'Seizing' the opportunity to understand antifibrinolytic drugs [Saisir la chance de comprendre les antifibrinolytiques]

摘要

Antifibrinolytic drugs have been used for decades primarily due to their capacity to decrease blood loss and reduce the need for allogeneic transfusion in patients undergoing cardiac or noncardiac surgery. The three main antifibrinolytic drugs are aprotinin, which was first used in Germany in the late 1950 s; aminocaproic acid, which was approved by the Food and Drug Administration in 1964; and tran-examic acid (TXA), which was made available in 1986. It is remarkable that despite widespread use of these drugs over several decades, there is still no consensus regarding their optimal dose and dosing regimen. The need to resolve this debate is becoming increasingly urgent, as the clinical use of antifibrinolytics is expected to rise due to the increasing number of complex surgeries being performed and the expanded use beyond cardiac surgery.