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Thrombelastography

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https://www.readbyqxmd.com/read/27897027/-acute-uterine-inversion-after-delivery
#1
E Pechová, I Bydžovská, M Krausová, M Lubušký
OBJECTIVE: A case of acute inversion of the uterus after childbirth, in which we successfully perform a manual vaginal reposition of the uterus. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Krajská nemocnice Liberec, a.s.; Department of Obstetrics and Gynaecology, Palacky University Hospital, Olomouc. OBSERVATION: Our case report describes acute post-partum uterine inversion of the second degree, which developed after delivery in a 36-year-old primigravida...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27894492/management-of-trauma-induced-coagulopathy-with-thrombelastography
#2
REVIEW
Eduardo Gonzalez, Ernest E Moore, Hunter B Moore
Viscoelastic assays, such as thrombelastography (TEG) and rotational thrombelastometry (ROTEM), have emerged as point-of-care tools that can guide the hemostatic resuscitation of bleeding injured patients. This article describes the role of TEG in contemporary trauma care by explaining this assay's methodology, clinical applications, and result interpretation through description of supporting studies to provide the reader with an evidence-based user's guide. Although TEG and ROTEM are assays based on the same viscoelastic principle, this article is focused on data supporting the use of TEG in trauma, because it is available in trauma centers in North America; ROTEM is mostly available in Europe...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27851615/1981-thrombelastography-in-children-with-purpura-fulminans-a-case-series
#3
Shashi Raj, Vasundhara Kailasnath
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27809712/first-report-of-the-point-of-care-teg-a-technical-validation-study-of-the-teg-6s-system
#4
Paul A Gurbel, Kevin P Bliden, Udaya S Tantry, Amy L Monroe, Adina A Muresan, Norman E Brunner, Carlos G Lopez-Espina, Peter R Delmenico, Eli Cohen, Gabriel Raviv, DeAnna L Haugen, Mark H Ereth
Thrombelastography (TEG) measured by the TEG5000 Hemostasis Analyzer is an established but the labor-intensive method for assessing global hemostasis. The first true point-of-care TEG, the TEG6s system, uses resonance-frequency viscoelasticity measurements and a disposable multi-channel microfluidic cartridge to assess hemostasis and response to antiplatelet therapy. TEG assays (n = 5,100) were performed on the blood of healthy volunteers (n = 157) and patients undergoing coronary revascularization at three hospitals (n = 300)...
November 2016: Platelets
https://www.readbyqxmd.com/read/27808346/fibrin-clot-strength-measured-by-thrombelastography-and-outcomes-after-percutaneous-coronary-intervention
#5
Rolf P Kreutz, Glen Schmeisser, Benjamin Maatman, Andrea Schaffter, Anjan Sinha, Elisabeth von der Lohe, Jeffrey A Breall
No abstract text is available yet for this article.
November 3, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27805995/rapid-thrombelastography-r-teg-thresholds-for-goal-directed-resuscitation-of-patients-at-risk-for-massive-transfusion
#6
Peter M Einersen, Ernest E Moore, Michael P Chapman, Hunter B Moore, Eduardo Gonzalez, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Uncontrolled hemorrhage is a leading cause of mortality following trauma accounting for up to 40% of deaths. Massive transfusion protocols (MTPs) offer a proven benefit in resuscitation of these patients. Recently, the superiority of thrombelastography (TEG)-guided resuscitation over strategies guided by conventional clotting assays (CCA) has been established. We seek to determine optimal thresholds for r-TEG driven resuscitation. METHODS: R-TEG data were reviewed for 190 patients presenting to our Level 1 Trauma Center from 2010 to 2015...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27787696/carbon-monoxide-releasing-molecule-2-inhibition-of-snake-venom-thrombin-like-activity-novel-biochemical-brake
#7
Vance G Nielsen, Charles M Bazzell
A complication of defibrinogenation therapy with snake venom enzymes such as ancrod is hypofibrinogenemia associated bleeding secondary to no human-derived inhibitor being available to inactivate or diminish the activity of such enzymes. Of interest, ancrod contains a critical histidine residue without which enzymatic activity is inhibited, and carbon monoxide has been demonstrated to inhibit biomolecular function by interacting with histidine moieties in ion channels. We tested the hypothesis that exposure of three different snake venoms containing serine proteases with thrombin-like activity (which included ancrod) to carbon monoxide derived from carbon monoxide releasing molecule-2 would diminish their effects on plasmatic coagulation as assessed by thrombelastography...
