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Thrombelastography

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https://www.readbyqxmd.com/read/29112094/thrombelastography-early-amplitudes-in-bleeding-and-coagulopathic-trauma-patients-results-from-a-multicenter-study
#1
Thomas H Laursen, Martin A S Meyer, Anna Sina P Meyer, Tina Gaarder, Paal A Naess, Jakob Stensballe, Sisse R Ostrowski, Pär I Johansson
BACKGROUND: Early amplitudes in the viscoelastic hemostatic assays Thrombelastography (TEG) and Rotation Thromboelastometry (ROTEM) provide fast results, which is critical in resuscitation of bleeding patients. This study investigated associations between TEG early amplitudes and standard TEG variables in a large multicenter cohort of moderately to severely injured trauma patients admitted at three North European level 1 Trauma Centers. METHODS: Prospective observational study of 404 trauma patients with clinical suspicion of severe injury from London, UK, Copenhagen, Denmark and Oslo, Norway...
November 3, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29078874/14-day-thawed-plasma-retains-clot-enhancing-properties-and-inhibits-tpa-induced-fibrinolysis
#2
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Raymond Shepherd-Singh, Angela Sauaia, Gregory R Stettler, Geoffrey R Nunns, Christopher C Silliman
BACKGROUND: Plasma-first resuscitation attenuates trauma-induced coagulopathy (TIC); however, the logistics of plasma-first resuscitation require thawed plasma (TP) be readily available due to the obligatory thawing time of fresh frozen plasma (FFP). The current standard is storage of TP for up to 5 days at 4°C, based on factor levels at outdate, for use in patients at risk for TIC, but there remains a 2.2% outdated wastage rate. However, the multitude of plasma proteins in attenuating TIC remains unknown...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29070132/-a-systematic-review-of-the-value-of-thrombelastography-or-thromboelastometry-for-prediction-of-venous-thromboembolism
#3
Zhi-Yun Jiang, Jun-Fen Ma, Qian Wang, Fan Wu, Jie-Dan Ping, Liang Ming
OBJECTIVE: To systematically collect the thrombelastography (TEG)-or thromboelastometry (ROTEM)-related data, and predict to evaluate their values for the prediction of thromboembolic events. METHODS: Databases including PubMed, Central and Embase were searched for the related clinical trials, and the references were retrieved manually; these included references were assessed qualitatively by the QUADAS-2 tool; finally the enrolled researches were qualitatively analyzed...
October 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/29049137/effects-of-dextran-70-and-albumin-on-coagulation-in-experimental-hemorrhage-in-the-guinea-pig
#4
Ulf Schött, Thomas Kander, Peter Bentzer
BACKGROUND: Dextran-70 is a more potent plasma volume expander than albumin but use has been hampered because of it's antithrombotic properties. However, also albumin has antithrombotic properties and little is known about relative effects of these two colloids on coagulation in-vivo when controlling for differences in efficacy as plasma volume expanders. AIM: Compare effects of dextran-70 and albumin on coagulation at a dose resulting in equal plasma volume expansion...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/28994690/perioperative-management-of-a-patient-with-glanzmann-s-thrombasthenia-for-mitral-valve-repair-under-cardiopulmonary-bypass
#5
Parimala Prasanna Simha, Prasanna Simha Mohan Rao, Deepak Arakalgud, Rakesh Rajashekharappa, Manjunath Narasimhaih
A 30-year-old male patient presented with Glanzmann's thrombasthenia and mitral valve prolapse. He was in acute decompensated congestive heart failure due to severe mitral and tricuspid regurgitation. After his cardiac failure had been stabilized, the patient was subjected to mitral and tricuspid valve repair. His transfusion requirements were guided by thrombelastography and his bleeding disorder was managed by infusing single donor plasmapheresed platelet transfusions in the perioperative period. The patient underwent surgery uneventfully...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28982391/the-impact-of-early-thromboelastography-directed-therapy-in-trauma-resuscitation
#6
Mohamed Mohamed, Karl Majeske, Gul R Sachwani, Kristin Kennedy, Mina Salib, Michael McCann
BACKGROUND: Conventional coagulation tests do not provide an accurate representation of the complex nature of trauma induced coagulopathy. Thrombelastography provides a prompt global overview of all dynamic sequential aspects of trauma induced coagulopathy. The objective of this study was to evaluate the impact of using thrombelastography on blood products utilization, crystalloids utilization, hospital, and intensive care using length of stay, and cost savings. METHODS: We retrospectively reviewed 134 patients (May of 2012 to February of 2015) meeting Class I trauma activation...
