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B Alcocer, P Bou, L Bosch, C Torrente
OBJECTIVE: To describe an unusual case of spontaneous hemothorax resulting from thymic involution in a dog with suspected acquired bleeding dyscrasia associated with steroid-responsive meningitis-arteritis (SRMA). CASE DESCRIPTION: A 6-month-old spayed female Golden Retriever was referred due to the sudden onset of lethargy, fever (pyrexia), loss of appetite (anorexia), and moderate neck pain. These symptoms emerged six days after an ovariohysterectomy performed by the primary veterinarian...
March 19, 2024: Topics in Companion Animal Medicine
#2
JOURNAL ARTICLE
Jack K Donohue, Nidhi Iyanna, John M Lorence, Joshua B Brown, Frances X Guyette, Brian J Eastridge, Raminder Nirula, Gary A Vercruysse, Terence O'Keeffe, Bellal Joseph, Matthew D Neal, Jason L Sperry
BACKGROUND: Tranexamic acid (TXA) has been hypothesized to mitigate coagulopathy in patients after traumatic injury. Despite previous prehospital clinical trials demonstrating a TXA survival benefit, none have demonstrated correlated changes in thromboelastography (TEG) parameters. We sought to analyze if missing TEG data contributed to this paucity of findings. METHODS: We performed a secondary analysis of the Study of Tranexamic Acid During Air Medical and Ground Prehospital Transport Trial...
2024: Trauma Surgery & Acute Care Open
#3
JOURNAL ARTICLE
Jian Yang, Jing Zhang, Jiayan Luo, Jie Ouyang, Qicai Qu, Qitao Wang, Yongyu Si
OBJECTIVE: In this study, we evaluated the efficacy of tranexamic acid (TXA) and acute normovolemic hemodilution (ANH) with 6% hydroxyethyl starch (130/0.4) in minimizing blood loss during open partial liver resection. Coagulation function was assessed using thromboelastography (TEG) and hemostasis tests, while renal function changes were tracked through serum creatinine values post-surgery. METHODS: Thirty patients undergoing open partial liver resection were allocated to two groups: Group T received TXA + ANH, and Group A received ANH alone...
2023: Journal of Pain Research
#4
JOURNAL ARTICLE
Chandan Bhogendra Jha, Chitrangda Singh, Parag Patil, Kuntal Manna, Sweta Singh, Raunak Varshney, R Mathur
External hemostatic agents play a crucial role in stabilising an impaired process during pathological conditions. The idea is to stabilise the in vivo system as soon as possible. This study uses a class I hemostatic drug tranexamic acid as reducing and capping agent for synthesising the gold nanoparticles (Tr-AuNPs). Being the synthetic analogue of lysine and a biologically inspired alkylamine molecule the chemistry can be fine-tuned for stable material which can target the intrinsic and extrinsic hemostatic pathway simultaneously making it a promising for hemostatic applications...
November 23, 2023: Nanotechnology
#5
JOURNAL ARTICLE
Wang-Yi Jin, Zi-Wen Yan, Xing Zhang, Sheng Pan, Chao-Ran Huang, Kai-Jin Guo, Xin Zheng
OBJECTIVE: This study aimed to assess the safety and efficacy of triple-dose intravenous tranexamic acid (TXA) in patients following total hip arthroplasty (THA) using thromboelastography (TEG). METHODS: One hundred thirty patients undergoing THA were prospectively enrolled in the study. According to the intravenous infusion TXA dose, patients were divided into single-dose (n=65; mean age=60.8 ± 8.1 years) and triple-dose groups (n=65; mean age=61.8 ± 8...
November 21, 2023: Acta Orthopaedica et Traumatologica Turcica
#6
JOURNAL ARTICLE
Haojie Yu, Minying Liu, Xingyue Zhang, Tingting Ma, Jingchao Yang, Yaru Wu, Jie Wang, Muhan Li, Juan Wang, Min Zeng, Liyong Zhang, Hailong Jin, Xiaoyuan Liu, Shu Li, Yuming Peng
INTRODUCTION: Tranexamic acid (TXA) has been proven to prevent thrombolysis and reduce bleeding and blood transfusion requirements in various surgical settings. However, the optimal dose of TXA that effectively reduce intraoperative bleeding and blood product infusion in patients undergoing neurosurgical resection of meningioma with a diameter ≥ 5 cm remains unclear. METHODS: This is a single-center, randomized, double-blinded, paralleled-group controlled trial...
