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Clotting time correction

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https://www.readbyqxmd.com/read/28804820/performance-and-interpretation-of-mixing-tests-in-coagulation
#1
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/28800610/anticoagulant-action-of-low-physiologic-and-high-albumin-levels-in-whole-blood
#2
Margret Paar, Christine Rossmann, Christoph Nusshold, Thomas Wagner, Axel Schlagenhauf, Bettina Leschnik, Karl Oettl, Martin Koestenberger, Gerhard Cvirn, Seth Hallström
Albumin is the most abundant plasma protein. Critical illness is often associated with altered, predominately decreased, serum albumin levels. This hypoalbuminaemia is usually corrected by administration of exogenous albumin. This study aimed to track the concentration-dependent influence of albumin on blood coagulation in vitro. Whole blood (WB) samples from 25 volunteers were prepared to contain low (19.3 ± 7.7 g/L), physiological (45.2 ± 7.8 g/L), and high (67.5 ± 18.1 g/L) levels of albumin. Haemostatic profiling was performed using a platelet function analyzer (PFA) 200, impedance aggregometry, a Cone and Platelet analyzer (CPA), calibrated automated thrombogram, and thrombelastometry (TEM)...
2017: PloS One
https://www.readbyqxmd.com/read/28700408/three-versus-four-factor-prothrombin-complex-concentrates-for-factor-based-resuscitation-in-a-porcine-hemorrhagic-shock-model
#3
Donald Michael Moe, Michael Scott Lallemand, John Mason McClellan, Joshua Porter Smith, Shannon T Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: Bleeding is a leading cause of preventable death following severe injury. Prothrombin complex concentrates (PCC) treat inborn coagulation disorders and reverse oral anticoagulants, but are proposed for use in "factor-based" resuscitation strategies. Few studies exist for this indication in acidosis, or that compare 3-factor (3PCC) versus 4-factor (4PCC) products. We aimed to assess and compare their safety and efficacy in a porcine model of severe hemorrhagic shock and coagulopathy...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28583756/thrombelastography-indicates-limitations-of-animal-models-of-trauma-induced-coagulopathy
#4
Gregory R Stettler, Ernest E Moore, Hunter B Moore, Peter J Lawson, Miguel Fragoso, Geoffrey R Nunns, Christopher C Silliman, Anirban Banerjee
BACKGROUND: Thrombelastography (TEG) has been used to characterize the coagulation changes associated with injury and shock. Animal models developed to investigate trauma-induced coagulopathy (TIC) have failed to produce excessive bleeding. We hypothesize that a native TEG will demonstrate marked differences in humans compared with these experimental models, which explains the difficulties in reproducing a clinically relevant coagulopathy in animal models. METHODS: Whole blood was collected from 138 healthy human volunteers, 25 swine and 66 Sprague-Dawley rats before experimentation...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28552276/adjuncts-to-blood-component-therapies-for-the-treatment-of-bleeding-in-the-intensive-care-unit
#5
REVIEW
Jerrold H Levy, Kamrouz Ghadimi, Quintin J Quinones, Raquel R Bartz, Ian Welsby
Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recognize coagulopathy while volume resuscitation with crystalloid or colloid takes place, or an unbalanced transfusion strategy focused on packed red blood cell transfusion can all significantly worsen coagulopathy, leading to increased transfusion requirements and poor outcomes...
April 25, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28486277/evaluation-of-recombinant-factor-viii-fc-eloctate-activity-by-thromboelastometry-in-a-multicenter-phase-3-clinical-trial-and-correlation-with-bleeding-phenotype
#6
Frank Driessler, Maricel G Miguelino, Glenn F Pierce, Robert T Peters, Jurg M Sommer
: The aim of this study was to compare the hemostatic efficacy of recombinant factor VIII Fc (rFVIIIFc) (Eloctate) and Advate by ex-vivo rotation thromboelastometry (ROTEM) of whole blood and to explore potential ROTEM parameters that may be more predictive of a patient's bleeding tendency than plasma FVIII activity. Thirteen clinical sites were selected to perform ROTEM on freshly collected blood samples from 44 patients in the phase 3 study for rFVIIIFc, including 16 patients undergoing sequential pharmacokinetic assessment of Advate and rFVIIIFc...
June 2, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28437748/rational-and-timely-haemostatic-interventions-following-cardiac-surgery-coagulation-factor-concentrates-or-blood-bank-products
#7
Mariann Tang, Christian Fenger-Eriksen, Per Wierup, Jacob Greisen, Jørgen Ingerslev, Vibeke Hjortdal, Benny Sørensen
BACKGROUND: Cardiac surgery may cause a serious coagulopathy leading to increased risk of bleeding and transfusion demands. Blood bank products are commonly first line haemostatic intervention, but has been associated with hazardous side effect. Coagulation factor concentrates may be a more efficient, predictable, and potentially a safer treatment, although prospective clinical trials are needed to further explore these hypotheses. This study investigated the haemostatic potential of ex vivo supplementation of coagulation factor concentrates versus blood bank products on blood samples drawn from patients undergoing cardiac surgery...
