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https://www.readbyqxmd.com/read/28922263/prospective-side-by-side-comparison-of-outcomes-and-complications-with-a-simple-versus-intensive-anticoagulation-monitoring-strategy-in-pediatric-extracorporeal-life-support-patients
#1
Jane S Yu, Ryan P Barbaro, Donald A Granoski, Mary E Bauman, M Patricia Massicotte, Laurance L Lequier, Gail M Annich, Lindsay M Ryerson
OBJECTIVES: A continuous infusion of unfractionated heparin is the most common anticoagulant used for pediatric patients on extracorporeal life support. The objective of this study was to compare extracorporeal life support complications and outcomes between two large-volume pediatric extracorporeal life support centers that use different anticoagulation strategies. DESIGN: Prospective, observational cohort study. SETTING: The University of Michigan used simple anticoagulation monitoring, whereas the University of Alberta used an intensive anticoagulation monitoring strategy...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#2
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28902081/activated-partial-thromboplastin-time-versus-anti-factor-xa-levels-for-monitoring-unfractionated-heparin-therapy-in-children-an-institutional-experience
#3
Gary M Woods, Joseph Stanek, Sheilah Harrison, Karen Texter, Bryce A Kerlin, Amy L Dunn, Riten Kumar
No abstract text is available yet for this article.
September 8, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28863196/impact-of-inr-monitoring-reversal-agent-use-heparin-bridging-and-anticoagulant-interruption-on-rebleeding-and-thromboembolism-in-acute-gastrointestinal-bleeding
#4
Naoyoshi Nagata, Toshiyuki Sakurai, Shiori Moriyasu, Takuro Shimbo, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Mikio Yanase, Junichi Akiyama, Naomi Uemura
BACKGROUND: Anticoagulant management of acute gastrointestinal bleeding (GIB) during the pre-endoscopic period has not been fully addressed in American, European, or Asian guidelines. This study sought to evaluate the risks of rebleeding and thromboembolism in anticoagulated patients with acute GIB. METHODS: Baseline, endoscopy, and outcome data were reviewed for 314 patients with acute GIB: 157 anticoagulant users and 157 age-, sex-, and important risk-matched non-users...
2017: PloS One
https://www.readbyqxmd.com/read/28862013/influence-of-direct-oral-anticoagulants-on-anti-factor-xa-measurements-utilized-for-monitoring-heparin
#5
Kelly A Macedo, Peter Tatarian, Kenneth R Eugenio
BACKGROUND: Unanticipated drug-laboratory interactions may occur between direct oral anticoagulants (DOACs) and anti-factor Xa (AXA) levels used to monitor parenteral heparin infusions. Characterization of the extent and duration of DOAC effect on AXA levels may reduce complications with transition to heparin infusions. OBJECTIVE: To evaluate the impact of oral factor Xa inhibitors on AXA levels with and without concurrent heparin. METHODS: This retrospective descriptive study was approved by institutional review board waiver and included patients with AXA levels drawn on a heparin calibrated assay who had received a factor Xa inhibitor...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28857854/heparin-free-prolonged-intermittent-hemodialysis-using-calcium-free-citrate-dialysate-in-critically-ill-patients
#6
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
August 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28854974/immunogenicity-of-the-plasmodium-vivax-merozoite-surface-protein-1-paralog-in-the-induction-of-naturally-acquired-antibody-and-memory-b-cell-responses
#7
Hay Man Kyaw Min, Siriruk Changrob, Phyu Thwe Soe, Jin Hee Han, Fauzi Muh, Seong-Kyun Lee, Patchanee Chootong, Eun-Taek Han
BACKGROUND: The Plasmodium vivax merozoite surface protein 1 paralog (PvMSP1P-19) is a glycosylphosphatidylinositol (GPI)-anchored blood-stage protein that is expressed on the merozoite surface. It is proposed as a blood-stage vaccine candidate against P. vivax because of its ability to induce immune responses upon natural P. vivax exposure and in immunized animals. This study aimed to demonstrate the presence of inhibitory antibodies and memory B cell responses to the PvMSP1P-19 antigen during acute P...
August 30, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28852315/postoperative-bleeding-in-patients-on-antithrombotic-therapy-after-gastric-endoscopic-submucosal-dissection
#8
Chiko Sato, Kingo Hirasawa, Ryonho Koh, Ryosuke Ikeda, Takehide Fukuchi, Ryosuke Kobayashi, Hiroaki Kaneko, Makomo Makazu, Shin Maeda
AIM: To investigated the relationship between postoperative bleeding following gastric endoscopic submucosal dissection (ESD) and individual antithrombotic agents. METHODS: A total of 2488 gastric neoplasms in 2148 consecutive patients treated between May 2001 and June 2016 were studied. The antithrombotic agents were categorized into antiplatelet agents, anticoagulants, and other antithrombotic agents, and we included combination therapies [e.g., dual antiplatelet therapy (DAPT)]...