October 27, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27773400/oral-antiplatelet-therapy-and-platelet-inhibition-an-experience-from-a-tertiary-care-center
#8
Jamshed J Dalal, Aarti Digrajkar, Alap Gandhi
AIMS AND OBJECTIVES: Although clopidogrel combined with aspirin is the most commonly used dual drug combination to avert thrombotic events in patients with coronary artery disease, the poor responsiveness to clopidogrel remains a concern. The objective of the current study is to assess the extent of resistance to clopidogrel, prasugrel, and ticagrelor in a real life set of patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). MATERIALS AND METHODS: A total of 539 patients, who underwent PCI and were on aspirin and on any of the three drugs, namely, clopidogrel, prasugrel and ticagrelor, were followed up regularly in the outpatient department...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27762468/thrombelastography-coagulation-index-may-be-a-predictor-of-venous-thromboembolism-in-gynecological-oncology-patients
#9
Jingfu Liu, Na Wang, Yujuan Chen, Rong Lu, Xianren Ye
AIM: Venous thromboembolism (VTE) is a well-recognized complication in gynecological oncology patients, and has an impact on the overall outcome. The purpose of this study was to identify whether thrombelastography (TEG) predicts VTE in gynecological oncology patients. METHODS: This retrospective study included patients with gynecological oncology who were hospitalized at the Fujian Provincial Cancer Hospital from May 2014 to April 2016. Univariate and logistic regression multivariate analyses were performed to determine the clinical and laboratorial factors for VTE in gynecological oncology patients...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27754238/os-34-05-high-on-treatment-platelet-reactivity-was-associated-with-smoking-in-clopidogrel-treated-patients
#10
Xingyu Wang, Xin Liu, Wei Zhang, Xianmin Meng, Lisheng Liu
OBJECTIVE: High on-treatment platelet reactivity (HTPR) was associated with an increased risk of ischemic events in clopidogrel-treated patients. Cigarette smoking was considered as an inducer of CYP1A2, and may theoretically enhance the biological effects and clinical efficacy of clopidogrel through facilitating the conversion of clopidogrel into its active metabolite. The purpose of this study was to examine the effect of cigarette smoking on the platelet response to clopidogrel. DESIGN AND METHOD: A total of 713 patients undergoing percutaneous coronary intervention were selected from Beijing Shijingshan Hospital and assigned to treatment with a loading 300 mg dose of clopidogrel...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27724023/coagulopathy-in-patients-with-acute-pulmonary-embolism-a-pilot-study-of-whole-blood-coagulation-and-markers-of-endothelial-damage
#11
Per Lehnert, Pär I Johansson, Sisse R Ostrowski, Christian H Møller, Lia E Bang, Peter Skov Olsen, Jørn Carlsen
Whole blood coagulation and markers of endothelial damage were studied in patients with acute pulmonary embolism (PE), and evaluated in relation to PE severity. Twenty-five patients were enrolled prospectively each having viscoelastical analysis of whole blood done using thrombelastography (TEG) and Multiplate aggregometry. Fourteen of these patients were investigated for endothelial damage by ELISA measurements of Syndecan-1 (endothelial glycocalyx degradation), soluble endothelial Selectin (endothelial cell activation), soluble Thrombomodulin (endothelial cell injury) and Histone Complexed DNA fragments (endothelial cytotoxic histones)...
October 11, 2016: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/27722160/monitoring-and-treatment-of-coagulation-disorders-in-end-stage-liver-disease
#12
REVIEW
Fuat H Saner, Carmen Kirchner
BACKGROUND: Patients with end-stage liver disease (ESLD) are assumed to be at high risk of bleeding when undergoing any kind of invasive intervention (any kind of operation, including transplantation or minimally invasive interventions). Both bleeding and thrombosis are associated with a poor outcome. METHODS: A selective literature research was conducted with the following key words: 'cirrhosis', 'coagulation', 'bleeding', 'INR' (international normalized ratio), 'aPTT' (activated partial thromboplastin time), and 'thrombocytopenia'...
August 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27643198/os-34-05-high-on-treatment-platelet-reactivity-was-associated-with-smoking-in-clopidogrel-treated-patients
#13
Xingyu Wang, Xin Liu, Wei Zhang, Xianmin Meng, Lisheng Liu
OBJECTIVE: High on-treatment platelet reactivity (HTPR) was associated with an increased risk of ischemic events in clopidogrel-treated patients. Cigarette smoking was considered as an inducer of CYP1A2, and may theoretically enhance the biological effects and clinical efficacy of clopidogrel through facilitating the conversion of clopidogrel into its active metabolite. The purpose of this study was to examine the effect of cigarette smoking on the platelet response to clopidogrel. DESIGN AND METHOD: A total of 713 patients undergoing percutaneous coronary intervention were selected from Beijing Shijingshan Hospital and assigned to treatment with a loading 300 mg dose of clopidogrel...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27616611/-use-of-thrombelastography-to-guide-posttraumatic-hemostatic-therapy-more-coagulation-factor-concentrates-and-less-allogenic-blood-transfusion
#14
J S David, E Imhoff, S Parat, L Augey, M-O Geay-Baillat, P Incagnoli, K Tazarourte
Viscoelastic technics are used for 10 years and include the ROTEM(®) and the TEG(®). These devices that exploit the viscoelastic properties of the clotting blood, allow a rapid and global analysis of the haemostatic process taking into account all the process interfering with haemostasis such as inflammation. It has been shown that the use of these technics in clinical situations such as trauma, postpartum haemorrhage, gastrointestinal bleeding or cardiac surgery may reduce the need for blood product, the cost and perhaps may improve the outcome of the patients...
