Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jun 13;61(6):1087.
doi: 10.3390/medicina61061087.

Normal Haemostasis, Inherited Bleeding Disorders and Surgery: What Does the Anaesthesiologist Need to Know?

Mihai Ștefan  1   2 , Daniela Filipescu  1   2 , Cornelia Predoi  1   2 , Liana Văleanu  1   2 , Ștefan Andrei  3 , Dana Tomescu  1   4
Affiliations
Review

Normal Haemostasis, Inherited Bleeding Disorders and Surgery: What Does the Anaesthesiologist Need to Know?

Mihai Ștefan et al. Medicina (Kaunas). .

Abstract

Haemostasis is a critical physiological process that ensures blood loss is minimised following vascular injury. Understanding the mechanisms of normal haemostasis is essential for managing patients with inherited bleeding disorders, particularly in the surgical setting. Inherited bleeding disorders, such as haemophilia and von Willebrand disease (vWD), pose unique challenges for anaesthesiologists and surgeons due to the increased risk of excessive bleeding during and after surgery. This state-of-the-art review outlines the essential knowledge for anaesthesiologists regarding normal haemostasis, the pathophysiology of inherited bleeding disorders, and the perioperative management strategies required for these patients. It draws on existing literature and current clinical guidelines to offer practical approaches for assessing and managing bleeding risks in surgical settings.

Keywords: haemophilia; haemostasis; inherited bleeding disorders; surgery; von Willebrand disease.

PubMed Disclaimer

Conflict of interest statement

D.F. is an author of ESAIC severe bleeding management guidelines (2013–2023). No other conflicts of interest declared.

Figures

Figure 1
Figure 1
General view of haemostasis. Created in BioRender.com. Stefan, M. (2024) BioRender.com/u56q111 (accessed on 9 June 2025).
Figure 2
Figure 2
Formation of the platelet plug. Created in BioRender. Stefan, M. (2024) BioRender.com/d28c946 (accessed on 9 June 2025).
Figure 3
Figure 3
Coagulation cascade and regulation. Created in BioRender. Stefan, M. (2024) BioRender.com/b38c128 (accessed on 9 June 2025).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Leung L.K. In: Overview of Haemostasis. Mannucci P., Tirnauer J., editors. Uptodate; Waltham, MA, USA: 2023.
    1. Chambers D., Huang C., Matthews G. Basic Physiology for Anaesthetists. 2nd ed. Cambridge University Press; Cambridge, UK: 2019. Chapter 72-Haemostasis; pp. 341–349.
    1. Sucker C., Zotz R.B. The Cell-Based Coagulation Model. In: Marcucci C.E., Schoettker P., editors. Perioperative Hemostasis. Springer; Berlin/Heidelberg, Germany: 2015. [(accessed on 1 April 2024)]. pp. 3–11. Available online: https://link.springer.com/10.1007/978-3-642-55004-1_1. - DOI
    1. Hall J., Hall M., editors. Guyton and Hall Textbook of Medical Physiology. 14th ed. Elsevier; Philadephia, PA, USA: 2021. Hemostasis and Blood Coagulation; pp. 483–496.
    1. Martinez M., Graf L., Tsakiris D.A. Congenital Bleeding Disorders. In: Marcucci C.E., Schoettker P., editors. Perioperative Hemostasis. Springer; Berlin/Heidelberg, Germany: 2015. [(accessed on 1 April 2024)]. pp. 71–87. Available online: http://link.springer.com/10.1007/978-3-642-55004-1_6. - DOI

MeSH terms

LinkOut - more resources