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https://www.readbyqxmd.com/read/27887785/thromboelastography-teg%C3%A2-demonstrates-that-tinzaparin-4500-international-units-has-no-detectable-anticoagulant-activity-after-caesarean-section
#1
S Griffiths, C Woo, V Mansoubi, A Riccoboni, A Sabharwal, S Napier, M Columb, M Laffan, G Stocks
BACKGROUND: Low molecular weight heparin is routinely used for thromboprophylaxis in pregnancy and the puerperium. Consensus guidelines recommend waiting 10-12h after administration of a thromboprophylactic dose of low molecular weight heparin before performing a neuraxial block or removing an epidural catheter. Thromboelastography (TEG®) has been reported to be sensitive to the effects of enoxaparin 4h after administration. The purpose of this study was to use TEG to examine coagulation changes in the first 10h after a thromboprophylactic dose of tinzaparin in an attempt to ratify the current consensus guidelines about timing of neuraxial blockade and epidural catheter removal...
October 8, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27861430/the-use-of-recombinant-antithrombin-iii-in-pediatric-and-neonatal-ecmo-patients
#2
Deanna R Todd Tzanetos, John Myers, Terri Wells, Dan Stewart, Jeffrey J Fanning, Janice E Sullivan
A retrospective review of 77 pediatric and neonatal ECMO patients who received recombinant antithrombin III (ATIII) for ATIII activity >80% was conducted.Anticoagulation management was per institutional protocol. An ATIII activity >80% was targeted. Diagnosis, reason for ECMO cannulation, blood product usage, heparin dosing, ATIII activity and doses, thrombotic and bleeding complications, hours on ECMO, and mortality were recorded. We calculated patient-level summary statistics and assessed differences between groups using χ2 tests (categorical variables) and Wilcoxon rank sum tests (continuous variables)...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27856667/protocolled-redefinition-of-the-therapeutic-range-for-unfractionated-heparin-lost-in-translation
#3
Karlien L M Coene, Fedde van der Graaf, Daan van de Kerkhof
BACKGROUND: Protocolled treatment with unfractionated heparin (UFH) is a subject of ongoing debate. Even though international guidelines prescribe calibration of the activated partial thromboplastin time (aPTT) to 0.3 to 0.7 U/mL anti-Xa activity to establish an UFH therapeutic range, evidence for this approach remains scarce. In this study, we evaluated different strategies to delineate the UFH therapeutic range and analyzed the effects on patient therapeutic classification. METHODS: In 109 patient samples, the aPTT was measured with 2 different reagents, both of which used mechanical clot detection...
November 16, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27850894/1258-thromboprophylaxis-using-anti-xa-levels-in-obese-critically-ill-patients-a-retrospective-study
#4
Joaquin Cagliani, Kosuma Nio, Wenchen Wu, Candace Smith, Jayoung Park, Horacio Rilo, Jeffrey Nicastro, Rafael Barrera
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849857/215-evaluating-anti-xa-and-aptt-monitoring-of-heparin-in-patients-with-an-impella-device
#5
Nadine Musallam, Diana Altshuler, Tania Ahuja, Caitlin Aberle, John Papadopoulos
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#6
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27847121/outcomes-following-routine-antithrombin-iii-replacement-during-neonatal-extracorporeal-membrane-oxygenation
#7
Brian K Stansfield, Linda Wise, P Benson Ham, Pinkal Patel, Malinda Parman, Chan Jin, Sunil Mathur, Gregory Harshfield, Jatinder Bhatia
BACKGROUND: We sought to examine the effect of routine antithrombin III (AT3) infusion on hemorrhagic and thrombotic complications, blood product utilization, and circuit lifespan in neonatal extracorporeal membrane oxygenation (ECMO). METHODS: We performed a retrospective cohort study of 162 infants placed on ECMO for hypoxic respiratory failure. Infants requiring ECMO for primary cardiac support were excluded. Demographic data, time on ECMO, blood product usage, coagulation profile, and complications were compared between 90 control patients and 72 patients treated with AT3...
October 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27811211/estimation-of-rivaroxaban-plasma-concentrations-in-the-perioperative-setting-in-patients-with-or-without-heparin-bridging
#8
Sarah Lessire, Jonathan Douxfils, Lionel Pochet, Anne-Sophie Dincq, Anne-Sophie Larock, Maximilien Gourdin, Jean-Michel Dogné, Bernard Chatelain, François Mullier
INTRODUCTION: Estimation of residual rivaroxaban plasma concentrations may be requested before invasive procedures and some patients at high thromboembolic risk will have a bridging therapy with heparins when rivaroxaban is interrupted. OBJECTIVE: The objective of this study was to assess the performance of the STA-Liquid Anti-Xa assay (STA LAX) and the low and normal procedures of the Biophen Direct Factor Xa Inhibitors (DiXaI) assay, in patients with and without bridging with low-molecular-weight heparins (LMWHs)...
