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TEG tranexamic acid

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https://www.readbyqxmd.com/read/27765582/major-liver-resection-systemic-fibrinolytic-activity-and-the-impact-of-tranexamic-acid
#1
Paul J Karanicolas, Yulia Lin, Jordan Tarshis, Calvin H L Law, Natalie G Coburn, Julie Hallet, Barto Nascimento, Janusz Pawliszyn, Stuart A McCluskey
BACKGROUND: Hyperfibrinolysis may occur due to systemic inflammation or hepatic injury that occurs during liver resection. Tranexamic acid (TXA) is an antifibrinolytic agent that decreases bleeding in various settings, but has not been well studied in patients undergoing liver resection. METHODS: In this prospective, phase II trial, 18 patients undergoing major liver resection were sequentially assigned to one of three cohorts: (i) Control (no TXA); (ii) TXA Dose I - 1 g bolus followed by 1 g infusion over 8 h; (iii) TXA Dose II - 1 g bolus followed by 10 mg/kg/hr until the end of surgery...
October 17, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27515056/the-confusion-continues-results-from-an-american-association-for-the-surgery-of-trauma-survey-on-massive-transfusion-practices-among-united-states-trauma-centers
#2
Eric Etchill, Jason Sperry, Brian Zuckerbraun, Louis Alarcon, Joshua Brown, Kevin Schuster, Lewis Kaplan, Greta Piper, Andrew Peitzman, Matthew D Neal
BACKGROUND: Massive transfusion practices have undergone several recent developments. We sought to examine institutional practices guiding hemostatic resuscitation in the setting of massive hemorrhage. STUDY DESIGN AND METHODS: A 37-question online survey was sent to American Association for the Surgery of Trauma members. RESULTS: A total of 191 surgeons from 125 institutions completed the survey. Level I and II centers composed 70 and 18% of responding sites, respectively...
October 2016: Transfusion
https://www.readbyqxmd.com/read/27445340/an-in-vitro-study-of-the-effects-of-t-pa-and-tranexamic-acid-on-whole-blood-coagulation-and-fibrinolysis
#3
Anne Godier, Kiran Parmar, Karuna Manandhar, Beverley J Hunt
AIMS: Acute traumatic coagulopathy is characterised by fibrinolysis and low fibrinogen. It is unclear how much fibrinogenolysis contributes to reduce fibrinogen levels. The study aim was to: investigate in vitro the effects of tissue-plasminogen activator (t-PA) and tranexamic acid (TXA) on coagulation and fibrinolysis. METHODS: Whole blood was spiked with varying t-PA concentrations. Clauss fibrinogen levels and thrombelastography (TEG, Haemonetics) were performed, including functional fibrinogen level (FLEV)...
July 21, 2016: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27100747/fibrinolytic-shutdown-fascinating-theory-but-randomized-controlled-trial-data-are-needed
#4
Ian Roberts
Administration of tranexamic acid (TXA) to bleeding trauma patients who are within 3 hours of injury has been shown to safely reduce mortality in bleeding trauma patients. However, some believe that thromboelastography (TEG or ROTEM) can be used to subdivide these patients into those that will benefit from TXA and those that will be harmed by it. If thromboelastography can be used in this way there could be important patient benefits. However, if the approach is misguided, patients could be denied a lifesaving treatment...
April 2016: Transfusion
https://www.readbyqxmd.com/read/27100746/rationale-for-the-selective-administration-of-tranexamic-acid-to-inhibit-fibrinolysis-in-the-severely-injured-patient
#5
Ernest E Moore, Hunter B Moore, Eduardo Gonzalez, Angela Sauaia, Anirban Banerjee, Christopher C Silliman
Postinjury fibrinolysis can manifest as three distinguishable phenotypes: 1) hyperfibrinolysis, 2) physiologic, and 3) hypofibrinolysis (shutdown). Hyperfibrinolysis is associated with uncontrolled bleeding due to clot dissolution; whereas, fibrinolysis shutdown is associated with organ dysfunction due to microvascular occlusion. The incidence of fibrinolysis phenotypes at hospital arrival in severely injured patients is: 1) hyperfibrinolysis 18%, physiologic 18%, and shutdown 64%. The mechanisms responsible for dysregulated fibrinolysis following injury remain uncertain...
