Bridge therapy is

therapy A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many different ...

intended, in transportation

metaphor A metaphor is a figure of speech that, for rhetorical effect, directly refers to one thing by mentioning another. It may provide (or obscure) clarity or identify hidden similarities between two different ideas. Metaphors are often compared wit ...

, to serve as a figurative bridge to another stage of therapy or health, carrying a

patient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...

past a challenging period of some kind. There are various types of bridge therapy, such as bridge to transplant, bridge to candidacy, bridge to decision, bridge to recovery, and anticoagulation bridge (such as heparin bridge). Bridge therapy exists in contrast to

destination therapy Destination therapy is a therapy that is final rather than being a transitional stage until another therapy—thus, in transportation metaphor, a destination in itself rather than merely a bridge or road to the destination. The term usually refers t ...

, which is the figurative destination rather than a bridge to something else. * Bridge to transplant: Such therapy preserves someone's health well enough and long enough that they can make it to

organ transplant Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transpo ...

, still being eligible for transplant after spending time waiting for an organ to become available. For example, a left ventricular assist device (LVAD) often serves as a bridge to

heart transplant A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. , the most common proce ...

, locoregional therapy (such as radiofrequency ablation) for

hepatocellular carcinoma Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer in adults and is currently the most common cause of death in people with cirrhosis. HCC is the third leading cause of cancer-related deaths worldwide. It occurs in t ...

can serve as a bridge to liver transplant, and lung volume reduction surgery (LVRS) can serve as a bridge to lung transplant. * Bridge to candidacy: A patient was too sick to be a candidate for a certain therapy, but the bridge carries them to a state of being eligible; for example,

ECMO Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate ...

as a bridge to nontransplant cardiac surgery. * Bridge to decision: A decision will soon be made about what to do next (that is, which

definitive therapy A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indication (medicine), indications and contraindications. Th ...

will come soon), but first the patient needs a bridge to support them until that decision; for example, short-term mechanical circulatory support as a bridge to durable

left ventricular assist device A ventricular assist device (VAD) is an electromechanical device for assisting cardiac circulation, which is used either to partially or to completely replace the function of a failing heart. The function of a VAD differs from that of an artifici ...

implant in refractory

cardiogenic shock Cardiogenic shock (CS) is a medical emergency resulting from inadequate blood flow due to the dysfunction of the ventricles of the heart.Textbooks of Internal MedicinHarrison's Principles of Internal Medicine 16th Edition, The McGraw-Hill Compan ...

. * Bridge to recovery: A recovery is likely, but first support is needed to carry someone through a tough time; for example,

methamphetamine Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamph ...

toxicity, which can be viewed as both rescue therapy and bridge to recovery. * Anticoagulation bridge: Temporary

anticoagulation Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where the ...

, such as with

heparin Heparin, also known as unfractionated heparin (UFH), is a medication and naturally occurring glycosaminoglycan. Since heparins depend on the activity of antithrombin, they are considered anticoagulants. Specifically it is also used in the treatm ...

, is used during a perioperative period when a patient's regular anticoagulant therapy, such as with

warfarin Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent strok ...

, is suspended; the goal is to prevent excess risk of severe bleeding during or after surgery. The heparin bridge provides some anticoagulant effect (to prevent

thrombosis Thrombosis (from Ancient Greek "clotting") is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (thro ...

from warfarin withdrawal) but not as much as would make severe bleeding likely. A related concept is linkage to care, which is a bridge ''to'' therapy, such as when community screening events (for conditions such as high blood pressure or high blood sugar) find new cases of hypertension or diabetes; recipients are helped to find appropriate care (for example, some have not been to a doctor for many years and can use help finding a new doctor).

References

{{Reflist Therapy