Prevention of Platelet Dysfunction
Prevention of platelet dysfunction relies on screening methods, such as blood work and platelet function testing in those at risk, such as patients with a strong history of bleeding diathesis (disorders), venous thrombosis, hemophilia, stroke, and inappropriate blood loss after minor trauma. A family history positive for platelet dysfunction is a major risk that calls for preventative measures. Identification of those as risk is the best strategy for preventing stroke, hemorrhage, gastrointestinal bleeding, surgery-associated blood loss, and spontaneous bleeding.
Prevention of Clotting
- Those with an increased tendency toward clotting (i.e., previous thrombosis, strong family history, previous stroke, venous stasis, or atherosclerosis): May benefit from anti-platelet therapy, using aspirin, NSAIDs, heparin, warfarin, or other agents.
Prevention of Bleeding
- Those with an increased tendency toward, or history of, uncontrolled bleeding: Can be treated preventatively with desmopressin, estrogens, or in critical thrombocytopenia where hemorrhagic stroke is likely, platelet transfusion. Stroke prevention is a major incentive for such preventative therapy.
- Prevention of the causes of platelet dysfunction: Can also prevent the dysfunction, such as prevention of liver disease (alcohol rehabilitation and avoiding high-risk sexual behavior that increases the risk of acquiring hepatitis B and C) and aggressive approaches to kidney disease.
- Using therapeutic agents is prudent when there is a planned surgery involving cardiopulmonary bypass.
- Strict glycemic control in diabetics: With a targeted hemoglobin A1c goal of >7%, can reduce the risk of bleeding diathesis in diabetics.