November 3, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27764730/effect-of-rivaroxaban-on-prothrombin-fragment-1-2-compared-with-warfarin-in-patients-with-acute-cardioembolic-stroke-insight-from-its-serial-measurement
#9
Joji Hagii, Hirofumi Tomita, Norifumi Metoki, Yoshiko Tamai, Shin Saito, Hiroshi Shiroto, Hiroyasu Hitomi, Takaatsu Kamada, Satoshi Seino, Koki Takahashi, Satoko Sasaki, Minoru Yasujima, Ken Okumura
INTRODUCTION: Patients with intracerebral hemorrhage during rivaroxaban treatment have small hematoma and favorable outcomes compared with those with warfarin. We investigated its possible mechanism, focusing on prothrombin fragment 1+2 (F1+2), a marker of thrombin generation. MATERIALS AND METHODS: In 65 patients with acute cardioembolic stroke (median 77years), rivaroxaban was initiated at 5days after the onset. Plasma F1+2 level (normal range, 69-229pmol/L), prothrombin time (PT), and rivaroxaban concentration evaluated by anti-Xa activity were serially measured...
October 13, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27761575/capillary-blood-samples-for-anti-xa-monitoring-of-heparin-in-paediatric-patients
#10
Sallyann Ridsdale, Victoria Martin, Jeanette H Payne
No abstract text is available yet for this article.
October 20, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27745797/thromboprophylaxis-with-heparin-during-orthotopic-liver-transplantation-comparison-of-hepcon-hms-plus-and-anti-xa-assays-for-low-range-heparin
#11
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
https://www.readbyqxmd.com/read/27736032/anti-iia-for-monitoring-unfractionated-heparin-in-children-results-of-the-heartcat-study
#12
Andreas Hanslik, Erwin Kitzmüller, Ulrich S Tran, Katharina Thom, Hratsch Karapetian, Nicole Prutsch, Jasmin Voitl, Ina Michel-Behnke, Fiona Newall, Christoph Male
BACKGROUND: Unfractionated heparin (UFH) is used for prophylaxis and treatment of thrombosis in children. Laboratory monitoring of UFH is needed to prevent over- or under-anticoagulation. OBJECTIVES: Study objectives were to investigate i) the association between UFH dose and UFH effect as monitored by anti-IIa, ii) the relationship of anti-IIa and anti-Xa effects, and iii) the influence of patients' age and other factors on UFH effect. PATIENTS AND METHODS: Randomized controlled trial in children during cardiac catheterization, comparing high-dose UFH (100 units/kg bolus) versus low-dose UFH (50 units/kg bolus)...
October 13, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27732770/thromboelastographic-monitoring-of-the-effect-of-unfractionated-heparin-in-healthy-dogs
#13
Christopher M McLaughlin, Steven L Marks, David C Dorman, Alison Motsinger-Reif, Rita M Hanel
OBJECTIVE: To characterize the correlation between thromboelastography (TEG) variables using strong activators and anti-Xa (AXa) activity in healthy dogs administered subcutaneous unfractionated heparin (UFH). DESIGN: Prospective experimental study. SETTING: University research facility. ANIMALS: Eight adult random-source male dogs. INTERVENTION: Dogs were randomized to receive subcutaneous UFH at 200, 250, or 300 IU/kg every 8 hours for a total of 10 injections...
October 12, 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/27722127/establishing-the-heparin-therapeutic-range-using-aptt-and-anti-xa-measurements-for-monitoring-unfractionated-heparin-therapy
#14
Jung-Hyun Byun, In-Seok Jang, Jong Woo Kim, Eun-Ha Koh
BACKGROUND: Unfractionated heparin (UFH) has unstable pharmacokinetics and requires close monitoring. The activated partial thromboplastin time (aPTT) test has been used to monitor UFH therapy for decades in Korea, but its results can be affected by numerous variables. We established an aPTT heparin therapeutic range (HTR) corresponding to therapeutic anti-Xa levels for continuous intravenous UFH administration, and used appropriate monitoring to determine if an adequate dose of UFH was applied...
