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Fig. 1 | Perioperative Medicine

Fig. 1

From: Gestational hemostasis: a natural model for hemostasis resuscitation of major periprocedural blood loss

Fig. 1

Comparison of global gestational hemostasis (A) with the pyramid of interventions (B) and the relevant steps of the algorithms reflecting the early, goal-directed, individualized, point-of-care-controlled hemostasis resuscitation (C). The analogy between the gestational adaptation as a natural prothrombotic mechanism and the therapeutic algorithms is remarkable (red arrows). (Abbreviations: ASA: aspirin, Ch: chapter, DOAC: direct acting oral anticoagulants, EXTEM: extrinsically triggered rotational thromboelastometry, FF-TEG functional fibrinogen TEG, FIBTEM: cytochalasin D added EXTEM test, FFP: fresh frozen plasma, FVII: coagulation factor VII, FXIII: coagulation factor XIII, Hb: hemoglobin, INTEM: intrinsically triggered rotational thromboelastometry, k-TEG: kaolin TEG, PAI-1: plasminogen activator inhibitor 1, PAI-2: plasminogen activator inhibitor 2, PT: prothrombin time, PTT: partial prothrombin time, rFVIIa: recombinant activated factor VII, (r)FXIII(a): recombinant activated factor XIII, r-TEG: rapid TEG, TAFI: thrombin-activatable-fibrinolysis-inhibitor, TEG: thromboelastography, t-PA: tissue plasminogen activator, TXA: tranexamic acid, vWF: von-Willebrandt factor, 4F PCC: four-factor prothrombin complex concentrate)

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