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interpretation of coagulation test

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https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#1
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28804834/one-stage-factor-viii-assays
#2
Elizabeth Duncan, Susan Rodgers
Coagulation factor assays using one-stage methodology are widely used to measure factor levels for the purpose of detecting a deficiency, or to monitor replacement therapy. In this chapter, we focus on a method to measure Factor VIII coagulant activity (FVIII:C) by the one-stage assay (FVIII:C-1), with extra information provided to also allow this method to apply to Factor IX (FIX), Factor XI (FXI), and Factor XII (FXII). From the perspective of laboratory testing, these factors are components of the "intrinsic" coagulation pathway and are all measured in test systems based on the correction of the Activated Partial Thromboplastin Time (APTT)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804820/performance-and-interpretation-of-mixing-tests-in-coagulation
#3
Geoffrey Kershaw
Mixing tests in coagulation studies allow the laboratory to correctly differentiate factor deficiency from inhibitors as the cause of a prolonged clotting time. This is important in terms of subsequent laboratory follow-up and clinical patient management. In this chapter, a suggested method of performing mixing tests is given, with procedures applying two different formulas for interpretation, the percent correction and the index of circulating anticoagulant.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28795966/the-coagulation-profile-of-end-stage-liver-disease-and-considerations-for-intraoperative-management
#4
Katherine T Forkin, Douglas A Colquhoun, Edward C Nemergut, Julie L Huffmyer
The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging...
August 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28752844/routine-use-of-clinical-exome-based-next-generation-sequencing-for-evaluation-of-patients-with-thrombotic-microangiopathies
#5
Joseph P Gaut, Sanjay Jain, John D Pfeifer, Katinka A Vigh-Conrad, Meagan Corliss, Mukesh K Sharma, Jonathan W Heusel, Catherine E Cottrell
Next-generation sequencing is increasingly used for clinical evaluation of patients presenting with thrombotic microangiopathies because it allows for simultaneous interrogation of multiple complement and coagulation pathway genes known to be associated with disease. However, the diagnostic yield is undefined in routine clinical practice. Historic studies relied on case-control cohorts, did not apply current guidelines for variant pathogenicity assessment, and used targeted gene enrichment combined with next-generation sequencing...
July 28, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28740434/a-global-quantitative-survey-of-hemostatic-assessment-in-postpartum-hemorrhage-and-experience-with-associated-bleeding-disorders
#6
Andra H James, David L Cooper, Michael J Paidas
PURPOSE: Coagulopathy may be a serious complicating or contributing factor to postpartum hemorrhage (PPH), and should be promptly recognized to ensure proper bleeding management. This study aims to evaluate the approaches of obstetrician-gynecologists worldwide towards assessing massive PPH caused by underlying bleeding disorders. METHODS: A quantitative survey was completed by 302 obstetrician-gynecologists from 6 countries (the UK, France, Germany, Italy, Spain, and Japan)...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28725305/international-normalized-ratio-does-not-predict-gastrointestinal-bleeding-after-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cirrhosis
#7
Abimbola Adike, Mohanad Al-Qaisi, Noemi J Baffy, Heidi Kosiorek, Rahul Pannala, Bashar Aqel, Douglas O Faigel, M Edwyn Harrison
BACKGROUND: Cirrhosis is often accompanied by an elevated international normalized ratio (INR) due to a decrease in pro-coagulant factors. An elevated INR in cirrhosis is often interpreted as an increased risk of bleeding. There are a paucity of data in the literature on the use of INR to predict risk of gastrointestinal bleeding (GIB) following endoscopic retrograde cholangiopancreatography (ERCP) in patients with cirrhosis. The aims of the study were to determine if there is a correlation between INR and GIB following ERCP in patients with cirrhosis, and to determine if there is a difference in frequency of post-ERCP complications in patients with and without cirrhosis...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28590357/rotem-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#8