April 2016: Transfusion
https://www.readbyqxmd.com/read/26962250/does-tranexamic-acid-reduce-blood-loss-during-head-and-neck-cancer-surgery
#6
Atul P Kulkarni, Devendra A Chaukar, Vijaya P Patil, Rajendra B Metgudmath, Rohini W Hawaldar, Jigeeshu V Divatia
BACKGROUND AND AIMS: Transfusion of blood and blood products poses several hazards. Antifibrinolytic agents are used to reduce perioperative blood loss. We decided to assess the effect of tranexamic acid (TA) on blood loss and the need for transfusion in head and neck cancer surgery. METHODS: After Institutional Review Board approval, 240 patients undergoing supramajor head and neck cancer surgeries were prospectively randomised to either TA (10 mg/kg) group or placebo (P) group...
January 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26934942/comparison-between-thrombelastography-and-thromboelastometry-in-hyperfibrinolysis-detection-during-adult-liver-transplantation
#7
COMPARATIVE STUDY
E Abuelkasem, S Lu, K Tanaka, R Planinsic, T Sakai
BACKGROUND: Hyperfibrinolysis is one of the main causes of non-surgical bleeding during liver transplantation (LT). Viscoelastic haemostatic assays, including thromboelastometry (ROTEM(®)) and thrombelastography (TEG(®)), can detect hyperfibrinolysis at the bedside. No study has yet demonstrated which device or assay is more suitable for detecting hyperfibrinolysis. METHODS: This prospective observational study compared ROTEM(®) and TEG(®) in isolated adult LT...
April 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26619853/practice-management-of-acute-trauma-haemorrhage-and-haemostatic-disorders-across-german-trauma-centres
#8
V Albrecht, N Schäfer, E K Stürmer, A Driessen, L Betsche, M Schenk, M Maegele
PURPOSE: Early detection and management of trauma haemorrhage and coagulopathy have been associated with improved outcomes. We assessed infrastructure, logistics and management practice of trauma-associated haemorrhage and coagulopathy across German trauma centres. METHODS: A web-based survey of 20 questions was developed using the open source survey application LimeSurvey(®). It was disseminated among surgeons and anaesthetists in Germany. RESULTS: 145 Questionnaires were returned of which 106 were completed and analysed...
November 30, 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/26088425/effects-of-intravenous-administration-of-tranexamic-acid-on-hematological-hemostatic-and-thromboelastographic-analytes-in-healthy-adult-dogs
#9
Efrat Kelmer, Gilad Segev, Victoria Papashvilli, Naomi Rahimi-Levene, Yaron Bruchim, Itamar Aroch, Sigal Klainbart
OBJECTIVE: To assess the effects of tranexamic acid (TA) on hematological, hemostatic, and thromboelastographic analytes in healthy adult dogs. DESIGN: Prospective study. SETTING: University teaching hospital. ANIMALS: Eleven healthy, staff-owned, adult dogs. MEASUREMENTS AND MAIN RESULTS: Dogs were administered TA as an IV bolus, followed by a 3-hour constant rate infusion (CRI). Complete blood count, prothrombin time, activated partial thromboplastin time, D-dimer, antithrombin, fibrinogen, and thromboelastography (TEG) were measured prior to, and immediately after TA administration...
July 2015: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/25769590/evaluation-of-flat-line-thromboelastography-after-reperfusion-during-liver-transplantation
#10
E H Kim, S H Song, G S Kim, J S Ko, M S Gwak, S K Lee
BACKGROUND: "Flat-line" (no clot formation) thromboelastography (TEG) is frequently observed after graft reperfusion during liver transplantation (LT). We aimed to evaluate the incidence and causes of flat-line TEG after graft reperfusion during LT. METHODS: With institutional review board approval, data of 208 consecutive recipients who underwent LT from May 2010 to May 2012 were retrospectively reviewed. We performed 3 different types of TEG measurements at 5 minutes after graft reperfusion: native TEG (nTEG), tranexamic acid-added TEG (tTEG), and protamine-added TEG (pTEG)...
