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Patrick Bosch, Tanya S Kenkre, Joanne A Londino, Antonio Cassara, Charles Yang, Jonathan H Waters
BACKGROUND: Blood loss and transfusion requirements during posterior spinal fusion for adolescent idiopathic scoliosis remain a concern. The mechanism of bleeding in these patients is poorly characterized. Thromboelastography is a comprehensive test of a patient's coagulation system commonly used in cardiac surgical procedures. It has not been well studied for use in patients with adolescent idiopathic scoliosis. METHODS: A prospective, observational study of the coagulation profile of patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion is presented...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
Shannon Piche, Scott Nei, Erin Frazee, Sarah Schettle, Barry Boilson, Ross Dierkhising, John Stulak
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
A 'Aho, K Byrne
Dabigatran is a direct thrombin inhibitor, which is increasingly likely to be encountered in patients presenting for surgery. This study examines whether there is a consistent effect of dabigatran on the thromboelastogram (TEG) and whether this correlates with the effects of dabigatran on traditional coagulation parameters. Twenty patients taking dabigatran had blood sampled for kaolin-activated whole blood TEG analysis and routine coagulation testing. There was a statistically significant correlation between thrombin clotting time (TCT) and R-time (R=0...
November 2016: Anaesthesia and Intensive Care
Christine M Leeper, Matthew D Neal, Christine McKenna, Jason Sperry, Barbara A Gaines
BACKGROUND: Abnormalities in fibrinolysis are common and associated with increased mortality in injured adults. While hyperfibrinolysis (HF) and fibrinolysis shutdown (SD) are potential prognostic indicators and treatment targets in adults, these derangements are not well-described in a pediatric trauma cohort. METHODS: Prospective analysis of highest level trauma activations age 0-18 presenting to our academic center between 6/1/2015-7/31/2016 with admission rapid thromboelastogram (TEG)...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Ramona Nicolau-Raducu, Elise Occhipinti, Thomas Marshall, Joseph Koveleskie, Donald Ganier, Brian Evans, William Daly, Brian Fish, Ari J Cohen, Trevor W Reichman, David Bruce, Humberto Bohorquez, John Seal, Emily Ahmed, Ian Carmody, George Loss, Jonathan Rayburn, Bobby Nossaman
OBJECTIVES: The purpose of this study was to compare the agreement between two heparin assays, Hepcon HMS plus/Kaolin-ACT and Anti-Xa, and their predictive power in detecting circulating heparin levels post-reperfusion of the liver graft when compared with thromboelastogram (TEG) r time ratio in patients undergoing orthotopic liver transplantation (OLT). DESIGN: Prospective, observational cohort study design. SETTING: Single center, university hospital...
August 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
A Iu Krylov, A M Shulutko, N V Prasolov, A A Petrovskaia, S E Khmyrova
The authors analysed the results of treating a total of 116 patients (68 men and 48 women aged from 20 to 84 years, mean age 59.5±15.5 years) presenting with various complications of prolonged therapy with warfarin. Prescription of prolonged therapy with warfarin had been caused by various cardiac diseases and lower extremity deep vein thromboses. The duration of anticoagulant therapy at the time of onset of complications was different and depended on the underlying disease. The majority of patients included into the study had been taking warfarin for one year and more, with nearly half of patients (48...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Funda Yildirim, Barıs Tuncer, Alper Ozbakkaloglu, Adnan Taner Kurdal, Tulun Ozturk, Ihsan Iskesen
OBJECTIVE: Blood transfusion after coronary artery bypass surgery is carried out according to general coagulation tests and blood counts. Our aim was to determine the effects of rotational thromboelastography results on the amount of blood products used in the intraoperative and postoperative periods in coronary artery bypass patients. METHODS: Our study included 164 patients who underwent coronary artery bypass. A control group was formed from 82 patients picked from hospital records, who had elective coronary artery bypass before the introduction of rotational thromboelastography in our clinic...
