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Heparin, monitoring

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https://www.readbyqxmd.com/read/28329078/apical-closure-device-for-full-percutaneous-transapical-valve-implantation-stress-test-in-an-animal-model%C3%A2
#1
Enrico Ferrari, Stefanos Demertzis, Jennifer Angelella, Denis Berdajs, Piergiorgio Tozzi, Tiziano Moccetti, Francesco Maisano, Ludwig K von Segesser
OBJECTIVES: Transapical valve implantation is traditionally performed through a left antero-lateral mini-thoracotomy. A self-expandable apical closure device has recently been developed for full-percutaneous transapical valve implantation. We performed haemodynamics stress-tests on an animal model to evaluate the sealing properties. METHODS: Under general anaesthesia 5 pigs (mean weight: 67 ± 6 Kg) received full heparinization (100 IU/Kg; activated clotting time >250 s and, through inferior mini-sternotomies, 21-Fr introducer sheaths for transapical aortic valve implantation (outer diameter: 25-Fr) were placed over-the-wire in the apexes...
January 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28320219/monitoring-of-argatroban-and-lepirudin
#2
Holger Seidel, Hans-Jürgen Kolde
Monitoring of direct thrombin inhibitors (DTIs) in patients with heparin-induced thrombocytopenia (HIT) is primarily performed using the activated partial thromboplastin time (aPTT). This assay is poorly standardized, reagent dependent, and not DTI specific. We compared aPTT, thrombin time (TT), and prothrombin time (PT) to drug levels obtained by the ecarin chromogenic assay (ECA). We analyzed 495 samples of patients with confirmed or suspected HIT on treatment with either argatroban (n = 37) or lepirudin (n = 80)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28318889/non-invasive-liver-ablation-using-histotripsy-preclinical-safety-study-in-an-in%C3%A2-vivo-porcine-model
#3
Eli Vlaisavljevich, Gabe Owens, Jonathan Lundt, Dejan Teofilovic, Kimberly Ives, Alexander Duryea, Jim Bertolina, Theodore H Welling, Zhen Xu
This study investigates the safety profile for use of histotripsy, a non-invasive ultrasonic ablation method currently being developed for the treatment of liver cancer, for liver ablation in an in vivo porcine model. Histotripsy treatments were applied to the liver and hepatic veins of 22 porcine subjects, with half of the subjects receiving systemic heparinization. Vital signs (heart rate, blood pressure, temperature, electrocardiogram and SpO2) were monitored throughout the procedure and for 1 h post-treatment...
March 16, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28301908/identification-of-cost-saving-opportunities-for-the-use-of-antithrombin-iii-in-adult-and-pediatric-patients
#4
Alana Ciolek, John Lindsley, Jessica Crow, Kristen Nelson-McMillan, David Procaccini
Thrombate III is a human plasma-derived antithrombin III (AT-III) often utilized in patients on extracorporeal membrane oxygenation (ECMO) with suspected AT-III-mediated heparin resistance. It is supplied as 500-U and 1000-U vials, costing US$4.66 per unit. Literature is limited in describing the clinical value of AT-III in relation to its high cost. The primary objective was to determine conditions of use and associated cost of potentially unnecessary utilization of AT-III at The Johns Hopkins Hospital. Secondary objectives included evaluating the effect of AT-III on anticoagulation parameters and the overall cost utilized and wasted on AT-III...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28298749/perioperative-considerations-and-management-of-patients-receiving-anticoagulants
#5
REVIEW
Safiya Imtiaz Shaikh, R Vasantha Kumari, Ganapati Hegade, M Marutheesh
Anticoagulants remain the primary strategy for the prevention and treatment of thrombosis. Unfractionated heparin, low molecular weight heparin (LMWH), fondaparinux, and warfarin have been studied and employed extensively with direct thrombin inhibitors typically reserved for patients with complications or those requiring interventions. Novel oral anticoagulants have emerged from clinical development and are expected to replace older agents with their ease to use and more favorable pharmacodynamic profiles...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#6
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28281226/polypharmacotherapy-and-blood-products-as-risk-factors-for-venous-thromboembolism-in-postsurgical-patients-a-case-control-study
#7
Alenka Premuš Marušič, Daniel Petrovič, Aleš Mrhar, Igor Locatelli
Background After surgical procedures, patients are at high risk of developing venous thromboembolism, clinically manifested as deep vein thrombosis (DVT) or pulmonary embolism (PE). Objective To evaluate the influence of polypharmacotherapy, comorbidity, drug treatments, packed red blood cells application, adequacy of thromboprophylaxis, and patient characteristics on the occurrence of DVT or PE in postsurgical patients. Setting The surgical department at Murska Sobota General Hospital, Slovenia. Methods In this retrospective case control study, the records of 286 surgical patients were analysed: DVT or PE group (n = 144) and control group (n = 142)...