September 2016: Blood Research
https://www.readbyqxmd.com/read/27720420/perioperative-thromboprophylaxis-in-severely-obese-patients-undergoing-bariatric-surgery-insights-from-a-french-national-survey
#15
Pierre-Antoine Moulin, Anne Dutour, Patricia Ancel, Pierre-Emmanuel Morange, Thierry Bege, Olivier Ziegler, Stéphane Berdah, Corinne Frère, Bénédicte Gaborit
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of death in obese patients undergoing bariatric surgery (BS), but there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. OBJECTIVE: We aimed to evaluate patterns of BS perioperative thromboprophylaxis practices. SETTING: French obesity specialized care centers (CSO), which are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey (11 opened, 15 closed questions) investigating their prophylactic schemes of anticoagulation (molecule, dose, weight-adjustment, duration, associated measures, follow-up) was sent to the 37 CSO...
September 1, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27717636/the-effect-of-dalteparin-on-thromboelastography-in-pregnancy-an-in-vitro-study
#16
L Chow, A Carr, L MacKenzie, A Walker, D Archer, A Lee
BACKGROUND: Dalteparin is often used for prophylaxis or treatment of venous thromboembolism during pregnancy, yet there is no laboratory test to accurately reflect its clinical activity. Thromboelastography is a point-of-care monitor of whole blood coagulation. The aim of this study was to determine if serial doses of dalteparin added in vitro to whole blood samples from term, pregnant women are detectable as changes in thromboelastography parameters. METHODS: Thirty healthy parturients presenting for elective caesarean section were recruited...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27693274/anti-xa-oral-anticoagulants-inhibit-in-vivo-platelet-activation-by-modulating-glycoprotein-vi-shedding
#17
Pasquale Pignatelli, Daniele Pastori, Simona Bartimoccia, Danilo Menichelli, Tommasa Vicario, Cristina Nocella, Roberto Carnevale, Francesco Violi
Anti Xa non-vitamin K oral anticoagulants (anti Xa NOACs) seem to possess antiplatelet effect in vitro, but it is unclear if this occurs also in vivo. Aim of the study was to compare the effect on platelet activation of two anti Xa NOACs, namely apixaban and rivaroxaban, to warfarin, and to investigate the potential underlying mechanism by evaluating soluble glycoprotein GPVI (sGPVI), a protein involved in platelet activation. We performed a cross-sectional including AF patients treated with warfarin (n=30), or apixaban 10mg/day (n=40), or rivaroxaban 20mg/day (n=40)...
September 28, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27692605/anti-xa-bioassays-for-the-laboratory-measurement-of-direct-factor-xa-inhibitors-in-plasma-in-selected-patients
#18
Jean Amiral, Claire Dunois, Cédric Amiral, Jerard Seghatchian
In the past decade Direct Oral Anti-Coagulants (DOACs), targeting Thrombin or Factor Xa, have enormously facilitated the daily treatment of all relevant patients, including those requiring lifelong therapy. These DOACs have considerable advantages over the use of oral Vitamin K Antagonist (VKA) treatments, in view of having little interferences with food and other medications and also not requiring adjustment for age, gender or weight, with some well-defined exceptions. In this current What's Happening Section we focus on measurements of DiXaIs in plasma using anti-Xa assays, with the objective of providing a tribute to Professor Michel Meyer Samama, who was not only a real leader in this field but, in the past, both authors benefited from his wisdom, as a teacher who dedicated his scientific and professional life (among many other interests in hemostasis, thrombosis and fibrinolysis) to develop and promote methods and strategies for laboratory monitoring of anticoagulants...
October 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27692303/direct-oral-anti-xa-inhibitors-and-vaginal-bleeding
#19
Melanie Ferreira
No abstract text is available yet for this article.
October 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27637548/laboratory-assessment-of-the-anticoagulant-activity-of-direct-oral-anticoagulants-doacs-a-systematic-review
#20
Bethany T Samuelson, Adam Cuker, Deborah M Siegal, Mark Crowther, David A Garcia
BACKGROUND: The direct oral anticoagulants (DOACs) are the treatment of choice for most patients with atrial fibrillation and/or non-cancer associated venous thromboembolic disease. While routine monitoring of these agents is not required, assessment of anticoagulant effect may be desirable in special situations. The objective of this study was to systematically review and summarize current evidence regarding laboratory assessment of the anticoagulant effects of dabigatran, rivaroxaban, apixaban and edoxaban...
September 13, 2016: Chest
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