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood (WB) by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28525532/the-effects-of-indirect-and-direct-acting-anticoagulants-on-lupus-anticoagulant-assays-a-large-retrospective-study-at-a-coagulation-reference-laboratory
#9
Jansen N Seheult, Michael P Meyer, Franklin A Bontempo, Irina Chibisov
Objectives: To investigate the effects of indirect- and direct-acting anticoagulants on the interpretation of lupus anticoagulant (LAC) assays. Methods: A retrospective database review was performed to identify all LAC panels from November 2012 to November 2015. The positivity rates for three LAC tests were compared among various anticoagulant medications. Results: This analysis included 7,721 LAC panels. Direct oral anticoagulants, warfarin, and unfractionated heparin (UFH) were associated with higher LAC positivity rates compared with patients not receiving documented anticoagulation (83% for argatroban, 58% for dabigatran, 72% for rivaroxaban, 53% for apixaban, 56% for warfarin, and 36% for UFH vs 29% for no anticoagulation, P < ...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28420603/the-coags-uncomplicated-app-fulfilling-educational-gaps-around-diagnosis-and-laboratory-testing-of-coagulation-disorders
#10
Craig Kessler, Ellinor I Peerschke, Meera B Chitlur, Roshni Kulkarni, Natalia Holot, David L Cooper
BACKGROUND: Patients with coagulation disorders may present to a variety of physician specialties; however, accurate and efficient diagnosis can be challenging for physicians not specialized in hematology, due to identified gaps in knowledge around appropriate laboratory assays and interpretation of test results. Coags Uncomplicated was developed to fill this unmet educational need by increasing practical knowledge of coagulation disorders among nonexpert physicians and other health care professionals (HCPs) in a point-of-care (POC) setting...
April 18, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28359136/point-of-care-testing-in-burn-patients
#11
Marion Wiegele, Sibylle Kozek-Langenecker, Eva Schaden
Severe burn injury has an impact on the coagulation system, but a unique definition regarding these changes is still missing. The results of conventional coagulation assays (CCAs) measured in daily clinical practice are often interpreted as coagulopathic, which implies a bleeding tendency. However, viscoelastic coagulation assays (VCA) like Rotational Thromboelastometry (ROTEM) and Thromboelastography (TEG) depict a hypercoagulable state. Therefore, hemostatic interventions should not be indicated according to deranged CCA results, but only in case of clinically relevant bleeding plus indicative VCA results...
June 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28318586/prediction-and-repeatability-of-milk-coagulation-properties-and-curd-firming-modeling-parameters-of-ovine-milk-using-fourier-transform-infrared-spectroscopy-and-bayesian-models
#12
A Ferragina, C Cipolat-Gotet, A Cecchinato, M Pazzola, M L Dettori, G M Vacca, G Bittante
The aim of this study was to apply Bayesian models to the Fourier-transform infrared spectroscopy spectra of individual sheep milk samples to derive calibration equations to predict traditional and modeled milk coagulation properties (MCP), and to assess the repeatability of MCP measures and their predictions. Data consisted of 1,002 individual milk samples collected from Sarda ewes reared in 22 farms in the region of Sardinia (Italy) for which MCP and modeled curd-firming parameters were available. Two milk samples were taken from 87 ewes and analyzed with the aim of estimating repeatability, whereas a single sample was taken from the other 915 ewes...
May 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28302338/-laboratory-diagnosis-of-antiphospholipid-syndrome-from-criteria-to-practice
#13
V Joste, M-A Dragon-Durey, L Darnige
The antiphospholipid syndrome is a bioclinical entity defined by thrombosis and/or obstetrical complications in the presence, at least 12 weeks apart, of antiphospholipid antibodies detected by coagulation test (lupus anticoagulant) or immunological assays (anticardiolipin, anti-β2-glycoprotein I antibodies). Biological markers' improvement such as anti-phosphatidylserine/prothrombin and biological score should allow better patients' management and preventive therapeutic for thrombosis and obstetrical complications...