March 9, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#8
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28275614/considerations-for-analgosedation-and-antithrombotic-management-during-extracorporeal-life-support
#9
REVIEW
Pamela K Burcham, Alan J Rozycki, Erik E Abel
Despite the immense growth in extracorporeal life support (ECLS) technology and experience, opportunity remains to better characterize the pharmacotherapeutic considerations during ECLS. Analgosedation can be particularly challenging in the ECLS population due to in drug-circuit interactions that may lead to decreased systemic concentrations and pharmacodynamic effect. ECLS also requires the use of antithrombotic agents to mitigate the prothrombotic state created by the artificial surface in the ECLS circuit...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28225297/development-of-an-uplc-ms-ms-micromethod-for-quantitation-of-cinitapride-in-plasma-and-its-application-in-a-pharmacokinetic-interaction-trial
#10
RANDOMIZED CONTROLLED TRIAL
Gabriel Marcelín-Jiménez, Leticia Contreras, Javier Esquivel, Óscar Ávila, Dany Batista, Alionka P Ángeles, Alberto García-González
AIM: Cinitapride (CIN) is a benzamide-derived molecule used for the treatment of gastroesophageal reflux and dyspepsia. Its pharmacokinetics are controversial due to the use of supratherapeutic doses and the lack of sensitive methodology. Therefore, a sensitive and accurate micromethod was developed for its quantitation in human plasma. RESULTS: CIN was extracted from 300 µl of heparinized plasma by liquid-liquid extraction using cisapride as internal standard, and analyzed with an ultra performance liquid chromatograph employing positive multiple-reaction monitoring-MS...
March 2017: Bioanalysis
https://www.readbyqxmd.com/read/28222250/long-term-treatment-of-cancer-associated-thrombosis-the-choice-of-the-optimal-anticoagulant
#11
REVIEW
I Elalamy, I Mahé, W Ageno, G Meyer
Patients with cancer associated thrombosis (CAT) carry a higher risk of recurrence, bleeding and mortality as compared to non-cancer patients. The specific profile of cancer patients combining frequent co-morbidities, the use of anti-tumoral therapies and the cancer progression itself represent a major therapeutic challenge for choosing a long-term anticoagulant treatment. This review discusses the practical basis of that choice among available drugs for the long-term antithrombotic strategy linked to their pharmacology, mechanism of action, evidence of clinical benefits, advantages and limitations in such a complex clinical context...
February 21, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28152184/analytic-and-quality-control-validation-and-assessment-of-field-performance-of-a-point-of-care-chemistry-analyzer-for-use-in-the-white-rhinoceros
#12
Emma H Hooijberg, Gerhard Steenkamp, Jacques P du Preez, Amelia Goddard
BACKGROUND: A chemistry point-of-care analyzer would be useful for evaluating injured wildlife, particularly White rhinoceros (Ceratotherium simum) that survive poaching attempts. The IDEXX VetTest could be suitable, but species-specific validation, development of a statistical quality control (QC) strategy, and evaluation under field conditions are necessary. OBJECTIVES: The objectives were to (1) validate the VetTest for the White rhinoceros, (2) perform QC validation on the VetTest and generate a statistical QC strategy, and (3) apply this QC strategy to monitor performance under typical field conditions...
February 2, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28140493/cerebral-high-intensity-transient-signals-during-pediatric-cardiac-catheterization-a-pilot-study-using-transcranial-doppler-ultrasonography
#13
Kerri L LaRovere, Kush Kapur, Doff B McElhinney, Alexander Razumovsky, Barry D Kussman
BACKGROUND AND PURPOSE: Cerebral emboli are one potential cause of acute brain injury in children with congenital heart disease (CHD) undergoing cardiac catheterization. In this pilot study using transcranial Doppler (TCD) ultrasonography, we sought to evaluate the incidence, burden, and circumstances of cerebral high-intensity transient signals (HITS), presumably representing emboli, during pediatric cardiac catheterization. METHODS: Emboli monitoring of the right middle cerebral artery was performed in five children...
January 31, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28118751/influence-of-prescribed-blood-products-on-the-incidence-of-deep-vein-thrombosis-and-pulmonary-embolism-in-surgical-patients
#14
Alenka Premuš Marušič, Igor Locatelli, Aleš Mrhar, Martin Caprnda, Ludovit Gaspar, Mariusz Adamek, Peter Kruzliak, Daniel Petrovič
Deep vein thrombosis (DVT) and pulmonary embolisms (PEs) are common complications after surgical procedures. The influence of prescribed blood products on the occurrence of DVT and PE was evaluated in postsurgical patients in this retrospective case-control study. The records of 286 surgical patients were analyzed: DVT (n = 52), PE (n = 92), and a control group (n = 142). The amounts of prescribed blood, blood products, and vitamin K were reviewed, together with appropriate prescribing of low-molecular-weight heparins...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28118627/prostacyclin-as-an-anticoagulant-for-continuous-renal-replacement-therapy-in-children
#15
Akash Deep, Mohammad Zoha, Pompa Dutta Kukreja
Effective delivery of continuous renal replacement therapy (CRRT) depends on the longevity of the filter and circuit used in the CRRT machine. Safe and effective anticoagulation is crucial for maintaining the patency of these circuits. In children, heparin and citrate are the commonly used anticoagulants but they are limited by serious side effects and thus calls for meticulous monitoring. In conditions where neither of these can be used, prostacyclin can be an effective alternative. Prostacyclin is a platelet inhibitor that can be safely used as an efficient anticoagulant in CRRT...