October 5, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28969894/targeting-resuscitation-to-normalization-of-coagulating-status-hyper-and-hypocoagulability-after-severe-injury-are-both-associated-with-increased-mortality
#7
Hunter B Moore, Ernest E Moore, Ioannis N Liras, Charles Wade, Benjamin R Huebner, Clay Cothren Burlew, Fredric M Pieracci, Angela Sauaia, Bryan A Cotton
INTRODUCTION: The prevalence and impact of hypercoagulability (hypo) in severely injured patients early after injury remains unclear. We hypothesize that the predominant phenotype of postinjury coagulopathy is hypercoagulability (hyper) and it is associated with increased mortality. MATERIAL AND METHODS: Blood samples from 141 healthy volunteers assayed with thrombelastography (TEG) were used to identify thresholds of hypo and hypercoagulability (above 95th/below the 5(th)percentile) in four TEG indices...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28969064/thrombin-induced-platelet-fibrin-clot-strength-in-relation-to-platelet-volume-indices-and-inflammatory-markers-in-patients-with-coronary-artery-disease
#8
Hai-Chen Lv, Hong-Yi Wu, Jia-Sheng Yin, Jun-Bo Ge
Platelet aggregation and inflammation are both implicated in coronary artery disease (CAD). Thrombin induced platelet-fibrin clot strength (MAThrombin) measured by thrombelastography (TEG) has been proved to be a novel marker of platelet aggregation. The aim of this study was to investigate the correlation of MAThrombin to platelet volume indices (PVIs) or to inflammatory markers in different types of CAD. 206 patients with different types of CAD were enrolled. MAThrombin, PVIs, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) as well as inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP) and fibrinogen (Fbg) were measured...
September 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28964508/platelet-adenosine-diphosphate-receptor-inhibition-provides-no-advantage-in-predicting-need-for-platelet-transfusion-or-massive-transfusion
#9
Gregory R Stettler, Ernest E Moore, Hunter B Moore, Geoffrey R Nunns, Benjamin R Huebner, Peter Einersen, Arsen Ghasabyan, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Thrombelastography platelet mapping is a useful assay to assess antiplatelet therapy. Inhibited response to the adenosine diphosphate receptor on platelets occurs early after injury, but recent work suggests this alteration occurs even with minor trauma. However, the utility of thrombelastography platelet mapping, specifically the percent of adenosine diphosphate receptor inhibition, in predicting outcomes and guiding platelet transfusion in trauma-induced coagulopathy remains unknown We assessed the role of percent of adenosine diphosphate-inhibition in predicting survival, requirement for massive transfusion or platelet transfusion in patients at risk for trauma-induced coagulopathy...
