Fibrin‐based haemostatic agents for reducing blood loss in adult liver resection
References
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| Anaesthetic techniques | Surgical techniques | Surgical instruments |
| Lowering venous pressure | Anatomical dissection | CUSA1 |
| Autologous transfusion | Hepatic inflow occlusion | RFA2 needle dissection |
| Antifibrinolytic agents | Ischaemic preconditioning | Monopolar Dissecting Sealer3 |
|
| Total vascular exclusion | Water jet dissection4 |
|
| In situ hypothermic perfusion | Argon beam coagulation |
| Harmonic scalpel5 | ||
| *Adapted from Berrevoet 2007. | ||
Figures and Tables -
Table 1. Surgical and anaesthetic techniques used to minimise intraoperative blood loss and maintain haemostasis in liver surgery*
| Product name | Fibrinogen concentration (mg/mL) | Thrombin concentration (IU/mL) | Factor XIII concentration (U/mL) | Antifibrinolytic agent |
| Beriplast®P (CSL Behring, Germany) | 90 | 500 | 60 | Bovine aprotinin: 1000 KIU/mL |
| Biocol® (LFB, France) | 127 | 558 | 11 | Bovine aprotinin: 3000 KIU/mL |
| Bolheal® (Kaketsuken Pharmaceutical, Japan) | 80 | 250 | 75 | Bovine aprotinin: 1000 KIU/mL |
| Evicel® ‐ formerly Crosseal® (Omrix Biopharmaceuticals, Israel) | 70 | 1000 | None | None |
| Quixil® (Omrix Biopharmaceuticals, Israel) | 50 | 1000 | None | Tranexamic acid: 85 to 105 mg/mL |
| Tachosil® (Nycomed, Switzerland) | 5.5* | 2.0** | None | None |
| Tisseel® (Baxter, Austria) | 90 | 500 | 30 | Bovine aprotinin: 3000 KIU/mL |
| *mg/cm2. | ||||
Figures and Tables -
Table 2. Examples of fibrin‐based haemostatic agents and their main components
