[Systemic hemostatic drugs]

Understanding the haemostatic changes is crucial in developing strategies for the management of haemorrhage syndroma. In recent years, the revised model of coagulation ("cell based" model) provided a much more authentic description of the coagulation process. Pharmacological intervention, especially desmopresin, antifibrinolytics (synthetics and nature) and increasingly recombinant activated factor VII are being used in prevention and therapeutically to control bleeding of variety etiologies. Skillfull surgery combined with blood saving methods and careful management of blood coagulation will all help in sucessfull haemorrhage prevention and treatment, and reduce unnecessary blood loss and transfusion requirements and its attendant risks. Among the all avalaible tests, the use of thromboelastography has allowed for more detailed dynamic assessment of the various steps of hemostasis.

[Treatment of severe anemia and gastrointestinal tract hemorrhage in a Jehovah's Witness]

This case report discribes the treatment of 67-year-old Jehovah's Witness with severe anemia and gastrointestinal haemorrhage from gastric leiomyoma and peptic ulcer. Minimal invasive surgery with meticulous hemostasis, controlled hypotension, hyperoxic normovolemia and normotermia were main principles. Minimal blood samples for necessary laboratory parameters and noninvasive onitoring were ways to decrease iatrogenic blood loss. The operative and postoperative period were uneventful and well tolerated. The patient was discharged home after eighteen days and well in follow up period.