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Thrombelastography

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https://www.readbyqxmd.com/read/29341793/platelet-transfusion-does-not-improve-outcomes-in-patients-with-brain-injury-on-antiplatelet-therapy
#1
Jeremy L Holzmacher, Cassandra Reynolds, Mayur Patel, Patrick Maluso, Seth Holland, Nathaniel Gamsky, Henry Moore, Elizabeth Acquista, Matthew Carrick, Richard Amdur, Heather Hancock, Michael Metzler, Julie Dunn, Babak Sarani
INTRODUCTION: Platelet dysfunction following traumatic brain injury (TBI) is associated with worse outcomes. The efficacy of platelet transfusion to reverse antiplatelet medication (APM) remains unknown. Thrombelastography platelet mapping (TEG-PM) assesses platelet function. We hypothesize that platelet transfusion can reverse the effects of APM but does not improve outcomes following TBI. METHODS: An observational study at six US trauma centres was performed. Adult patients on APM with CT evident TBI after blunt injury were enrolled...
January 17, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29304563/the-anticoagulant-effect-of-therapeutic-levels-of-dabigatran-in-atrial-fibrillation-evaluated-by-thrombelastography-teg%C3%A2-hemoclot-thrombin-inhibitor-hti-assay-and-ecarin-clotting-time-ect
#2
Sacha Solbeck, Annette Schophuus Jensen, Christian Maschmann, Jakob Stensballe, Sisse Rye Ostrowski, Pär I Johansson
Monitoring the effect of dabigatran (Pradaxa®) is challenging. The aim of this study was to evaluate if thrombelastography reaction time (TEG® R) could detect the anticoagulant effect of dabigatran showing a correlation between TEG® R, Hemoclot Thrombin Inhibitor (HTI) assay and Ecarin Clotting Time (ECT) in patients with non-valvular atrial fibrillation (NVAF). Blood samples from 35 AF patients receiving either 110 mg (n 19) or 150 mg (n 16) dabigatran twice daily were analyzed with TEG®, HTI and ECT 2-3 h after dabigatran intake...
January 5, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29302119/teg-directed-transfusion-in-complex-cardiac-surgery-impact-on-blood-product-usage
#3
Kevin Fleming, Roberta E Redfern, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29289392/abnormalities-of-laboratory-coagulation-tests-versus-clinically-evident-coagulopathic-bleeding-results-from-the-prehospital-resuscitation-on-helicopters-study-prohs
#4
Ronald Chang, Erin E Fox, Thomas J Greene, Michael D Swartz, Stacia M DeSantis, Deborah M Stein, Eileen M Bulger, Sherry M Melton, Michael D Goodman, Martin A Schreiber, Martin D Zielinski, Terence O'Keeffe, Kenji Inaba, Jeffrey S Tomasek, Jeanette M Podbielski, Savitri Appana, Misung Yi, Pär I Johansson, Hanne H Henriksen, Jakob Stensballe, Jacob Steinmetz, Charles E Wade, John B Holcomb
BACKGROUND: Laboratory-based evidence of coagulopathy (LC) is observed in 25-35% of trauma patients, but clinically-evident coagulopathy (CC) is not well described. METHODS: Prospective observational study of adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers in 2015. Patients meeting predefined highest-risk criteria were divided into CC+ (predefined as surgeon-confirmed bleeding from uninjured sites or injured sites not controllable by sutures) or CC-...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29280928/thrombin-provokes-degranulation-of-platelet-%C3%AE-granules-leading-to-the-release-of-active-plasminogen-activator-inhibitor-1-pai-1
#5
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Gregory R Stettler, Geoffrey R Nunns, Peter Lawson, Angela Sauaia, Marguerite Kelher, Anirban Banerjee, Christopher C Silliman
BACKGROUND: The balance of fibrinolytic mediators is crucial to the survival of the critically ill patient, with tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) playing significant roles. While elevated levels of PAI-1 are associated with increased morbidity and mortality, the source of this PAI-1 remains elusive. Platelets contain 90% of circulating plasma PAI-1, however, their ability to release active PAI-1 is controversial. We hypothesize platelets contain active PAI-1 in α-granules capable of immediate degranulation when exposed to high concentrations of thrombin...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29276028/evaluation-for-effects-of-severe-acidosis-on-hemostasis-in-trauma-patients-using-thrombelastography-analyzer
#6
Xin Lv, Yong Mao, Zonghe Qin
OBJECTIVE: To investigate effects of metabolic acidosis on hemostasis function in trauma patients using thromboelastography analyzer. METHODS: 65 critically injured patients and 19 healthy volunteers were enrolled in the study. Three samples of whole blood were collected from each patient or healthy volunteer. These three samples were acidified with 50mmol/l phosphate-buffered saline (PBS) (pH5.8) or a neutral buffer (50mmol/l phosphate, pH7.4) and acidified blood sample with target pH of 6...
December 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29243334/effects-of-a-targeted-blood-management-programme-on-allogeneic-blood-transfusion-in-abdominal-aortic-aneurysm-surgery
#7
M D Stoneham, S Von Kier, L Harvey, M Murphy
OBJECTIVES: To investigate the impact of a dedicated cell salvage practitioner team on blood loss and allogeneic transfusion in abdominal aortic aneurysm (AAA) surgery. BACKGROUND: Cell salvage reduces allogeneic transfusion in AAA surgery, but is commonly performed by the anaesthetic nurse. At our hospital, a dedicated patient blood management practitioner is present for all elective open AAA repairs. METHODS/MATERIALS: Data were collected on 171 AAA patients operated on at the John Radcliffe Hospital, Oxford over a 3-year period, looking at the Patient Blood Management processes, including: blood loss, cell salvage, near-patient testing (thrombelastography) and transfusion rates of allogeneic blood products...