March 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/25660118/hemostatic-resuscitation-in-postpartum-hemorrhage-a-supplement-to-surgery
#11
REVIEW
Kim Ekelund, Gabriele Hanke, Jakob Stensballe, Anne Wikkelsøe, Charlotte Krebs Albrechtsen, Arash Afshari
BACKGROUND: Postpartum hemorrhage is a potentially life-threatening albeit preventable condition that persists as a leading cause of maternal death. Identification of safe and cost-effective hemostatic treatment options remains crucial as a supplement to surgery and uterotonic agents. OBJECTIVE: This review summarizes the background, current evidence and recommendations with regard to the role of fibrinogen, tranexamic acid, prothrombin complex concentrate, desmopressin, and recombinant factor VIIa in the treatment of patients with postpartum hemorrhage...
July 2015: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/25030852/repeated-doses-of-intravenous-tranexamic-acid-are-effective-and-safe-at-reducing-perioperative-blood-loss-in-total-knee-arthroplasty
#12
Qintong Xu, Yi Yang, Peng Shi, Jian Zhou, Wenda Dai, Zhenjun Yao, Chi Zhang
Fibrin sealant (FS) and tranexamic acid (TXA) have been used in total knee arthroplasty (TKA) to minimize perioperative blood loss. The efficacy of FS has been debated, and few studies have looked into the effects of FS and TXA on perioperative coagulability. The current study retrospectively reviewed 100 cases of unilateral primary TKA. Twenty-five cases served as blank controls, FS was used without TXA in 23, TXA was used without FS in 20, and both FS and TXA (FS + TXA) were used in 32. FS was sprayed before wound closure whereas 1 g of TXA was intravenously administered before incision and 1 g was administered 15 min before tourniquet release...
June 2014: Bioscience Trends
https://www.readbyqxmd.com/read/24482057/-perioperative-coagulation-management-in-multiple-trauma-patients-based-on-viscoelastic-test-results
#13
H Schöchl, C J Schlimp, W Voelckel
Exsanguination represents the most common and potentially preventable cause of death in major trauma patients. Rapid surgical intervention coupled with an early and aggressive hemostatic therapy not only results in survival benefits of coagulopathic trauma patients, but also reduces the incidence of complications and costs. Standard coagulation tests are not suitable to adequately characterize the complexity of trauma-induced coagulopathy (TIC). This fact has led to a renaissance of viscoelastic tests, such as rotational thromboelastometry (ROTEM®) and thrombelastography (TEG®), which can be used as point-of-care monitors...
February 2014: Der Unfallchirurg
https://www.readbyqxmd.com/read/24398771/hypercoagulability-and-other-risk-factors-in-trauma-intensive-care-unit-patients-with-venous-thromboembolism
#14
COMPARATIVE STUDY
Robert M Van Haren, Evan J Valle, Chad M Thorson, Jassin M Jouria, Alexander M Busko, Gerardo A Guarch, Nicholas Namias, Alan S Livingstone, Kenneth G Proctor
BACKGROUND: Thromboelastography (TEG) on hospital admission can identify hypercoagulable trauma patients at risk for venous thromboembolism (VTE), but the value of TEGs obtained after multiple interventions, including tranexamic acid (TXA), has not been defined. We test the following hypotheses. (1) TEG on intensive care unit (ICU) admission can help stratify patients screened with Greenfield's risk assessment profile (RAP) for VTE. (2) TXA is a VTE risk factor, and its effect on fibrinolysis can be identified with TEG...
February 2014: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/24180723/utility-of-thromboelastography-in-managing-acquired-factor-viii-inhibitor-associated-massive-haemorrhage
#15
C Fisher, A Mo, S Warrillow, C Smith, D Jones
Disorders of clotting and coagulation are common in the intensive care unit. Diagnosis, treatment and monitoring of these disorders are traditionally based on conventional coagulation tests such as activated partial thromboplastin time (APTT) and international normalised ratio (INR). We present here a patient who developed massive postoperative haemorrhage secondary to an acquired factor VIII inhibitor. The case highlights the utility and sensitivity of thromboelastography (TEG) in the diagnosis of the condition and monitoring the response to therapy...
