperative thrombo-embolic events. Ranging from simple deep venous thrombosis to pulmonary embolism or arterial thrombosis, this class of complication invariably increases length of hospital stay or may result in mortality. The purpose of this review is to identify the procedures and patient populations noted to have thrombophilia in the postoperative period, link the changes in circulating and in situ haematological/biochemical substrates most likely responsible for morbidity, identify the clinical diagnostic modalities that detect recent/impending thrombosis and, lastly, consider the rational therapeutic approaches recommended for minimising postoperative thrombotic complications.

Keywords: perioperative hypercoagulability, thrombophilia, haemostatic monitoring, fibrinolysis, thrombelastography, thromboprophylaxis, low-molecular-weight heparins

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PII: S1521-6896(09)00076-7

doi:10.1016/j.bpa.2009.09.012

Best Practice & Research Clinical Anaesthesiology
Volume 24, Issue 1 , Pages 133-144, March 2010