June 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28431860/predictive-value-of-perfusion-defects-on-dual-energy-cta-in-the-absence-of-thromboembolic-clots
#8
Richard A P Takx, Thomas Henzler, U Joseph Schoepf, Thomas Germann, Stefan O Schoenberg, Aysel Shirinova, Ralf W Bauer, Claudia Frellesen, Long Jiang Zhang, John W Nance, Christian Fink, Paul Apfaltrer
BACKGROUND: To determine the predictive value of volumetrically measured lung perfusion defects (PDvol) and right ventricular dysfunction on dual-energy computed tomography angiography (DE-CTA) for predicting all cause mortality in patients suspected of pulmonary embolism (PE) but without evident thromboembolic clot on CTA. METHODS: 448 patients underwent DE-CTA on a 64-channel DSCT system between January 2007 and December 2012 for suspected PE, of which 115 were without detectable thromboembolic clot on CTA...
April 18, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28429138/prothrombotic-state-in-asthma-is-related-to-increased-levels-of-inflammatory-cytokines-il-6-and-tnf%C3%AE-in-peripheral-blood
#9
Stanislawa Bazan-Socha, Lucyna Mastalerz, Agnieszka Cybulska, Lech Zareba, Romy Kremers, Michal Zabczyk, Grazyna Pulka, Teresa Iwaniec, Coenraad Hemker, Anetta Undas
Recently, we have reported that asthma is associated with enhanced plasma thrombin formation and impaired fibrinolysis. The mechanisms underlying the prothrombotic state in this disease are unknown. Our aim was to investigate whether prothrombotic alterations in asthmatics are associated with inflammation. We studied 164 adult, white, stable asthmatics and 72 controls matched for age, sex, body mass index (BMI), and smoking. Plasma tumor necrosis factor α (TNFα), interleukin (IL)-6, and serum periostin were evaluated using ELISAs, and their associations with thrombin generation, fibrinolytic capacity, expressed as clot lysis time (CLT), and platelet markers were later analyzed...
August 2017: Inflammation
https://www.readbyqxmd.com/read/28203580/unusual-presentation-of-diffuse-large-b-cell-lymphoma-with-splenic-infarcts
#10
Vivek Kumar, Parita Soni, Vishangi Dave, Jonathan Harris
A 67-year-old man presented with a 3-day history of abdominal pain, fever, and significant weight loss over 2 months. Physical examination revealed left upper quadrant tenderness, hepatomegaly, splenomegaly, and bilateral pitting edema but peripheral lymphadenopathy was absent. Laboratory tests showed anemia, thrombocytopenia, elevated prothrombin time (PT), partial thromboplastin time (PTT), and increased lactate dehydrogenase (LDH). PTT was corrected completely in mixing study. Further workup for the cause of coagulopathy revealed decreased levels of all clotting factors except factor VIII and increase fibrinogen levels, which ruled out disseminated intravascular coagulation (DIC)...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28159767/ticagrelor-reversal-in-vitro-assessment-of-four-haemostatic-agents
#11
Leyla Calmette, Anne-Céline Martin, Bernard Le Bonniec, Diane Zlotnik, Isabelle Gouin-Thibault, Christilla Bachelot-Loza, Pascale Gaussem, Anne Godier
AIM: Management of ticagrelor-induced bleeding is challenging as platelet transfusion is ineffective. An effective strategy is needed. This study aimed to investigate in vitro the efficacy of four haemostatic drugs (HDs), namely recombinant activated factor VII (rFVIIa), fibrinogen concentrate (Fib), tranexamic acid (TXA) and factor XIII concentrate (FXIII) to improve the haemostatic capacity in the presence of ticagrelor. METHODS: Blood was spiked with ticagrelor then supplemented by either HD or control...
February 3, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28107395/prevalence-of-pre-analytical-errors-in-clinical-chemistry-diagnostic-labs-in-sulaimani-city-of-iraqi-kurdistan
#12
Dereen Najat
BACKGROUND: Laboratory testing is roughly divided into three phases: a pre-analytical phase, an analytical phase and a post-analytical phase. Most analytical errors have been attributed to the analytical phase. However, recent studies have shown that up to 70% of analytical errors reflect the pre-analytical phase. The pre-analytical phase comprises all processes from the time a laboratory request is made by a physician until the specimen is analyzed at the lab. Generally, the pre-analytical phase includes patient preparation, specimen transportation, specimen collection and storage...
