3rd Edition of Global Conference on Surgery and Anesthesia

September 14-15, 2022 | Online Event

September 14 -15, 2022 | Online Event
GCSA 2020

Fibrinolytic bleeding

Agnese Ozolina, Speaker at Surgery Conferences
Rigas Stradins University, Latvia
Title : Fibrinolytic bleeding


During the last few years, increasing attention has been paid to reports demonstrating the influence of the fibrinolytic system on increased peri -and postoperative bleeding in terms of anti-fibrinolytic prophylaxis and treatment of bleeding. Particularly, increased attention is focused on trauma patients and fibrinolytic system activation through to Protein C activation in early haemorrhagic shock stages. It is well established that hyper-fibrinolysis occurs in 30–50% of patients undergoing surgery (cardiac, liver, orthopaedics, obstetrics) and in 80% of trauma patients. However, inter-individual variations are relatively large due to different inhibitory potential of fibrinolysis determinate by mechanism of injury and genetic predisposition to higher fibrinolytic activity. Moreover, it is often difficult to sort out whether a bleeding results from changes in haemostasis alone, or from concomitantly occurring hyper-fibrinolysis. Therefore, it is essential to refresh the knowledge of fibrinolysis, both with regard to its pathophysiology, ways of activation, diagnostic tools and individual markers that can lead to a goal-directed treatment. Take Away Notes: • To evaluate the benefits and disadvantages of anti-fibrinolytic prophylaxis: is it always indicated? • To recognise fibrinolytic bleeding – clinical picture and diagnostic options: individual fibrinolysis markers (PAI-1, t-PA, t-PA/PAI-1 complex), role of genetical screening with viscoelastic tests • How to treat hyper-fibrinolysis in major bleeding


Dr. med, PhD Agnese Ozolina studied in Rīgas Stradiņš University Medical faculty and graduated as MD in 2004. Then she continued training in Anaesthesia and Intensive Care medicine becoming a specialist in 2010. My greatest interest has always been directed toward to the management of bleeding and thrombosis. A growing interest in research and lecturing, led me to a prospective observational study on genetically determinated fibrinolytic bleeding after cardiac surgery, which founded the basis of my dissertation and PhD degree in 2013. Consequently, several publications were reported. Parallel, I have an experience as invited lecturer in local and international meetings. As assistant professor of Rīgas Stradiņš University I am involved in teaching of physiological and pathophysiological aspects of haemostasis in local and international students. Presently, I am mostly involved in the management of haemostasis in orthopaedic and microvascular free flap surgery patients, including such essentials as individual goal-directed treatment based on ROTEM analysis for bleeding as well as for anticoagulation management.