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Thrombelastography

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https://www.readbyqxmd.com/read/28522144/viscoelastic-tissue-plasminogen-activator-challenge-predicts-massive-transfusion-in-15-minutes
#1
Hunter B Moore, Ernest E Moore, Michael P Chapman, Benjamin R Huebner, Peter M Einersen, Solimon Oushy, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Coagulopathy is associated with massive transfusion in trauma, yet most clinical scores to predict this end point do not incorporate coagulation assays. Previous work has identified that shock increases circulating tissue plasminogen activator (tPA). When tPA levels saturate endogenous inhibitors, systemic hyperfibrinolysis can occur. Therefore, the addition of tPA to a patient's blood sample could stratify a patients underlying degree of shock and early coagulation changes to predict progression to massive transfusion...
April 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28503123/thromboelastometry-and-thrombelastography-analysis-under-normal-physiological-conditions-systematic-review
#2
Marcel Adler, Sandra Ivic, Nicolas S Bodmer, Hugo Ten Cate, Lucas M Bachmann, Walter A Wuillemin, Michael Nagler
BACKGROUND: Studies investigating thromboelastometry or thrombelastography analyses in a physiological context are scattered and not easy to access. OBJECTIVE: To systematically retrieve and describe published reports studying healthy subjects and targeting at the correlation of ROTEM® and TEG® measurements with conventional parameters of hemostasis. METHODS: Systematic Review: Papers were searched in Medline, Scopus and the Science Citation Index database...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28500653/blood-transfusion-in-the-surgical-treatment-of-adolescent-idiopathic-scoliosis-a-single-center-experience-of-patient-blood-management-in-210-cases
#3
Søren Ohrt-Nissen, Naeem Bukhari, Casper Dragsted, Martin Gehrchen, Pär I Johansson, Jesper Dirks, Jakob Stensballe, Benny Dahl
BACKGROUND: The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. STUDY DESIGN AND METHODS: Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28500652/freeze-dried-plasma-enhances-clot-formation-and-inhibits-fibrinolysis-in-the-presence-of-tissue-plasminogen-activator-similar-to-pooled-liquid-plasma
#4
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Angela Sauaia, Gregory Stettler, Monika Dzieciatkowska, Kirk Hansen, Anirban Banerjee, Christopher C Silliman
BACKGROUND: Systemic hyperfibrinolysis is an integral part of trauma-induced coagulopathy associated with uncontrolled bleeding. Recent data suggest that plasma-first resuscitation attenuates hyperfibrinolysis; however, the availability, transport, storage, and administration of plasma in austere environments remain challenging and have limited its use. Freeze-dried plasma (FDP) is a potential alternative due to ease of storage, longer shelf life, and efficient reconstitution. FDP potentially enhances clot formation and resists breakdown better than normal saline (NS) and albumin and similar to liquid plasma...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28372957/hypercoagulability-after-distal-pancreatectomy-just-meaningless-alterations
#5
Matthias Hassenpflug, Christin Tjaden, Ulf Hinz, Johanna Volpert, Thilo Hackert, Markus W Büchler, Jens Werner
BACKGROUND: Perioperative and short-term postoperative parameters are similar comparing spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS). But there are no sound data evaluating the long term risk of postoperative thromboses and infectious complications after splenectomy. The present study evaluated whether the coagulation status differs in patients after SPDP and DPS, and whether that matters clinically. METHODS: A total of 41 patients after DP (SPDP = 20; DPS = 21) were followed up, focusing on alterations of patient coagulation and immune status...
March 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28277060/thrombelastographic-hypercoagulability-and-antiplatelet-therapy-after-coronary-artery-bypass-surgery-teg-cabg-trial-a-randomized-controlled-trial
#6
Sulman Rafiq, Pär I Johansson, Klaus F Kofoed, Jens T Lund, Peter S Olsen, Simon Bentsen, Daniel A Steinbrüchel
A hypercoagulable state has, in observational studies, been associated with increased risk of thromboembolic events. The aim of this trial was to study whether dual antiplatelet therapy (DAPT) with clopidogrel in addition to aspirin could reduce the rate of graft occlusions, thromboembolic events, and death compared to aspirin monotherapy in hypercoagulable patients undergoing coronary artery bypass surgery. A total of 1683 patients were screened for eligibility, among which 165 patients were randomized and 133 patients underwent multislice computed tomography scan to evaluate their grafts...