December 2017: Surgery
https://www.readbyqxmd.com/read/28931362/dual-antiplatelet-therapy-is-associated-with-coagulopathy-detectable-by-thrombelastography-in-acute-stroke
#10
Mark M McDonald, Tareq S Almaghrabi, Daniel M Saenz, Chunyan Cai, Mohammad H Rahbar, H Alex Choi, Kiwon Lee, James C Grotta, Tiffany R Chang
BACKGROUND: Thrombelastography (TEG) provides a global, dynamic measure of coagulation. We examined the effect of antiplatelet (AP) medications on coagulation in patients with acute stroke as measured by TEG. METHODS: We reviewed prospectively collected data on patients presenting with acute ischemic stroke (AIS) and spontaneous intracerebral hemorrhage (ICH) between 2009 and 2014. Patient demographics and baseline TEG values were compared among 4 different drug use groups: aspirin only, clopidogrel only, both aspirin and clopidogrel, and no AP...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28911288/impact-of-thrombelastography-in-paediatric-intensive-care
#11
B G Carter, E Carland, P Monagle, S B Horton, W Butt
We assessed the clinical impact of thrombelastography (TEG®) results (TEG® 5000, Haemonetics Corporation, Braintree, MA, USA) by measuring their ability to cause changes in a theoretical treatment plan and contribute to the understanding of haemostasis. We prospectively included paediatric intensive care unit (PICU) patients who had standard tests of haemostasis and TEG ordered and had an arterial catheter or extracorporeal access port in situ. Blood for standard tests and TEG was taken simultaneously. Independent of patient care, general patient information and results of standard laboratory tests were presented to five clinicians who were asked to document their theoretical treatment plan...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28767444/thrombin-induced-platelet-fibrin-clot-strength-in-relation-to-platelet-volume-indices-and-inflammatory-markers-in-patients-with-coronary-artery-disease
#12
Hai-Chen Lv, Hong-Yi Wu, Jia-Sheng Yin, Jun-Bo Ge
Platelet aggregation and inflammation are both implicated in coronary artery disease (CAD). Thrombin induced platelet-fibrin clot strength (MAThrombin) measured by thrombelastography (TEG) has been proved to be a novel marker of platelet aggregation. The aim of this study was to investigate the correlation of MAThrombin to platelet volume indices (PVIs) or to inflammatory markers in different types of CAD. 206 patients with different types of CAD were enrolled. MAThrombin, PVIs, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) as well as inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP) and fibrinogen (Fbg) were measured...
July 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28764996/coagulopathy-as-a-predictor-of-mortality-after-penetrating-traumatic-brain-injury
#13
Lindley E Folkerson, Duncan Sloan, Elizabeth Davis, Ryan S Kitagawa, Bryan A Cotton, John B Holcomb, Jeffrey S Tomasek, Charles E Wade
STUDY HYPOTHESIS: Traumatic brain injury (TBI) is a leading cause of mortality with penetrating TBI (p-TBI) patients having worse outcomes. These patients are more likely to be coagulopathic than blunt TBI (b-TBI) patients, thus we hypothesize that coagulopathy would be an early predictor of mortality. METHODS: We identified highest-level trauma activation patients who underwent an admission head CT and had ICU admission orders from August 2009-May 2013, excluding those with polytrauma and anticoagulant use...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28755903/tranexamic-acid-is-associated-with-increased-mortality-in-patients-with-physiological-fibrinolysis
#14
Hunter B Moore, Ernest E Moore, Benjamin R Huebner, Gregory R Stettler, Geoffrey R Nunns, Peter M Einersen, Christopher C Silliman, Angela Sauaia
BACKGROUND: Tranexamic acid (TXA) administration after trauma has not been proven to improve survival in the United States. Trauma patients were presented to the hospital with a spectrum of fibrinolytic activity, in which physiological levels of fibrinolysis are associated with the lowest mortality. We hypothesize that trauma patients who present to the hospital with physiological levels of fibrinolysis will have increased mortality if they receive TXA. MATERIALS AND METHODS: Severely injured trauma patients, followed prospectively from 2014 to 2016, were included in the analysis...
May 8, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28738008/randomized-placebo-controlled-study-of-the-effects-of-yunnan-baiyao-on-hemostasis-in-horses
#15
SallyAnne L Ness, Amelia H Frye, Thomas J Divers, Mark Rishniw, Hollis N Erb, Marjory B Brooks
OBJECTIVE To determine effects of oral administration of Yunnan Baiyao on platelet activation, coagulation, and fibrinolysis in healthy horses. ANIMALS 12 healthy adult horses. PROCEDURES In a randomized blinded crossover study that included a 4-week washout period between treatments, horses were orally administered a paste containing Yunnan Baiyao (15 mg/kg) or placebo at 12-hour intervals for 3 days. Blood samples were collected before start of treatment (time 0) and at 24 and 72 hours for a CBC, measurement of fibrinogen concentration, coagulation screening tests, and a panel of assays to assess platelet activation (including ADP- and collagen-induced aggregation and closure times, flow-cytometric variables of platelet-leukocyte aggregates, platelet membrane P-selectin and phosphatidylserine expression, and microparticle release), von Willebrand factor (vWF) concentration, and cofactor activity...