2023: PloS One
#7
REVIEW
Peter Collins
The use of viscoelastic haemostatic assays (VHAs) to guide blood product replacement during postpartum haemorrhage is expanding. Rotem and TEG devices can be used to detect and treat clinically significant hypofibrinogenaemia, although evidence to support the role of VHAs for guiding fresh frozen plasma and platelet transfusion is less clear. If Rotem/TEG traces are normal, clinicians should investigate for another cause of bleeding, and haemostatic support is not required. Guidelines support the use of VHAs during postpartum haemorrhage as part of locally agreed algorithms...
December 2022: Best Practice & Research. Clinical Anaesthesiology
#8
JOURNAL ARTICLE
Ting Zhang, Hua Feng, Wei Xiao, Jingsheng Li, Qinghai Liu, Xuexin Feng, Dezhou Qi, Xiaotong Fan, Yongzhi Shan, Tao Yu, Guoguang Zhao, Tianlong Wang
Background: Intraoperative bleeding and allogeneic transfusion remain common problems in pediatric resective epilepsy surgery. Tranexamic acid (TXA) is a widely recommended antifibrinolytic drug that reduces blood loss and transfusion requirements for bleeding patients. Thromboelastography (TEG)-guided hemostatic algorithm is commonly used in bleeding management. This trial was designed to validate the efficacy of a multimodal coagulation therapy involving continuous TXA infusion with TEG-guided hemostatic algorithm in reducing allogeneic exposure risk in pediatric resective epilepsy surgery...
2022: Frontiers in Pharmacology
#9
JOURNAL ARTICLE
Leonid B Markin, Olena I Popovych, Alla I Popovych
OBJECTIVE: The aim: To establish the effectiveness of thromboelastography (TEG) and tranexamic acid (TXA) for prognosis and prevention of early postpartum period bleedings (PPB) for postpartum women with idiopathic arterial hypotension (IAH). PATIENTS AND METHODS: Materials and methods: Coagulogical research was conducted (coaugologram screening, dynamic function of platelets under the influence of adenosine diphosphate (ADP) (visual assessment), measurement of soluble fibrin-monomer complexes (FMC) and TEG of 36 in parturient women during the I chilbirth period with arterial hypotension...
2022: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
#10
REVIEW
Taylor N Anderson, Martin A Schreiber, Susan E Rowell
The role of viscoelastic testing in the evaluation and management of traumatic brain injury (TBI) remains a subject of ongoing exploration. This review highlights four key publications that provide significant insights into this subject. Holcomb et al. provided early evidence of the relationship between thromboelastography (TEG) and conventional coagulation tests (CCTs). Later, Samuels et al. used TEG to identify a unique coagulopathy phenotype in TBI characterized by a notable absence of fibrinolytic abnormalities...
October 2021: Transfusion Medicine Reviews
#11
JOURNAL ARTICLE
Rachel N Heilbronner, Michelle Kincaid, Grant Walliser, Michelle Pershing, M Chance Spalding
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic therapy intended to decrease blood loss and improve hemostasis in traumatic hemorrhage. Viscoelastic assays, such as thromboelastography (TEG), allow for the identification of a patient's specific hemostasis. The purpose of this research study was to explore the safety and efficacy of TEG-guided antifibrinolytic therapy in trauma patients. METHODS: This study was a retrospective review of trauma patients meeting institution-specific inclusion criteria for TXA...
2021: International Journal of Critical Illness and Injury Science
#12
JOURNAL ARTICLE
Juan Duchesne, Sharven Taghavi, Scott Ninokawa, Charles Harris, Rebecca Schroll, Patrick McGrew, Clifton McGinness, Robert Reily, Chrissy Guidry, Danielle Tatum
BACKGROUND: Numerous advancements in hemorrhage control and volume replacement that comprise damage control resuscitation (DCR) have been implemented in the last decade to reduce deaths from bleeding. We sought to determine the impact of DCR interventions on mortality over 12 years in a massive transfusion protocol (MTP) population. We hypothesized that mortality would be decreased in later years, which would have used more DCR interventions. STUDY DESIGN: This was a retrospective review of all MTP patients treated at a large regional Level I trauma center from 2008-2019...