January 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/28100901/pancreas-transplant-with-duodeno-duodenostomy-and-caval-drainage-using-a-diamond-patch-graft-a-single-center-experience
#16
Je Ho Ryu, Tae Beom Lee, Young Mok Park, Kwang Ho Yang, Chong Woo Chu, Jung Hee Lee, Taeun Kim, Byung Hyun Choi
BACKGROUND The surgical technique used in pancreas transplant is essential for patient safety and graft survival, and problems exist with conventional strategies. When enteric exocrine drainage is performed, there is no method of immunologic monitoring other than direct graft pancreas biopsy. The most common cause of early graft failure is graft thrombosis, and adequate preventive and treatment strategies are unclear. To overcome these disadvantages, we suggest a modified surgical technique. MATERIAL AND METHODS Eleven patients underwent pancreas transplant with our modified technique...
January 19, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28070048/-role-of-local-citrate-anticoagulation-in-continuous-blood-purification-to-patients-at-high-risk-of-bleeding-in-icu
#17
Shangping Zhao, Hao Ou, Yue Peng, Zuoliang Liu, Mingshi Yang, Xuefei Xiao
To evaluate the safety and efficiency of citrate anticoagulant-based continuous blood purification in patients at high risk of bleeding. 
 Methods: One hundred and fifty-two patients at high risk of bleeding were divided into local citrate group (group A, n=68) and heparin group (group B, n=84). Clotting function, change of pH, ionized sodium, bicarbonate ion, ionized calcium, activated clotting time (ACT) and complications were monitored before and during treatment. 
 Results: Compared to the group A, the incidence of clotting in filter and chamber, the degree of bleeding or fresh bleeding were significantly reduced in the group B (P<0...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28068607/micro-electromechanical-film-bulk-acoustic-sensor-for-plasma-and-whole-blood-coagulation-monitoring
#18
Da Chen, Shuren Song, Jilong Ma, Zhen Zhang, Peng Wang, Weihui Liu, Qiuquan Guo
Monitoring blood coagulation is an important issue in the surgeries and the treatment of cardiovascular diseases. In this work, we reported a novel strategy for the blood coagulation monitoring based on a micro-electromechanical film bulk acoustic resonator. The resonator was excited by a lateral electric field and operated under the shear mode with a frequency of 1.9GHz. According to the apparent step-ladder curves of the frequency response to the change of blood viscoelasticity, the coagulation time (prothrombin time) and the coagulation kinetics were measured with the sample consumption of only 1μl...
May 15, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28067489/fluorescent-strips-of-electrospun-fibers-for-ratiometric-sensing-of-serum-heparin-and-urine-trypsin
#19
Long Zhao, Tao Wang, Qiang Wu, Yuan Liu, Zhoujiang Chen, Xiaohong Li
"Turn-on" or "turn-off" probes remain challenges in the establishment of sensitive, easily operated, and reliable methods for in situ monitoring bioactive substances. In the current study, electrospun fibrous strips are designed to provide straightforward observations of ratiometric color changes with the naked eye in the presence of serum heparin or urine trypsin. A tetraphenylethene (TPE) derivative is constructed and along with phloxine B is grafted on fibers, followed by protamine adsorption to induce static quenching of phloxine B and aggregation-induced emission of the TPE derivative...
February 1, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28062629/unraveling-the-molecular-complexity-of-o-glycosylated-endogenous-n-terminal-pro-b-type-natriuretic-peptide-forms-in-blood-plasma-of-patients-with-severe-heart-failure
#20
Bernhard Halfinger, Angelika Hammerer-Lercher, Benno Amplatz, Bettina Sarg, Leopold Kremser, Herbert H Lindner
BACKGROUND: Currently, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and its physiologically active counterpart, BNP, are most frequently used as biomarkers for diagnosis, prognosis, and disease monitoring of heart failure (HF). Commercial NT-proBNP and BNP immunoassays cross-react to varying degrees with unprocessed proBNP, which is also found in the circulation. ProBNP processing and immunoassay response are related to O-linked glycosylation of NT-proBNP and proBNP. There is a clear and urgent need to identify the glycosylation sites in the endogenously circulating peptides requested by the community to gain further insights into the different naturally occurring forms...
January 2017: Clinical Chemistry
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