Prohemostatic agents to prevent perioperative blood loss.

Surgical patients represent a unique group of patients where therapeutic approaches can be preemptively administered. Pharmacologic strategies to prevent or decrease perioperative bleeding function to attenuate inflammatory responses, reduce hemostatic activation, or provide prohemostatic effects to reduce bleeding and the need for allogeneic transfusions. This article will discuss pharmacologic prohemostatic agents (antifibrinolytics, protamine, desmopressin, fibrinogen, purified protein concentrates, recombinant factor VIIa).