May 27, 2021: Shock
#13
JOURNAL ARTICLE
Rebecca Langhorn, Matilde K Poulsen, Pernille L Heidemann, Louise Bochsen, Christian Ritz, Annemarie T Kristensen, Lise N Nielsen
Primary hyperfibrinolysis is not well characterised in canine cancer. This prospective case-control pilot study aimed to evaluate tissue plasminogen activator-modified thromboelastography (tPA-TEG) for diagnosis of primary hyperfibrinolysis in dogs with cancer and establish the in vitro therapeutic concentration of tranexamic acid (TXA). Nine dogs with sarcomas and normocoagulable thromboelastograms and 11 healthy dogs were included. For each a whole blood tPA-TEG, and four tPA-TEGs with added TXA in different concentrations were analysed...
March 31, 2021: Research in Veterinary Science
#14
JOURNAL ARTICLE
Zhen-Feng Zhou, Wen Zhai, Li-Na Yu, Kai Sun, Li-Hong Sun, Xiu-Fang Xing, Min Yan
BACKGROUND: The blood saving efficacy of TXA in cardiac surgery has been proved in several studies, but TXA dosing regimens were varied in those studies. Therefore, we performed this study to investigate if there is a dose dependent in-vivo effect of TXA on fibrinolysis parameters by measurement of fibrinolysis markers in adults undergoing cardiac surgery with CPB. METHODS: A double-blind, randomized, controlled prospective trial was conducted from February 11, 2017 to May 05, 2017...
February 2, 2021: BMC Anesthesiology
#15
JOURNAL ARTICLE
Christopher D Barrett, Hunter B Moore, Navin Vigneshwar, Sanjeev Dhara, James Chandler, Michael P Chapman, Angela Sauaia, Ernest E Moore, Michael B Yaffe
BACKGROUND: Trauma patients with hyperfibrinolysis and depletion of fibrinolytic inhibitors (DFIs) measured by thrombelastography (TEG) gain clot strength with TXA, but TEG results take nearly an hour. We aimed to develop an assay, plasmin TEG (P-TEG), to more expeditiously stratify risk for massive transfusion (MT), mortality, and hyperfibrinolysis. METHODS: Trauma patients (N = 148) were assessed using TEG assays without exogenous additives (rapid/native), with exogenous plasmin (P-TEG) or tissue plasminogen activator (tPA TEG)...
December 2020: Journal of Trauma and Acute Care Surgery
#16
RANDOMIZED CONTROLLED TRIAL
Alexandra L Dixon, Belinda H McCully, Elizabeth A Rick, Elizabeth Dewey, David H Farrell, Laurie J Morrison, Jason McMullan, Bryce R H Robinson, Jeannie Callum, Brian Tibbs, David J Dries, Jonathan Jui, Rajesh R Gandhi, John S Garrett, Myron L Weisfeldt, Charles E Wade, Tom P Aufderheide, Ralph J Frascone, John M Tallon, Delores Kannas, Carolyn Williams, Susan E Rowell, Martin A Schreiber
BACKGROUND: No Food and Drug Administration-approved medication improves outcomes following traumatic brain injury (TBI). A forthcoming clinical trial that evaluated the effects of two prehospital tranexamic acid (TXA) dosing strategies compared with placebo demonstrated no differences in thromboelastography (TEG) values. We proposed to explore the impact of TXA on markers of coagulation and fibrinolysis in patients with moderate to severe TBI. METHODS: Data were extracted from a placebo-controlled clinical trial in which patients 15 years or older with TBI (Glasgow Coma Scale, 3-12) and systolic blood pressure of ≥90 mm Hg were randomized prehospital to receive placebo bolus/placebo infusion (placebo), 1 g of TXA bolus/1 g of TXA infusion (bolus maintenance), or 2 g of TXA bolus/placebo infusion (bolus only)...