August 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28701681/inflammation-is-associated-with-platelet-coagulation-function-rather-than-enzymatic-coagulation-function-in-patients-with-takayasu-arteritis
#16
Xiao Wang, Aimin Dang, Naqiang Lv, Nan Cheng, Xuesen Cheng
The integral changes of coagulation and fibrinolysis, and their relationships with inflammation in patients with Takayasu arteritis (TA) remain undetermined. The purpose of this study was to analyze the changes of coagulation and fibrinolysis process in patients with TA by thrombelastography (TEG).A total of 127 patients with TA and 55 healthy controls were enrolled. Patients with TA were grouped according to disease activity. The routine hematological parameters, traditional coagulation assays, and TEG parameters were summarized retrospectively...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28696521/characterization-of-the-rabbit-as-an-in-vitro-and-in-vivo-model-to-assess-the-effects-of-fibrinogenolytic-activity-of-snake-venom-on-coagulation
#17
Vance G Nielsen, Elda E Sánchez, Daniel T Redford
Several in vitro investigations have demonstrated that anticoagulant effects of fibrinogenolytic snake venom metalloproteinases have been abrogated in human plasma by modifying fibrinogen with iron (Fe) and carbon monoxide (CO) to prevent catalysis or by directly inhibiting these enzymes with CO. To translate these findings, we chose to assess the rabbit as a model of envenomation with Crotalus atrox venom. It was determined with thrombelastography that 15 times the concentration of venom noted to compromise coagulation in plasma in vitro was required to cause coagulopathy in vivo, likely secondary to venom binding to blood cells and being cleared from the circulation rapidly...
July 11, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28695310/central-aortic-pulse-pressure-thrombogenicity-and-cardiovascular-risk
#18
Gailing Chen, Kevin P Bliden, Rahul Chaudhary, Fang Liu, Himabindu Kaza, Eliano P Navarese, Udaya S Tantry, Paul A Gurbel
High central aortic pulse pressure (CPP) and thrombin-induced platelet-fibrin clot strength (TIP-FCS) have been associated with ischemic outcomes in patients with coronary artery disease in separate studies. But, the ischemic risk associated with these factors has never been analyzed in a single study and their interrelation is unknown. The primary aim of the study was to establish cut points for CPP and TIP-FCS measured at the time of catheterization associated with long term major adverse cardiovascular events...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28693686/the-correlation-of-indices-in-r-teg-with-intra-operative-blood-loss-in-neurosurgical-patients
#19
Xue Zhang, Xuerong Yu, Yuguang Huang
Objective Intra-operative coagulopathy has a close relationship with blood loss and the prognosis of patients. Rapid-thrombelastography (r-TEG) is a comprehensive assessment of coagulation abnormalities and also an effective way for constructing blood transfusion. This study attempts to investigate the correlation of r-TEG indices with intra-operative hemorrhage.Methods Patients who underwent transphenoidal hypophysectomy and craniotomy from January 15 to April 30, 2013 in Peking Union Medical College hospital were recruited...
June 10, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28691277/crotalus-atrox-venom-exposed-to-carbon-monoxide-has-decreased-fibrinogenolytic-activity-in-vivo-in-rabbits
#20
Vance G Nielsen
Envenomation by haemotoxic enzymes remains a significant source of human morbidity and mortality worldwide, with administration of long-acting or multiple doses of antivenom first-line therapy. However, coagulopathy can still occur and recur. Of interest, it has been recently demonstrated that direct, isolated exposure of snake venom enzymes with fibrinogenolytic activity to carbon monoxide (CO) abrogates venom-mediated loss of coagulation in human plasma. These observations of CO inhibition of venom fibrinogenolytic activity were subsequently repeated in rabbit whole blood...
July 10, 2017: Basic & Clinical Pharmacology & Toxicology
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