bleeding and hemostasis

Apr 15th, 2015
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SURGICAL BLEEDING& HEMOSTASISDr MungatanaMarch 2013HemostasisObjective of hemostasis: Toprevent or terminate blood loss from a site ofvascular disruptionMechanism Formationof a stable clotThe Hemostatic EventsTransient VasospasmPlatelet PlugFibrin DepositionFibrinolysisHemostasis:BV InjuryTissueFactorNeuralBlood VesselPlateletCoagulationVasospasmActivationActivationPrimary hemostaticplugReducedPlt-FusionBloodflowThrombin,FibrinStable Hemostatic PlugTransient VasospasmThe initial response to vascular injuryMay be enough by itself to stop bleedingStimuli for vasoconstrictionStimuli for vasodilationTXA2 mostly from platelet AA5-HTBradykinin and fibrinopeptidesProstacyclin (PGI2)Factors affecting effectiveness of vasospasmTangent of injuryPerivascular pressureLinear bleeds more than cross sectionalSteroids, weight loss, ageingVascular abnormalitiesEhlers DanlosThe Role of PlateletsAre 200,000-400,000 with a lifespan 9 daysMediates primary hemostasis: reversible clot formed immediatelyafter injury . vW factor dependentUpon exposure to subendothelial collagen platelets undergo arelease reaction that recruits more platelets hence the primaryhemostasisFrom platelet AATXA mediates vasoconstriction and platelet aggregationProstacyclin (PGI2) the reve

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