November 2013: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/24118238/therapeutic-plasma-concentrations-of-epsilon-aminocaproic-acid-and-tranexamic-acid-in-horses
#16
D J Fletcher, B M Brainard, K Epstein, R Radcliffe, T Divers
BACKGROUND: Antifibrinolytic drugs such as epsilon aminocaproic acid (EACA) and tranexamic acid (TEA) are used to treat various bleeding disorders in horses. Although horses are hypofibrinolytic compared to humans, dosing schemes have been derived from pharmacokinetic studies targeting plasma concentrations in humans. HYPOTHESIS/OBJECTIVES: We hypothesized therapeutic plasma concentrations of antifibrinolytic drugs in horses would be significantly lower than in humans...
November 2013: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/23406662/influence-of-resuscitation-fluids-fresh-frozen-plasma-and-antifibrinolytics-on-fibrinolysis-in-a-thrombelastography-based-in-vitro-whole-blood-model
#17
Vadim Kostousov, Yao-Wei W Wang, Bryan A Cotton, Charles E Wade, John B Holcomb, Nena Matijevic
Hyperfibrinolysis has been identified as a mechanism of trauma coagulopathy associated with poor outcome. The aim of the study was to create a trauma coagulopathy model (TCM) with a hyperfibrinolysis thrombelastography (TEG) pattern similar to injured patients and test the effects of different resuscitation fluids and antifibrinolytics on fibrinolysis. TCM was established from whole blood by either 15% dilution with isotonic saline, lactated Ringer's, Plasma-Lyte, 5% albumin, Voluven, Hextend, 6% dextran in isotonic saline or 30% dilution with lactated Ringer's plus Voluven and supplementation with tissue factor and tissue plasminogen activator (tPA)...
July 2013: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/22508200/a-randomized-prospective-analysis-of-alteration-of-hemostatic-function-in-patients-receiving-tranexamic-acid-and-hydroxyethyl-starch-130-0-4-undergoing-off-pump-coronary-artery-bypass-surgery
#18
RANDOMIZED CONTROLLED TRIAL
Murali Chakravarthy, Geetha Muniraj, Swapnil Patil, Sharadaprasad Suryaprakash, Sona Mitra, Benak Shivalingappa
Postoperative hemorrhagic complications is still one of the major problems in cardiac surgeries. It may be caused by surgical issues, coagulopathy caused by the side effects of the intravenous fluids administered to produce plasma volume expansion such as hydroxyl ethyl starch (HES). In order to thwart this hemorrhagic issue, few agents are available. Fibrinolytic inhibitors like tranexamic acid (TA) may be effective modes to promote blood conservation; but the possible complications of thrombosis of coronary artery graft, precludes their generous use in coronary artery bypass graft surgery...
April 2012: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/22348384/combined-treatment-with-apcc-feiba%C3%A2-and-tranexamic-acid-in-patients-with-haemophilia-a-with-inhibitors-and-in-patients-with-acquired-haemophilia-a-a-two-centre-experience
#19
MULTICENTER STUDY
M Holmström, H T T Tran, P A Holme
The management of bleeding in haemophilia patients with inhibitors can be challenging when using monotherapy with either activated prothrombin complex concentrate (APCC) or recombinant activated FVII (rFVIIa) fail. The antifibrinolytic agent tranexamic acid (TXA) increases clot stability and is used concomitantly with coagulation factor replacement to improve haemostasis in haemophilia patients without inhibitors in many countries in Europe. Combined treatment with TXA and rFVIIa is not contraindicated in haemophilia patients with inhibitors...
July 2012: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/22314689/comparison-of-whole-blood-fibrin-based-clot-tests-in-thrombelastography-and-thromboelastometry
#20
COMPARATIVE STUDY
Cristina Solomon, Benny Sørensen, Gerald Hochleitner, Jeffry Kashuk, Marco Ranucci, Herbert Schöchl
BACKGROUND: Fibrin-based clot firmness is measured as maximum amplitude (MA) in the functional fibrinogen (FF) thrombelastographic assay and maximum clot firmness (MCF) in the FIBTEM thromboelastometric assay. Differences between the assays/devices may be clinically significant. Our objective was to compare clot firmness parameters through standard (FF on a thrombelastography device [TEG®]; FIBTEM on a thromboelastometry device [ROTEM®]) and crossover (FF on ROTEM®; FIBTEM on TEG®) analyses...
April 2012: Anesthesia and Analgesia
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