Hemostasis

Abstract

Hemostasis includes all the mechanisms by which excessivebleeding is stopped and by which undesired thrombosis is prevented, thus allowing the blood to remain liquid and flowing in an intact vasculature. In the perioperative period, excessivebleeding is prevented by maintaining or restoring vascular integrity, by providing sufficient coagulation factor activity so that the coagulation cascade produces ample fibrin, and by maintaining adequate platelet function. Excessive thrombosis in the postoperative period is controlled by antithrombotic systems that limit fibrin accumulation in the vasculature: antithrombin, protein C/protein S, tissue factor pathway inhibitor, and fibrinolysis.