February 22, 2017: Platelets
https://www.readbyqxmd.com/read/28247290/determination-of-non-vitamin-k-oral-anticoagulant-noac-effects-using-a-new-generation-thrombelastography-teg-6s-system
#7
Kevin P Bliden, Rahul Chaudhary, Nafees Mohammed, Adina A Muresan, Carlos G Lopez-Espina, Eli Cohen, Gabriel Raviv, Marc Doubleday, Fowzia Zaman, Blessy Mathew, Udaya S Tantry, Paul A Gurbel
Non vitamin K oral anticoagulants (NOACs) do not require regular monitoring but information about their pharmacodynamic effect may be importantin situations like trauma, stroke oremergent surgery. Currently, no standardized point-of-care test is available to evaluate the anticoagulant effects of NOACs. We evaluated the anticoagulant effect of NOACs with the next generation point-of-care TEG assay (TEG® 6S) based on a fully-automated thrombelastography system. We used two TEG® 6S assays, the DTI assay and Anti-Factor Xa (AFXa) assay, to detect anticoagulant effects and classify NOACs...
May 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28240645/point-of-care-monitoring-for-the-management-of-trauma-induced-bleeding
#8
REVIEW
Alexander A Hanke, Hauke Horstmann, Michaela Wilhelmi
PURPOSE OF REVIEW: Knowledge of trauma-induced coagulopathy has been grown in the past and point-of-care suitable devices for coagulation testing have been introduced. Methodology and clinical application of different systems for point-of-care coagulation monitoring are shown with a focus on thrombelastography as measured by TEG, rotational thromboelastometry as measured by ROTEM and impedance aggregometry as measured by the multiplate analyser and ROTEM platelet. RECENT FINDINGS: Two different methods for point-of-care coagulation assessment are available: viscoelastic tests (ROTEM, TEG) and impedance aggregometry...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28230634/platelet-dysfunction-in-critically-ill-patients
#9
Travis Hase, Sarah Sirajuddin, Patrick Maluso, Raksha Bangalore, Louis DePalma, Babak Sarani
Thrombelastography Platelet Mapping (TEG-PM) allows for measurement of maximal potential clot strength (MA) and strength from stimulation of arachidonic acid (MA-AA) and adenosine disphosphate (MA-ADP) receptors. This study was conducted to assess degree of platelet dysfunction in critically ill adult patients. A retrospective study of critically ill, adult, nontrauma patients in a medical/surgical ICU was conducted from August 2013 to September 2014. All patients who underwent TEG-PM were enrolled. Patients with intracerebral hemorrhage, following cardiac surgery, or without an APACHE II score were excluded...
February 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28176468/correlation-of-pre-operative-plasma-protein-concentrations-in-cardiac-surgery-patients-with-bleeding-outcomes-using-a-targeted-quantitative-proteomics-approach
#10
Nathan Clendenen, Ashley Tollefson, Monika Dzieciatkowska, Alice Cambiaghi, Manuela Ferrario, Miranda Kroehl, Anirban Banerjee, Angelo D'Alessandro, Kirk C Hansen, Nathaen Weitzel
PURPOSE: Despite recent advancements in the use of thrombelastography (TEG) in the surgical setting, adequate technology to accurately predict bleeding phenotypes for patients undergoing cardiopulmonary bypass on the basis of non-mechanical parameters is lacking. While basic science and translational studies have provided key mechanistic insights about the protein components of coagulation cascades and regulatory mediators of hemostasis and fibrinolysis, targeted protein assays are still missing and the association of protein profiles to bleeding phenotypes and TEG readouts have yet to be discovered...
February 8, 2017: Proteomics. Clinical Applications
https://www.readbyqxmd.com/read/28131925/prevalence-and-impact-of-admission-acute-traumatic-coagulopathy-on-treatment-intensity-resource-use-and-mortality-an-evaluation-of-956-severely-injured-children-and-adolescents
#11
Ioannis N Liras, Henry W Caplan, Jakob Stensballe, Charles E Wade, Charles S Cox, Bryan A Cotton
BACKGROUND: Acute coagulopathy of trauma in children is of potential importance to clinical outcomes, but knowledge is limited and has only been investigated using conventional coagulation testing. The purpose of this study was to assess the prevalence and impact of arrival coagulopathy, determined by viscoelastic hemostatic testing, in severely injured children. STUDY DESIGN: Pediatric patients (younger than 17 years of age) who were admitted January 2010 to May 2016 and met highest-level trauma activation were included...