November 2020: Journal of Trauma and Acute Care Surgery
#17
JOURNAL ARTICLE
Xing-Chen Zhang, Ma-Ji Sun, Sheng Pan, Min Rui, Feng-Chao Zhao, Guo-Chun Zha, Yong Pang, Xin Zheng, Kai-Jin Guo
OBJECTIVE: Despite the wide use of tranexamic acid (TXA) in the perioperative period of total hip arthroplasty (THA), whether the hemostatic state changes after the application of intravenous (IV)-TXA are still unknown. The aim of this study was to investigate whether IV administration of TXA changes the blood coagulation following primary THA via thrombelastography (TEG) analysis and conventional laboratory tests. METHODS: A total of 174 patients who underwent primary THA from September 2016 to July 2018 were selected...
September 2020: Journal of Orthopaedic Surgery
#18
JOURNAL ARTICLE
Alexandra L Dixon, Belinda H McCully, Elizabeth A Rick, Elizabeth Dewey, David H Farrell, Laurie J Morrison, Jason McMullan, Bryce R H Robinson, Jeannie Callum, Brian Tibbs, David J Dries, Jonathan Jui, Rajesh R Gandhi, John S Garrett, Myron L Weisfeldt, Charles E Wade, Tom P Aufderheide, Ralph J Frascone, John M Tallon, Delores Kannas, Carolyn Williams, Susan E Rowell, Martin A Schreiber, Barbara McKnight, Eric N Meier, Susanne May, Kellie Sheehan, Eileen M Bulger, Ahamed H Idris, Jim Christenson, Patrick L Bosarge, M Riccardo Colella, Jay Johannigman, Bryan A Cotton, Neal J Richmond, Martin D Zielinski, Rob Schlamp, Lauren Klein, Sandro Rizoli, Mark Gamber, Michael Fleming, Jun Hwang, Laura E Vincent, Audrey Hendrickson, Robert Simonson, Patricia Klotz, Michael Ferrara, George Sopko, William Witham
BACKGROUND: No FDA-approved medication improves outcomes following traumatic brain injury (TBI). A forthcoming clinical trial that evaluated the effects of two prehospital tranexamic acid (TXA) dosing strategies compared with placebo demonstrated no differences in thromboelastography (TEG) values. We proposed to explore the impact of TXA on markers of coagulation and fibrinolysis in patients with moderate to severe TBI. METHODS: Data were extracted from a placebo-controlled clinical trial in which patients ≥15 years old with TBI (Glascow Coma Scale 3-12) and systolic blood pressure ≥90 mmHg were randomized prehospital to receive placebo bolus/placebo infusion (Placebo), 1 gram (g) TXA bolus/1g TXA infusion (Bolus Maintenance [BM]); or 2g TXA bolus/placebo infusion (Bolus Only [BO])...
August 28, 2020: Journal of Trauma and Acute Care Surgery
#19
JOURNAL ARTICLE
Christopher D Barrett, Navin Vigneshwar, Hunter B Moore, Arsen Ghasabyan, James Chandler, Ernest E Moore, Michael B Yaffe
: Trauma with hemorrhagic shock causes massive tissue plasminogen activator release, plasmin generation, and hyperfibrinolysis. Tranexamic acid (TXA) has recently been used to treat bleeding in trauma by preventing plasmin generation to limit fibrinolysis. Trauma patients also have increased complement activation that correlates with mortality and organ failure, but the source of activation is not clear, and plasmin has recently been shown to efficiently cleave C3 and C5 to their activated fragments. We hypothesized that trauma patients in hemorrhagic shock with hyperfibrinolysis on thromboelastography (TEG) LY30 would have increased complement activation at early time points, as measured by soluble C5b-9 complex, and TXA would prevent this...
July 27, 2020: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
#20
RANDOMIZED CONTROLLED TRIAL
Yi-Ting Lei, Jin-Wei Xie, Qiang Huang, Wei Huang, Fu-Xing Pei
PURPOSE: The aim of this study was to evaluate the effects of a high initial-dose (60 mg/kg) intravenous tranexamic acid (IV-TXA) on fibrinolysis and inflammation after total knee arthroplasty (TKA). METHODS: A total of 132 patients were categorized into two groups based on different TXA regimens: 20 mg/kg before incision (A) or 60 mg/kg before incision (B). All patients received five doses of 1 g TXA at three, six, 12, 18, and 24 hours after the first dose...
March 2020: International Orthopaedics
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