September 5, 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/27554264/effects-of-non-vitamin-k-antagonist-oral-anticoagulants-on-fibrin-clot-and-whole-blood-clot-formation-integrity-and-thrombolysis-in-patients-with-atrial-fibrillation
#15
Yee Cheng Lau, Qinmei Xiong, Eduard Shantsila, Gregory Y H Lip, Andrew D Blann
Non-vitamin K antagonist oral anticoagulants (NOACs) are replacing warfarin and heparins in several clinical situations. With varying modes of action, the effects of NOACs on thrombus formation, integrity, and lysis is unknown. To determine whether two techniques of thrombelastography (TEG) and a micro-plate assay (MPA) provide novel data on thrombus formation, integrity and lysis in those taking a NOACs compared to warfarin and a control group taking aspirin. We assessed thrombogenesis, clot integrity and fibrinolysis in blood (TEG) and plasma (MPA) from 182 atrial fibrillation patients-50 on aspirin, 50 on warfarin, and 82 on a NOAC (17 apixaban, 19 dabigatran and 46 rivaroxaban)...
November 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27546530/direct-inhibitory-effects-of-carbon-monoxide-on-six-venoms-containing-fibrinogenolytic-metalloproteinases
#16
Vance G Nielsen, Philip A Losada
Since the introduction of antivenom administration over a century ago to treat venomous snake bite, it has been the most effective therapy for saving life and limb. However, this treatment is not always effective and not without potential life-threatening side effects. We tested a new paradigm to abrogate the plasmatic anticoagulant effects of fibrinogenolytic snake venom metalloproteinases by inhibiting these Zn(+2) -dependent enzymes directly with carbon monoxide exposure. Assessment of the fibrinogenolytic effects of venoms collected from the Arizona Black rattlesnake, Northern Pacific rattlesnake, Western cottonmouth, Eastern cottonmouth, Broad-banded copperhead and Southern copperhead on human plasmatic coagulation kinetics was performed with thrombelastography in vitro...
August 22, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27541720/comparison-of-thrombelastography-derived-fibrinogen-values-at-rewarming-and-following-cardiopulmonary-bypass-in-cardiac-surgery-patients
#17
Michael Fabbro, Jacob T Gutsche, Todd A Miano, John G Augoustides, Prakash A Patel
BACKGROUND: The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest is factor I (fibrinogen). Hypofibrinogenemia is typically tested for using time-consuming standard laboratory assays. The thrombelastography (TEG)-based functional fibrinogen level (FLEV) provides an assessment of whole blood clot under platelet inhibition to report calculated fibrinogen levels in significantly less time...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27492573/decreased-snake-venom-metalloproteinase-effects-via-inhibition-of-enzyme-and-modification-of-fibrinogen
#18
Vance G Nielsen, Marc A Cerruti, Olivia M Valencia, Quinlan Amos
Since the introduction of antivenom administration 120 years ago to treat venomous snake bit, it has been the gold standard for saving life and limb. However, this therapeutic approach is not always effective and not without potential life-threatening side effects. We tested a new paradigm to abrogate the plasmatic anticoagulant effects of fibrinogenolytic snake venom metalloproteinases by modification of fibrinogen with iron and carbon monoxide and by inhibiting these Zn(2+) dependent metalloproteinases directly with carbon monoxide exposure...
October 2016: Biometals: An International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine
https://www.readbyqxmd.com/read/27488540/effects-of-iron-and-carbon-monoxide-on-lachesis-muta-muta-venom-mediated-degradation-of-plasmatic-coagulation
#19
V G Nielsen, R W Matika
Hypofibrinogenemia is an important clinical consequence following envenomation by Lachesis muta muta, usually attenuated or prevented by administration of antivenom. The venom of L. m. muta contains both a metalloproteinase fibrinogenase and a serine protease thrombin-like enzyme, and exposure of fibrinogen to iron (Fe) and carbon monoxide (CO) has been demonstrated to decrease its catalysis by such enzymes. Using thrombelastographic analytical techniques, it was determined that this venom displayed weak procoagulant effects combined with fibrinogenolytic effects, and pretreatment of plasma with Fe and CO markedly attenuated venom-mediated effects...
August 3, 2016: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/27487253/thrombelastography-based-dosing-of-enoxaparin-for-thromboprophylaxis-in-trauma-and-surgical-patients-a-randomized-clinical-trial
#20
Christopher R Connelly, Philbert Y Van, Kyle D Hart, Scott G Louis, Kelly A Fair, Anfin S Erickson, Elizabeth A Rick, Erika C Simeon, Eileen M Bulger, Saman Arbabi, John B Holcomb, Laura J Moore, Martin A Schreiber
Importance: Prophylactic enoxaparin is used to prevent venous thromboembolism (VTE) in surgical and trauma patients. However, VTE remains an important source of morbidity and mortality, potentially exacerbated by antithrombin III or anti-Factor Xa deficiencies and missed enoxaparin doses. Recent data suggest that a difference in reaction time (time to initial fibrin formation) greater than 1 minute between heparinase and standard thrombelastogram (TEG) is associated with a decreased risk of VTE...
August 3, 2016: JAMA Surgery
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