December 15, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29227173/changes-in-platelet-function-with-inflammation-in-patients-undergoing-vascular-surgery
#8
Bartosz Olechowski, Vikram Khanna, Mark Mariathas, Alexander Ashby, Richard T Dalton, Ian Nordon, Nicola Englyst, Scott Harris, Zoe Nicholas, Kala Thayalasamy, Michael Mahmoudi, Nick Curzen
The role of platelets in ischaemic events is well established. Aspirin represents the default antiplatelet and blocks the metabolism of arachidonic acid (AA) at the cyclo-oxygenase enzyme (COX). AA is commonly used as a test of response to aspirin, but recent data raise uncertainty about the validity of this approach. Specifically, in some patients AA-induced clotting is not suppressed, but the level of COX-dependent AA metabolite, thromboxane B2 (TXB2) is negligible. Furthermore, AA-induced whole blood clotting varies dynamically in individuals, who are aspirin responsive according to TXB2 levels...
December 11, 2017: Platelets
https://www.readbyqxmd.com/read/29196248/coagulation-factor-hyperfunction-after-subarachnoid-hemorrhage-induces-deep-venous-thrombosis
#9
Wang Miao, Ke Zhao, Wenjing Deng, Junfang Teng
OBJECT: To explore the change of coagulation function and associated potential mechanism, the relationship between coagulation disorders and deep venous thrombosis (DVT) after subarachnoid hemorrhage (SAH) within 3 days of onset. METHODS: 150 SAH patients within 3 days of onset and 100 healthy subjects were recruited. Thrombelastography (TEG) analysis and traditional lab tests were performed. Tissue factor (TF), tissue factor pathway inhibitor (TFPI) and activated protein C (APC) were tested by using ELISA kits...
November 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29188749/bleeding-during-veno-venous-ecmo-cannot-reliably-be-predicted-by-rotational-thrombelastometry-rotem%C3%A2
#10
Christina Hellmann, Axel Schmutz, Johannes Kalbhenn
INTRODUCTION: Veno-venous extracorporeal membrane oxygenation (vvECMO) used for respiratory support is associated with clinical bleeding in at least one third of patients. Mechanisms promoting bleeding, like acquired von Willebrand syndrome, cannot be identified by routine coagulation tests. This study was performed to evaluate rotational Thrombelastography (ROTEM™) for specific results predicting bleeding events during vvECMO. METHODS: Five hundred and thirty-four ROTEM™ analyses of 57 patients over 574 days have been evaluated...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29187198/preliminary-reference-intervals-and-the-impact-of-citrate-storage-time-for-thrombelastography-in-cats-including-delta-and-the-velocity-curve
#11
Carolin Engelen, Andreas Moritz, Franziska Barthel, Natali Bauer
BACKGROUND: Thrombelastography is a useful tool in assessment of hemostasis. Beside the traditional variables, the velocity curve and the variable delta have lately earned attention. The velocity curve provides knowledge about the speed of clot formation including information about thrombin generation. Delta, which only reflects enzymatic coagulation, allows the determination of the origin of hypercoagulability when compared to clot rigidity, a variable that reflects both platelet and enzymatic activity...
November 29, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29180179/preoperative-thrombelastography-maximum-amplitude-predicts-massive-transfusion-in-liver-transplantation
#12
Peter J Lawson, Hunter B Moore, Ernest E Moore, Gregory R Stettler, Thomas J Pshak, Igal Kam, Christopher C Silliman, Trevor L Nydam
BACKGROUND: Massive transfusion (MT) is frequently required during liver transplantation. Risk stratification of transplant patients at risk for MT is an appealing concept but remains poorly developed. Thrombelastography (TEG) has recently been shown to reduce mortality when used for trauma resuscitation. We hypothesize that preoperative TEG can be used to risk stratify patients for MT. MATERIAL AND METHODS: Liver transplant patients had blood drawn before surgical incision and assayed via TEG...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29175655/thrombogenicity-and-central-pulse-pressure-to-enhance-prediction-of-ischemic-event-occurrence-in-patients-with-established-coronary-artery-disease-the-magma-ischemia-score
#13
Kevin P Bliden, Rahul Chaudhary, Eliano P Navarese, Tushar Sharma, Himabindu Kaza, Udaya S Tantry, Paul A Gurbel
BACKGROUND AND AIMS: Conventional cardiovascular risk estimators based on clinical demographics have limited prediction of coronary events. Markers for thrombogenicity and vascular function have not been explored in risk estimation of high-risk patients with coronary artery disease. We aimed to develop a clinical and biomarker score to predict 3-year adverse cardiovascular events. METHODS: Four hundred eleven patients, with ejection fraction ≥40% undergoing coronary angiography, and found to have a luminal diameter stenosis ≥50%, were included in the analysis...
January 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29170850/carbon-monoxide-inhibits-hemotoxic-activity-of-elapidae-venoms-potential-role-of-heme
#14
Vance G Nielsen, Nathaniel Frank, Ryan W Matika
Envenomation by hemotoxic enzymes continues to be a major cause of morbidity and mortality throughout the world. With regard to treatment, the gold standard to abrogate coagulopathy caused by these venoms is still the administration of antivenom; however, despite antivenom therapy, coagulopathy still occurs and recurs. Of interest, this laboratory has demonstrated in vitro and in vivo that coagulopathy inducing venom derived from snakes of the family Viperidae exposed to carbon monoxide (CO) is inhibited, potentially by an attached heme...
November 23, 2017: Biometals: An International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine
https://www.readbyqxmd.com/read/29112094/thrombelastography-early-amplitudes-in-bleeding-and-coagulopathic-trauma-patients-results-from-a-multicenter-study
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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