Perioperative Coagulopathies and Management

INTRODUCTION The coagulation system involves a cascade of factors responsible for maintenance of haemostasis in the body. This system is not only made for forming clots but is also involved in tissue repair, defence against micro-organisms, autoimmune processes, arteriosclerosis, tumour growth and metastasis. Surgical procedures often cause imbalance of this system, leading to a tendency to either thrombosis or bleeding. Operative intervention, clinical risk factors including immobility, infections, anticancer drugs and various other perioperative factors such as hypothermia, metabolic acidosis, volume expanders and extracorporeal circulation are increasingly being demonstrated to interfere with the coagulation system.