2017: PloS One
https://www.readbyqxmd.com/read/28069785/postoperative-mycoplasma-hominis-brain-abscess-keep-it-in-mind
#13
Sarah Maria Bergin, Shehara M Mendis, Barnaby Young, Ezlyn Binti Izharuddin
A temporal lobe abscess was diagnosed in a 57-year-old man. A urethral catheter had been inserted 12 days earlier, just prior to clot evacuation of a subacute haematoma secondary to an arterio-venous malformation. Fever persisted despite debridement and treatment with meropenem and vancomycin. Gram stains of operative samples showed no bacteria. Extended cultures grew pinpoint colonies after 5 days. Meanwhile, sequencing of bacterial 16S rDNA from operative specimens had identified Mycoplasma hominis; the bacterial colonies were subsequently similarly identified...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28050452/primary-abdominal-pregnancy-a-case-report
#14
Sunita Dubey, Mohit Satodiya, Priyanka Garg, Mamta Rani
Abdominal pregnancy is a potentially life threatening form of ectopic gestation with an incidence of 1% of all the ectopic pregnancies. Rarely, it may reach at advanced gestation and a viable fetal outcome is indeed a rare event. Most of them are terminated earlier due to poor fetal prognosis and higher chances of maternal mortality secondary to haemorrhagic shock following spontanous placental separation. A high index of suspicion is important for making a diagnosis of abdominal pregnancy and its timely management after correct diagnosis...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28050066/antiphospholipid-syndrome-a-diagnostic-challenge
#15
REVIEW
R S Mallhi, Neerja Kushwaha, T Chatterjee, J Philip
The antiphospholipid syndrome (APS) is an acquired autoimmune thrombophilic disorder that is characterized by thrombosis (venous, arterial and microvascular) and obstetric morbidity due to a diverse family of antibodies against phospholipid-binding proteins present in plasma. The term antiphospholipid antibody is actually a misnomer as the antibodies are not against the phospholipid per se, but target the plasma protein co-factors, which bind to anionic PLs. The exact etiology has not been elucidated and is multifactorial...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28001097/perirenal-hematoma-after-ureteroscopy-a-systematic-review
#16
Lily A Whitehurst, Bhaskar K Somani
INTRODUCTION: With the broadening indications of ureteroscopy (URS) for complex stones and high-risk patients, more URS is being performed and hence there is an increasing risk of major potentially life-threatening complications. We wanted to define the incidence, predisposing factors, management, and long-term sequelae for post-URS perirenal hematoma (PRH). MATERIAL AND METHODS: We conducted a systematic review of literature according to Cochrane and preferred reporting items for systematic reviews and meta-analysis guidelines for all studies reporting on post-URS PRH from 1980 to September 2016...
May 2017: Journal of Endourology
https://www.readbyqxmd.com/read/27942517/troubleshooting-an-isolate-prolongation-of-activated-partial-thromboplastin-time-in-a-patient-with-acute-myocardial-infarction-a-paradigmatic-case-report
#17
Giovanni Poli, Piero Castiglioni, Martina Montagnana, Emmanuel J Favaloro, Giuseppe Lippi
We describe here the case of a 46-year-old man admitted to the emergency department (ED) and diagnosed with a non-ST elevation myocardial infarction. Before referring the patient to the coronary care unit and initiating antiplatelet and anticoagulant therapy, a highly prolonged activated partial thromboplastin time (APTT) was observed among results of laboratory testing. Results of mixing test showed complete correction of APTT, thus ruling out the presence of inhibitors of blood coagulation. On the following day, second line coagulation testing revealed normal activity of all clotting factors except factor XII, the concentration of which was found to be 1...
November 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27940454/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#18
J W Simmons, M F Powell
Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27760979/intra-amniotic-hemorrhage-imitating-gastroschisis-a-case-report-and-review-of-the-literature
#19
REVIEW
Everett F Magann, Kinsey I Dinnel, Nader Z Rabie, Amanda L Shoemaker, Nirvana A Manning
BACKGROUND A spontaneous intra-amniotic hemorrhage is rarely encountered during pregnancy. The correct diagnosis and management are problematic because of the infrequency of this condition and the high likelihood of a misdiagnosis. CASE REPORT A primigravida with an uncomplicated pregnancy and a normal targeted ultrasound presented late in the second trimester of pregnancy with antepartum bleeding of unknown origin. A repeat ultrasound was suggestive of an abdominal wall defect (gastroschisis). The patient continued to have antepartum bleeding and developed uterine contractions and abdominal pain necessitating frequent visits to labor and delivery...
October 20, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27676645/fatal-hemorrhage-due-to-a-spontaneous-factor-v-inhibitor-with-lupus-anticoagulant-properties
#20
Nicholas J Olson, Donna Robert, Amin A Hedayat, Xiaoying Liu, Deborah L Ornstein
: Factor V inhibitors are rare and have varied clinical presentations. We report on a 76-year-old female admitted to the hospital for pneumonia and treated with multiple antibiotics. Her baseline prothrombin time was 15.6 s and the activated partial thromboplastin time was 35 s. On admission day 10, she developed arm weakness and brain imaging showed a subdural hematoma. The prothrombin time was now 59.1 s with an activated partial thromboplastin time of more than 160 s and a normal thrombin time. A mixing study did not correct the clotting times and coagulation factor assays showed a nonspecific inhibition pattern...
July 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
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