The amount of blood loss that occurs during major complex surgery is limited by the body’s ability to form blood clots. These close off small vessels and prevent more blood leaking out of the patient’s circulatory system. One problem is that the body also has mechanisms that break down blood clots.This Cochrane Review concludes that drugs that slow down the rate at which these blood clots are dissolved, called anti-fibrinolytics, can significantly reduce blood loss, particularly during cardiac surgery, and reduce the need for re-operation because of continued bleeding. One of the effective drugs, tranexamic acid, is quite cheap and is likely to be cost effective, particularly in cardiac surgery.
