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https://www.readbyqxmd.com/read/29350493/bleeding-and-thrombotic-complications-of-pediatric-liver-transplant
#1
Alexandra J Borst, Debra L Sudan, Laura A Wang, Michael J Neuss, Jennifer A Rothman, Thomas L Ortel
BACKGROUND: Pediatric patients undergoing liver transplant are at significant risk for bleeding and thrombotic complications due to the complex nature of rebalanced hemostasis in patients with liver disease. METHODS/OBJECTIVES: We reviewed records of 92 pediatric liver and multivisceral transplant cases at Duke University Medical Center between January 2009 and December 2015. The goal was to define the nature and incidence of bleeding and thrombotic complications in this cohort and define potential risk factors...
January 19, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#2
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29343861/sensing-native-protein-solution-structures-using-a-solid-state-nanopore-unraveling-the-states-of-vegf
#3
Nitinun Varongchayakul, Diana Huttner, Mark W Grinstaff, Amit Meller
Monitoring individual proteins in solution while simultaneously obtaining tertiary and quaternary structural information is challenging. In this study, translocation of the vascular endothelial growth factor (VEGF) protein through a solid-state nanopore (ssNP) produces distinct ion-current blockade amplitude levels and durations likely corresponding to monomer, dimer, and higher oligomeric states. Upon changing from a non-reducing to a reducing condition, ion-current blockage events from the monomeric state dominate, consistent with the expected reduction of the two inter-chain VEGF disulfide bonds...
January 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29340875/thromboelastography-based-anticoagulation-management-during-extracorporeal-membrane-oxygenation-a-safety-and-feasibility-pilot-study
#4
Mauro Panigada, Giacomo E Iapichino, Matteo Brioni, Giovanna Panarello, Alessandro Protti, Giacomo Grasselli, Giovanna Occhipinti, Cristina Novembrino, Dario Consonni, Antonio Arcadipane, Luciano Gattinoni, Antonio Pesenti
BACKGROUND: There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened by a high rate of hemostatic complications, possibly associated with inadequate monitoring of heparin anticoagulation. This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol...
January 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29336967/con-activated-clotting-time-should-not-be-monitored-during-heparinization-for-vascular-surgery
#5
Elizabeth Wolo, Corey Herman
No abstract text is available yet for this article.
May 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29332812/thrombodynamics-a-new-global-coagulation-test-measurement-of-heparin-efficiency
#6
Elena I Sinauridze, Tatiana A Vuimo, Ivan D Tarandovskiy, Ruzanna A Ovsepyan, Stepan S Surov, Natalia G Korotina, Ilya I Serebriyskiy, Maxim M Lutsenko, Alexander L Sokolov, Fazoil I Ataullakhanov
The actual coagulation status may be reliably measured using only highly sensitive global functional tests; however, they are not numerous and all of them have disadvantages. Thrombodynamics (TD), a novel global coagulation test, is sensitive to hypo- and hypercoagulable states. The main properties of this test were investigated, and its capabilities for hemostasis analysis were verified through pharmacodynamic monitoring of the most widely used anticoagulants, heparins. The anticoagulant effects in the plasma of donors (n = 20) and patients after hip replacement (n = 20) spiked with unfractionated heparin or enoxaparin were measured in vitro to eliminate the influence of pharmacokinetic factors...
April 1, 2018: Talanta
https://www.readbyqxmd.com/read/29329093/size-exclusion-chromatography-sec-hplc-as-an-alternative-to-study-thrombin-inhibition
#7
Emmanuel Pérez-Escalante, Luis Guillermo González-Olivares, Alma Elizabeth Cruz-Guerrero, Carlos Andrés Galán-Vidal, Ma Elena Páez-Hernández, Giaan Arturo Álvarez-Romero
In vitro analysis of anticoagulant compounds with a potential use as antithrombotic drugs, has been traditionally performed using techniques like spectrophotometry, turbidimetry, as well as electrochemical and clinical assays. Although, these techniques have some disadvantages such as: the inability to measure the total biological activity of thrombin, interferences and, sometimes, the quantitative determination of the inhibition ratio is not accurate. In the present work, the conversion of fibrinogen to fibrin was monitored by molecular exclusion chromatography (SEC-HPLC) in three different reaction systems...