April 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28053389/is-pre-operative-assessment-of-coagulation-profile-with-thrombelastography-teg-useful-in-predicting-venous-thromboembolism-vte-following-orthopaedic-surgery
#12
Apurve Parameswaran, Vignesh P Krishnamoorthy, Anil T Oommen, Anita Jasper, Ravi J Korula, Sukesh C Nair, Pradeep M Poonnoose
INTRODUCTION: Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication. METHODS: The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27938373/pre-hospital-transfusion-of-plasma-in-hemorrhaging-trauma-patients-independently-improves-hemostatic-competence-and-acidosis
#13
Hanne H Henriksen, Elaheh Rahbar, Lisa A Baer, John B Holcomb, Bryan A Cotton, Jacob Steinmetz, Sisse R Ostrowski, Jakob Stensballe, Pär I Johansson, Charles E Wade
BACKGROUND: The early use of blood products has been associated with improved patient outcomes following severe hemorrhage or traumatic injury. We aimed to investigate the influence of pre-hospital blood products (i.e. plasma and/or RBCs) on admission hemostatic properties and patient outcomes. We hypothesized that pre-hospital plasma would improve hemostatic function as evaluated by rapid thrombelastography (rTEG). METHODS: We conducted a prospective observational study recruiting 257 trauma patients admitted to a Level I trauma center having received either blood products pre-hospital or in-hospital within 6 hours of admission...
December 9, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27928886/f376a-m388a-solulin-a-new-promising-antifibrinolytic-for-severe-haemophilia-a
#14
J Parcq, K U Petersen, A Borel-Derlon, P Gautier, M Ebel, D Vivien, Y Repessé
INTRODUCTION: Haemophilia is a major bleeding disorder due to a deficiency of procoagulant factor VIII (type A) or IX (type B). The treatment is substitutive and based on infusion of factor concentrates. Main limitations of this therapy are cost, short factor half-life and the development of inhibitors (up to 30% of severe HA patients). An important aggravating factor of haemophilia is due to a premature fibrinolysis, directing attention to the therapeutic potential of suitable antifibrinolytics...
March 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27926661/the-effect-of-intraoperative-and-6-h-postoperative-intravenous-administration-of-low-dose-prostacyclin-on-the-endothelium-hemostasis-and-hemodynamics-in-patients-undergoing-a-pancreaticoduodenoctemy-a-randomized-controlled-pilot-study
#15
Pär I Johansson, Christian R Mortensen, Tatiana Nielsen, Carsten Tollund, Jakob Stensballe, Carsten P Hansen, Hans J Frederiksen, Sisse R Ostrowski
BACKGROUND: Capillary leakage, secondary to endothelial breakdown, is common in patients undergoing major surgical procedures with extensive tissue injury and this is associated with increased morbidity and mortality. Prostacyclin has been ascribed cytoprotective properties together with its vasodilatory and antiplatelet effects. The present pilot study investigated the safety and endothelial protective effects of low-dose prostacyclin infusion. PATIENTS AND METHODS: A randomized placebo-controlled pilot study evaluating the effect of prostacyclin (iloprost) infusion (1...
April 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27916047/-the-impact-of-different-doses-of-atorvastatin-on-plasma-endothelin-and-platelet-function-in-acute-st-segment-elevation-myocardial-infarction-after-emergency-percutaneous-coronary-intervention
#16
X R Xu, K B Li, P Wang, L Xu, Y Liu, Z S Yang, X C Yang
Objective: To investigate the effects of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction (STEMI) patients after emergency percutaneous coronary intervention(PCI). Methods: A total of 120 patients with acute STEMI treated with emergency PCI were enrolled and randomly divided into 20 mg of atorvastatin treatment group (standard group, n=60), and 40 mg of atorvastatin treatment group (intensive group, n=60). The blood C reactive protein (CRP), blood lipid profiles, plasma endothelin (ET) were measured before atorvastatin treatment and after 7 days of treatment, respectively...
December 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27897027/-acute-uterine-inversion-after-delivery
#17
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
#18
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
#19
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
#20
MULTICENTER STUDY
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
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