June 2016: Asian Cardiovascular & Thoracic Annals
Sharon Orbach-Zinger, Leonid A Eidelman, Alexander Lutsker, Galia Oron, Benjamin Fisch, Avi Ben-Haroush
OBJECTIVES: In vitro fertilization (IVF) induced elevated estrogen levels are associated with a hypercoagulable state. Thromboelastogram (TEG) is a point of care whole blood hemostasis analyzer which measures functionality of clotting parameters. Our study's objective was to examine the influence of the early and late follicular phase of an IVF simulation cycle on coagulation parameters as measured by TEG and to evaluate the influence of age on coagulation parameters. STUDY DESIGN: In a single center, prospective, observational trial, 46 women undergoing IVF therapy were studied...
June 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jennifer Song, Kenneth J Drobatz, Deborah C Silverstein
OBJECTIVE: To evaluate the relationship between shortened prothrombin time (PT) or activated partial thromboplastin time (aPTT) values, clinical findings associated with hypercoagulability, suspicion of pulmonary thromboembolism (PTE), D-dimer concentrations, and thromboelastogram (TEG) indices. DESIGN: Retrospective observational study from 2006 to 2011. SETTING: University veterinary teaching hospital. ANIMALS: Twenty-three dogs with TEG tracings and shortened PT or aPTT values and 23 control dogs with TEG tracings and normal PT and aPTT values...
May 2016: Journal of Veterinary Emergency and Critical Care
Kenneth N Hiller
Dual antiplatelet therapy (DAPT) is the standard of care for primary and secondary prevention strategies in patients with coronary artery disease after stenting. Current guidelines recommend that DAPT be continued for 12 months in patients after receiving drug eluting stents. Approximately 5% of these patients will present within this 12-month period for noncardiac surgery. This case report describes a clinically relevant exaggerated pharmacodynamic response to DAPT detected by preoperative assessment of platelet function...
January 2016: Journal of Anaesthesiology, Clinical Pharmacology
Seung H Yoo, Emilee Venn, Lauren A Sullivan, Christine S Olver
OBJECTIVE: To describe the thromboelastographic changes in fibrinolysis with ε-aminocaproic acid treatment in a dog with suspected acute traumatic coagulopathy. CASE SUMMARY: A 9-year-old female spayed Airedale Terrier was presented with multiple injuries consistent with motor vehicle trauma. After surgical repair of a diaphragmatic hernia and minor laceration of the right cranial lung lobe, the dog continued to produce copious volumes of hemorrhagic fluid from the thoracic cavity despite multiple plasma transfusions, autotransfusions, and failure to locate a definitive source of bleeding during 2 separate surgeries...
September 2016: Journal of Veterinary Emergency and Critical Care
M J Daley, Z Enright, J Nguyen, S Ali, A Clark, J D Aydelotte, P G Teixeira, T B Coopwood, C V R Brown
PURPOSE: The purpose of this study is to determine if adenosine diphosphate (ADP) platelet dysfunction on thromboelastogram (TEG) is associated with increased in-hospital mortality in patients with head trauma. The hypothesis is that ADP dysfunction is associated with increased mortality. METHODS: This retrospective review evaluated trauma patients admitted to a level 1 trauma center from February 2011 to October 2013 who received a TEG. Patients were included if the TEG was drawn within the first 24 h of admission and the head abbreviated injury score was greater than or equal to three...
February 18, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
R C Gosselin, E E Estacio, J Y Song, D M Dwyre
OBJECTIVE: To verify the manufacturer performance claims of the TEG5000 with traditional laboratory methods. MATERIALS AND METHODS: Samples were concurrently measured using the TEG5000 analyzer and either PT, APTT, fibrinogen, factor activities, platelet count, or platelet function testing using whole blood or platelet-rich plasma methods. RESULTS: Within-run imprecision yielded coefficient of variation (CV) of <5%. There was no correlation of PT or APTT with R time...
April 2016: International Journal of Laboratory Hematology
Mark H Yazer, Emily M Glackin, Darrell J Triulzi, Louis H Alarcon, Alan Murdock, Jason Sperry
BACKGROUND: Increasingly, cold-stored whole blood (WB) is being considered for the resuscitation of civilian trauma patients. It is unclear whether the WB should be agitated to enhance the function of the platelets (PLTs) or whether agitation will cause RBC damage. STUDY DESIGN AND METHODS: WB units were collected by standard procedures using a PLT-sparing inline leukoreduction filter and stored between 1 and 6°C. On Storage Day 3 each unit was divided into 4 subunits that were stored under one of the following conditions for 21 days: unrocked, manually rocked once daily, continuously rocked end over end, or continuously rocked horizontally...