January 6, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/29316202/anticoagulant-prophylaxis-and-therapy-in-children-current-challenges-and-emerging-issues
#8
Fiona Newall, Brian Branchford, Christoph Male
This review aims to describe the unique challenges of anticoagulant prophylaxis and treatment in children, and to highlight areas for research for improving clinical outcomes of children with thromboembolic disease. The evidence presented demonstrates the challenges of advancing the evidence-base informing optimal management of thromboembolic disease in children. Recent observational studies have identified risk factors of venous thromboembolism in children, but there are few interventional studies assessing the benefit-risk of using thromboprophylaxis in risk-stratified clinical subgroups...
January 6, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29315961/reduction-of-thromboembolic-events-during-ablation-using-the-laserballoon-the-rethreva-registry
#9
Martin Eichenlaub, Arne Pfeufer, Lars Behrens, Volker Klauss, Michael Roettinger, Turgut Brodherr, Thorsten Lewalter
INTRODUCTION: Cerebral events (CE), including silent (SCE), are a known complication of left atrial catheter ablation (LACA) in patients with atrial fibrillation. The aim of this prospective registry was to gain more information about CE during laserballoon LACA and to reduce the risk of their occurrence. METHODS AND RESULTS: We enrolled 74 patients (age 61 ± 11 years; 74% male; CHA2 DS2 -VASc 1.9 ± 1.4). Cerebral MRI (1.5 Tesla) was performed to detect CE...
January 9, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#10
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29302288/direct-oral-anticoagulants-and-its-implications-in-dentistry-a-review-of-literature
#11
REVIEW
Neus Lanau, Javier Mareque, Lluis Giner, Michel Zabalza
Background: Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaban have been recently introduced to overcome some of the drawbacks of existing anticoagulants. They have less interactions and do not require routine monitoring. However, there is not enough scientific data about the protocol to apply in these patients on DOACs undergoing dental treatment. Thus is necessary to evaluate the potential bleeding risk of these drugs, the possibility of thromboembolic events occurring if they are withdrawn or the need to change to heparin previously...
November 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/29302115/colloid-oncotic-pressure-monitoring-its-effects-in-cardiac-surgery
#12
Jeffrey B Chores, David W Holt
Hemodilution is a common perioperative practice. The deleterious effects of excessive hemodilution and subsequent edema formation have been well documented by numerous authors. Colloid oncotic pressure (COP) is a reliable clinical indicator of hemodilution in cardiac surgery. The intent of this study is to determine if a correlation exists between COP and various patient outcome variables. It would also be helpful to know if there is a particular COP value to avoid preventing or limiting patient morbidity. Blood samples from 61 adult patients (mean age = 70 years old) undergoing cardiopulmonary bypass surgery were collected for COP calculation and comparison...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29286428/stenosis-of-the-inferior-vena-cava-a-murine-model-of-deep-vein-thrombosis
#13
Holly Payne, Alexander Brill
Deep vein thrombosis (DVT) and its devastating complication, pulmonary embolism, are a severe health problem with high mortality. Mechanisms of thrombus formation in veins remain obscure. Lack of mobility (e.g., after surgery or long-haul flights) is one of the main factors leading to DVT. The pathophysiological consequence of the lack of mobility is blood flow stagnation in venous valves. Here, a model is described that mimics such flow disturbance as a thrombosis-driving factor. In this model, partial flow restriction (stenosis) in the inferior vena cava (IVC) is created...
December 22, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29284430/successful-anticoagulant-therapy-for-disseminated-intravascular-coagulation-during-conservative-management-of-placenta-percreta-a-case-report-and-literature-review
#14
Shinya Matsuzaki, Kiyoshi Yoshino, Masayuki Endo, Takuji Tomimatsu, Tsuyoshi Takiuchi, Kazuya Mimura, Keiichi Kumasawa, Yutaka Ueda, Tadashi Kimura
BACKGROUND: Placenta percreta is a rare obstetric condition associated with the risk of massive intraoperative hemorrhage. Recently, conservative management of placenta percreta has been performed to reduce maternal morbidity. However, various complications have been reported during such management. Only a few cases of asymptomatic disseminated intravascular coagulation (DIC) or fever without infection have been reported. Here, we discuss such a case and review the related literature to understand this rare condition better...
December 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29280619/dual-role-of-a-fluorescent-peptidyl-probe-based-on-the-self-assembly-for-the-detection-of-heparin-and-for-the-inhibition-of-the-heparin-digestive-enzyme-reaction
#15
Hyeri Lee, Byunggyu In, Pramod Kumar Mehta, Mallela Y L N Kishore, Keun-Hyeung Lee
The detection of fluorescent probes for biomolecules and control of the function of a complex through a recognition process have not been investigated intensively. A fluorescent peptidyl probe (1) based on the self-assembly stimulated by heparin was synthesized. The fluorescent probe with an aggregation-induced emission fluorophore formed a self-assembling complex with heparin, resulting in the sensitive and selective turn-on response to heparin compared to its biological competitors. The detection limit for heparin was measured to be 138...