March 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28302286/viscoelastic-hemostatic-assays-in-the-management-of-the-pediatric-trauma-patient
#14
Christine M Leeper, Barbara A Gaines
Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28219085/fibrinolysis-in-trauma-myth-reality-or-something-in-between
#15
REVIEW
Mark Walsh, Jacob Shreve, Scott Thomas, Ernest Moore, Hunter Moore, Daniel Hake, Tim Pohlman, Patrick Davis, Victoria Ploplis, Andres Piscoya, Julie Wegner, John Bryant, Anton Crepinsek, James Lantry, Forest Sheppard, Francis Castellino
The emphasis on fibrinolysis as an important contributor to trauma-induced coagulopathy (TIC) has led to a debate regarding the relative clinical significance of fibrinolysis in the setting of trauma. The debate has centered on two camps. The one camp defines fibrinolysis in trauma by standard coagulation tests as well as fibrin split products, D-dimers, and plasmin/antiplasmin levels. This camp favors a more liberal use of tranexamic acid and attributes more significance to hyperfibrinolysis in TIC. The other camp favors a definition of fibrinolysis based on the viscoelastic tests (VET), rotational thromboelastometry (ROTEM), and thromboelastography (TEG)...
March 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28201865/prolongation-of-prothrombin-time-in-the-presence-of-rivaroxaban-is-this-the-only-cause
#16
Safoorah Sagheer, Simon McRae
Rivaroxaban is an oral direct Xa inhibitor that can lead to prolongation of prothrombin time and activated partial thromboplastin time. However, these basic coagulation tests are not specific for the anticoagulant effect of rivaroxaban and other confounding factors should be considered while interpreting the test results. We report a case of a patient on rivaroxaban, where underlying factor VII deficiency led to confusion in the interpretation of prothrombin time results and delayed her surgery.
February 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28196919/estimates-of-within-subject-biological-variation-of-protein-c-antithrombin-protein-s-free-protein-s-activity-and-activated-protein-c-resistance-in-pregnant-women
#17
Ann H Kristoffersen, Per H Petersen, Thomas Røraas, Sverre Sandberg
BACKGROUND: In pregnancy, interpretation of results from coagulation parameters can be difficult because of the procoagulant physiological changes. The aim of this study was to describe the course of 5 coagulation parameters (thrombophilia markers) in healthy pregnancies, and to estimate and compare the within-subject biological variation (CVI) of these parameters in healthy pregnant and nonpregnant women. METHODS: Blood samples were obtained every 4th week during pregnancy and 3 samples after delivery in 20 healthy women and every 4th week during 40 weeks in 19 healthy nonpregnant women...
April 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28166379/reference-values-for-rotational-thromboelastometry-rotem-in-clinically-healthy-cats
#18
Charlotte Marly-Voquer, Barbara Riond, Rahel Jud Schefer, Annette P N Kutter
OBJECTIVE: To establish reference intervals for rotational thromboelastometry (ROTEM) using feline blood. DESIGN: Prospective study. SETTING: University teaching hospital. ANIMALS: Twenty-three clinically healthy cats between 1 and 15 years. INTERVENTION: For each cat, whole blood was collected via jugular or medial saphenous venipuncture, and blood was placed into a serum tube, a tube containing potassium-EDTA, and tubes containing 3...
March 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/27999475/pre-analytical-issues-in-the-haemostasis-laboratory-guidance-for-the-clinical-laboratories
#19
REVIEW
A Magnette, M Chatelain, B Chatelain, H Ten Cate, F Mullier
Ensuring quality has become a daily requirement in laboratories. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. This step, based on a variety of manual activities, is the most vulnerable part of the total testing process and is a major component of the reliability and validity of results in haemostasis and constitutes the most important source of erroneous or un-interpretable results...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27896254/laparoscopic-tube-preserving-surgical-procedures-for-ectopic-tubal-pregnancy
#20
Taejong Song, Dong Hee Lee, Hwa Cheung Kim, Seok Ju Seong
OBJECTIVE: To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy. METHODS: This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success rates and homolateral patency rates...
November 2016: Obstetrics & Gynecology Science
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