August 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28846826/autoimmune-heparin-induced-thrombocytopenia
#9
REVIEW
A Greinacher, Kathleen Selleng, T E Warkentin
Autoimmune heparin-induced thrombocytopenia (aHIT) indicates patients with anti-PF4/polyanion antibodies that are able to activate platelets strongly even in the absence of heparin (heparin-independent platelet activation). Nevertheless, as seen with serum obtained from patients with otherwise typical HIT, serum-induced platelet activation is inhibited at high heparin concentrations (10-100 IU/mL heparin). Further, upon serial dilution, aHIT serum will usually exhibit heparin-dependent platelet activation. Clinical syndromes associated with aHIT include: delayed-onset HIT, persisting HIT, spontaneous HIT, fondaparinux-associated HIT, heparin "flush"-induced HIT, and severe HIT (platelet count <20×10(9) /L) with associated disseminated intravascular coagulation (DIC)...
August 28, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28830286/anticoagulation-of-percutaneous-ventricular-assist-device-using-argatroban-based-purge-solution-a-case-series
#10
Emily C Blum, Carolyn R Martz, Yelena Selektor, Hassan Nemeh, Zachary R Smith, Long To
Impella devices are percutaneously inserted ventricular assist devices which require a continuous purge solution that contains heparin to prevent pump thrombosis and device failure. We describe 2 patients with heparin-induced thrombocytopenia (HIT) supported with an Impella device utilizing an argatroban-based purge solution. Case 1 involved an 83-year-old female with biventricular failure which resulted in right ventricle Impella support. The purge solution was changed to include argatroban due to concern of device clotting in the setting of HIT...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28828713/efficacy-of-standard-dose-unfractionated-heparin-for-venous-thromboembolism-prophylaxis-in-morbidly-obese-and-non-morbidly-obese-critically-ill-patients
#11
Young R Lee, Delilah D Blanco
To determine the efficacy of standard dose unfractionated heparin (UFH) for venous thromboembolism (VTE) prophylaxis in critically ill morbidly obese patients. Retrospective single-center observational cohort study in a single tertiary teaching hospital intensive care units (ICUs) in Multiparameter Intelligent Monitoring in Intensive Care II Clinical Database. Patients 18 years or older, admitted to the ICU, and received either UFH 5000 units subcutaneously twice daily or UFH 5000 units three times daily for VTE prophylaxis between 2001 and 2008 were included...
August 21, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28822141/applicability-of-quantitative-optical-imaging-techniques-for-intraoperative-perfusion-diagnostics-a-comparison-of-laser-speckle-contrast-imaging-sidestream-dark-field-microscopy-and-optical-coherence-tomography
#12
Sanne M Jansen, Daniel M de Bruin, Dirk J Faber, Iwan J G G Dobbe, Erik Heeg, Dan M J Milstein, Simon D Strackee, Ton G van Leeuwen
Patient morbidity and mortality due to hemodynamic complications are a major problem in surgery. Optical techniques can image blood flow in real-time and high-resolution, thereby enabling perfusion monitoring intraoperatively. We tested the feasibility and validity of laser speckle contrast imaging (LSCI), optical coherence tomography (OCT), and sidestream dark-field microscopy (SDF) for perfusion diagnostics in a phantom model using whole blood. Microvessels with diameters of 50, 100, and 400  μm were constructed in a scattering phantom...
August 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/28804819/performance-of-activated-partial-thromboplastin-time-aptt-determining-reagent-sensitivity-to-factor-deficiencies-heparin-and-lupus-anticoagulants
#13
Geoffrey Kershaw
The activated partial thromboplastin time (APTT) is a useful global assay for the assessment of the contact factor pathway of hemostasis and its inhibitors. The test is usually performed on fully automated analyzers using commercially prepared reagents. The three main clinical areas of interest are detection of factor deficiencies, detection of lupus anticoagulants and in the monitoring of therapy with unfractionated heparin. Methods are described here for assessing APTT reagents for their sensitivity to clotting time prolongation in each of these areas of interest...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804058/intravenous-enoxaparin-anticoagulation-in-percutaneous-left-atrial-cardiac-procedures
#14
Paul Guedeney, Nadjib Hammoudi, Guillaume Duthoit, Yan Yan, Johanne Silvain, Françoise Pousset, Richard Isnard, Alban Redheuil, Mathieu Kerneis, Jean-Philippe Collet, Gilles Montalescot
AIMS: Percutaneous transcatheter device closure of left atrial appendage (LAA), patent foramen ovale (PFO) and atrial septal defect (ASD) are usually performed with unfractionated heparin anticoagulation. We report a first experience using intravenous (IV) enoxaparin without anticoagulation monitoring in transcatheter structural heart interventions performed in the left atrium (LA). METHODS AND RESULTS: This retrospective, non-controlled study included all consecutive and unselected patients who underwent percutaneous LAA, PFO or ASD closure at a tertiary care center using IV enoxaparin anticoagulation...