March 2016: Transfusion
Allison E Berndtson, Wan-Ting Huang, Kevin Box, Leslie Kobayashi, Laura N Godat, Alan M Smith, David Weingarten, Raul Coimbra
BACKGROUND: As the population ages, more trauma patients are admitted with coagulopathy. Fresh frozen plasma is effective in reversing coagulopathy caused by warfarin; however, it is not appropriate for all patients. Prothrombin complex concentrates (PCCs) are an alternative for patients who require emergent reversal, minimal-volume administration and who have a supratherapeutic international normalized ratio (INR). A four-factor PCC initially approved in Europe is now available in the United States...
December 2015: Journal of Trauma and Acute Care Surgery
Xinyu Yang, Haichao Wang, Menmen Zhang, Jin Liu, Ben Lv, Fangping Chen
BACKGROUND: Thrombotic diseases are a group of prevalent and life-threatening diseases. Selective inhibition of pathological thrombosis holds the key to treat variety of thrombotic diseases. The pathological thrombosis can be induced by either tissue necrosis and deregulated inflammation. HMGB1, as an important proinflammatory cytokine and a late mediator, also involves on thrombosis disease. However, the underlying mechanisms are not fully understood. METHODS: Immunofluorescence, ELISA assay, Platelet Aggregation, Thromboelastogram (TEG) analyzes...
2015: Diagnostic Pathology
Huan-Ming Xu, Dong-Yang Zhao, Yi-Wen Hao, Ning-Ning Gao, Ji-Xiang Cui
OBJECTIVE: To investigate the changes of physiological activities and functions in vitro of apheresis platelets during storage. METHOD: 17 units of apheresis platelets were randomly chosen and stored at 20 °C to 24 °C with agitation. Platelet counting (Plt), mean platelet volume (MPV), blood gases, pH value, glucose (Glu) concentration, lactate (LA) concentration, LDH concentration, thromboelastogram (TEG), hypotonic shock response (HSR), CD62p expression rate and anew expression rate were measured on days 0, 1, 3, 5 after platelet storage...
June 2015: Zhongguo Shi Yan Xue Ye Xue za Zhi
Maraya N Camazine, Mark R Hemmila, Julie C Leonard, Rachel A Jacobs, Jennifer A Horst, Rosemary A Kozar, Grant V Bochicchio, Avery B Nathens, Henry M Cryer, Philip C Spinella
BACKGROUND: Massive transfusion protocols (MTPs) have been developed to implement damage control resuscitation (DCR) principles. A survey of MTP policies from American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) participants was performed to establish which MTP activation, hemostatic resuscitation, and monitoring aspects of DCR are included in the MTP guidelines. METHODS: On October 10, 2013, ACS-TQIP administration administered a cross-sectional electronic survey to 187 ACS-TQIP participants...
June 2015: Journal of Trauma and Acute Care Surgery
Negar Hamzianpour, Daniel L Chan
BACKGROUND: Hypercoagulability is a well-known feature of canine immune-mediated hemolytic anemia (IMHA) and is believed to increase the risk of thrombosis. This study was undertaken to differentiate the relative contribution of platelets and clotting proteases to this hypercoagulability using thromboelastography (TEG). STUDY DESIGN: Retrospective observational study. METHODS: Thromboelastograms from 27 dogs with IMHA were retrospectively evaluated...
March 2016: Journal of Veterinary Emergency and Critical Care
O K Levchenko, E M Shulutko, É G Gemdzhian, V M Gorodetskiĭ
OBJECTIVE: To develop effective and safe measures of postoperative multimodal analgesia (optimizing the use of narcotic analgesics) in surgical treatment of hematological patients with thrombocytopenia. DESIGN: A pilot and prospective comparative controlled study. METHODS: We studied 27 patients with acquired thrombocytopenia who underwent laparoscopic splenectomy. Three schemes of anesthesia were used: 1) Nefopam 20 mg/day + trimeperidin (n = 7); 2) Paracetamol 4 g/day + trimeperidin (n = 10); 3) paracetamol + trimeperidin + glucocorticosteroids (GC) (through treatment of the underlying disease) (n = 10)...
September 2014: Anesteziologiia i Reanimatologiia
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