December 27, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29279638/prophylaxis-and-incidence-of-symptomatic-deep-vein-thrombosis-in-indian-patients-with-sepsis-detect-deep-vein-thrombosis-registry
#16
Nagarajan Ramakrishnan, Detect-Dvt Investigators
Purpose: To assess thromboprophylaxis rate and incidence of symptomatic deep vein thrombosis (DVT) in Indian patients with acute sepsis. Materials and Methods: Adult patients with sepsis, within 48 h of sepsis onset/hospital admission were included. DVT was assessed using Doppler ultrasonography if clinical signs were present. Data were collected at inclusion, discharge, and 30 ± 7 days (if discharged before 30 days). Results: The study included 278 patients (men: 69...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29277535/determination-of-dolutegravir-s-unbound-fraction-in-human-plasma-using-validated-equilibrium-dialysis-and-lc-ms-ms-methods
#17
David Metsu, Thomas Lanot, François Fraissinet, Mélanie Picot, Didier Concordet, Marion Cabrol, Frédérique Dubois-Galopin, Etienne Chatelut, Pierre Delobel, Peggy Gandia
Assessment of the unbound pharmacologically active fraction (fu; as the ratio of unbound to total concentration) of dolutegravir could improve therapeutic drug monitoring (TDM) in patients that experience virological failure or toxicity, despite receiving adequate total concentrations. This study evaluated (i) dolutegravir's fu through equilibrium dialysis (ED), (ii) the pre-analytical parameters that influence fu, and (iii) fu's inter-individual variability in HIV patients. Validation of the LC-MS/MS method followed FDA guidelines...
December 22, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29220362/optimized-plasma-preparation-is-essential-to-monitor-platelet-stored-molecules-in-humans
#18
Marion Mussbacher, Waltraud C Schrottmaier, Manuel Salzmann, Christine Brostjan, Johannes A Schmid, Patrick Starlinger, Alice Assinger
Platelets store a plethora of different molecules within their granules, modulating numerous pathways, not only in coagulation, but also in angiogenesis, wound healing, and inflammatory diseases. These molecules get rapidly released upon activation and therefore represent an easily accessible indirect marker for platelet activation. Accurate analysis of platelet-derived molecules in the plasma requires appropriate anticoagulation to avoid in vitro activation and subsequent degranulation of platelets, potentially causing artificially high levels and masking biologically relevant differences within translational research studies...
2017: PloS One
https://www.readbyqxmd.com/read/29212374/performance-of-anti-factor-xa-versus-activated-partial-thromboplastin-time-for-heparin-monitoring-using-multiple-nomograms
#19
Emily Whitman-Purves, James C Coons, Taylor Miller, Jeannine V DiNella, Andrew Althouse, Mark Schmidhofer, Roy E Smith
The purpose of this study was to compare the performance of anti-factor Xa concentration versus activated partial thromboplastin time (aPTT) monitoring with multiple indication-specific heparin nomograms. This was a prospective, nonrandomized study with historical control at a large academic medical center. A total of 201 patients who received intravenous heparin in the cardiology units were included. The prospective cohort included patients (n = 101) with anti-factor Xa (anti-Xa) monitoring, and the historical control group included patients (n = 100) who had aPTT monitoring...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29204888/initial-robotic-assistance-in-the-surgical-management-of-renal-cell-carcinoma-with-level-4-cavoatrial-thrombus
#20
Isaac Palma-Zamora, Deepansh Dalela, Ravi Barod, Linda Hsu, Mani Menon, Craig G Rogers
We report a case of left-sided renal cell carcinoma (RCC) with level 4 cavoatrial tumor thrombus where robotic assistance was used to achieve hemostasis around the kidney in order to minimize coagulopathic hemorrhage from the nephrectomy bed during subsequent open completion nephrectomy and cavoatrial thrombectomy under extracorporeal circulation and hypothermic circulatory arrest. Robotic assistance allowed for meticulous dissection and ligation of parasitic and arterial vessels to the kidney, release of renal attachments, and exposure of the inferior vena cava...
December 4, 2017: Journal of Robotic Surgery
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