August 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28802634/individual-differences-in-heparin-sensitivity-and-their-effect-on-heparin-anticoagulation-during-arterial-vascular-surgery
#15
D Veerhoek, F Groepenhoff, M G J M van der Sluijs, J W B de Wever, J D Blankensteijn, A B A Vonk, C Boer, C F W Vermeulen
OBJECTIVES: To investigate whether a fixed heparin dose results in adequate heparinisation levels and consequent inhibition of haemostatic activation in all patients. METHODS: This prospective clinical pilot study included 24 patients undergoing arterial vascular surgery. Individual heparin responsiveness was assessed using the Heparin Dose Response (HDR) test, while the activated clotting time (ACT) and heparin concentration were measured to monitor the peri-procedural degree of anticoagulation...
August 9, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28771571/optical-sensing-of-anticoagulation-status-towards-point-of-care-coagulation-testing
#16
Diane M Tshikudi, Markandey M Tripathi, Zeinab Hajjarian, Elizabeth M Van Cott, Seemantini K Nadkarni
Anticoagulant overdose is associated with major bleeding complications. Rapid coagulation sensing may ensure safe and accurate anticoagulant dosing and reduce bleeding risk. Here, we report the novel use of Laser Speckle Rheology (LSR) for measuring anticoagulation and haemodilution status in whole blood. In the LSR approach, blood from 12 patients and 4 swine was placed in disposable cartridges and time-varying intensity fluctuations of laser speckle patterns were measured to quantify the viscoelastic modulus during clotting...
2017: PloS One
https://www.readbyqxmd.com/read/28771049/direct-oral-anticoagulants-in-the-treatment-of-pulmonary-embolism
#17
Joanna B Eldredge, Alex C Spyropoulos
OBJECTIVE: The objective of this review is to examine the management strategies for pulmonary embolism (PE) with an emphasis of the role of direct oral anticoagulants (DOACs). METHODS: PubMed was searched to identify relevant journal articles published through April 2017. Additional references were obtained from articles discovered during the database search. RESULTS: Initial heparinization followed by long-term anticoagulation with vitamin K antagonists (VKAs) has been considered the mainstay for the treatment of PE...
August 3, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28767200/correlation-between-activated-partial-thromboplastin-time-and-anti-xa-activity-in-patients-who-received-low-molecular-weight-heparin-as-anticoagulation-for-haemodialysis
#18
Steve Siu-Man Wong, Wai-Yan Lau, Ping-Kwan Chan, Ching-Kit Wan, Yuk-Lun Cheng
Plasma anti-Xa activity, the recommended test to monitor low-molecular weight heparin (LMWH) therapy, is not readily available in many laboratories. In our clinical trials on the use of LMWH as anticoagulation for haemodialysis, a consistent prolongation of APTT in addition to the elevated anti-Xa activity was observed in the patients after LMWH administration. Hence, the paired anti-Xa activity and APTT data were re-analyzed. The APTT ratio, which was the proportional change in APTT from the baseline value after LMWH administration, was found to have a strong correlation with anti-Xa activity (coefficient of determination, R(2) = 0...
August 2, 2017: Nephrology
https://www.readbyqxmd.com/read/28763294/prevalence-and-causes-of-abnormal-psa-recovery
#19
Noémie Lautenbach, Michael Müntener, Paolo Zanoni, Lanja Saleh, Karim Saba, Martin Umbehr, Srividya Velagapudi, Danielle Hof, Tullio Sulser, Peter J Wild, Arnold von Eckardstein, Cédric Poyet
BACKGROUND: Prostate-specific antigen (PSA) test is of paramount importance as a diagnostic tool for the detection and monitoring of patients with prostate cancer. In the presence of interfering factors such as heterophilic antibodies or anti-PSA antibodies the PSA test can yield significantly falsified results. The prevalence of these factors is unknown. METHODS: We determined the recovery of PSA concentrations diluting patient samples with a standard serum of known PSA concentration...
August 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28759760/should-we-abandon-the-aptt-for-monitoring-unfractionated-heparin
#20
D R J Arachchillage, F Kamani, S Deplano, W Banya, M Laffan
INTRODUCTION: The activated partial thromboplastin time (APTT) is commonly used to monitor unfractionated heparin (UFH) but may not accurately measure the amount of heparin present. The anti-Xa assay is less susceptible to confounding factors and may be a better assay for this purpose. MATERIALS AND METHODS: The validity of the APTT for monitoring UFH was assessed by comparing with an anti-Xa assay on 3543 samples from 475 patients (infants [n=165], children 1-15years [n=60] and adults [n=250]) receiving treatment dose UFH...
July 6, 2017: Thrombosis Research
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