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Hugo Maas, Savion Gropper, Fenglei Huang, Joachim Stangier, Igor Tartakovsky, Martina Brueckmann, Jacqueline M L Halton, Lesley G Mitchell
BACKGROUND:  Physiological age-related changes in the haemostatic and coagulation systems result in differing anticoagulant assay responses to standard anticoagulants. Therefore, we investigated the response of anticoagulant assays to dabigatran etexilate (DE) in children compared with adults. OBJECTIVE:  This article assesses the relationship between plasma dabigatran concentration and coagulation assay results across age groups in children and adults. PATIENTS AND METHODS:  Data from three clinical trials in which children received DE following standard of care for venous thromboembolism were compared with data from adult clinical trials...
August 15, 2018: Thrombosis and Haemostasis
Thomas Martens, Martin Kostolny, Helen Spencer, Nagarajan Muthialu
Pulmonary arterial hypertension after arterial switch operation for transposition of the great arteries is rare. Lung transplantation can be the last option in cases of failed medical therapy. We report 2 paediatric patients who underwent lung transplantation for this indication. Altered hilar anatomy, mediastinal adhesions and haemostatic control represent the main technical challenges. Volume-reduction surgery is sometimes necessary to address altered cardiopulmonary relationships while expanding the donor pool...
August 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Roberta Troìa, Giulia Mascalzoni, Stefano Calipa, Ilaria Magagnoli, Francesco Dondi, Massimo Giunti
Objectives The current study was designed to evaluate the prevalence and prognostic significance of multi-organ dysfunction syndrome (MODS) in cats with sepsis. Methods Cats hospitalised in the intensive care unit of a veterinary university hospital with a diagnosis of sepsis were prospectively enrolled and divided according to disease severity and outcome (survivors; non-survivors). The feline acute patient physiological and laboratory evaluation (APPLE) scores were calculated upon admission, as previously described...
August 13, 2018: Journal of Feline Medicine and Surgery
Alice P Sowton, Sarah L Millington-Burgess, Andrew J Murray, Matthew T Harper
Platelet activation plays a key role in normal haemostasis and pathological thrombosis. Platelet activation is rapid; within minutes of stimulation, platelets generate bioactive phospholipids, secrete their granule contents, activate integrins and aggregate together to form a haemostatic plug. These events are dependent on ATP synthesis. Mitochondrial function in platelets from healthy volunteers and patients with a range of diseases indicate an important role for oxygen consumption in oxidative phosphorylation in normal and pathological function...
August 6, 2018: Biochemical and Biophysical Research Communications
Patience A Akpan, Josephine O Akpotuzor, Eme E Osim
Tuberculosis (TB) is an infectious disease inducing a state of chronic inflammation which could affect thehaemostatic mechanism as part of host defences against infection. Proper diagnosis and monitoring of tuberculosis patientsundergoing therapy is still a challenge especially in a poor resource country such as Nigeria. This study aims to assess somehaemostatic indices of tuberculosis patients and their possible use as markers in monitoring response to anti-tuberculosistreatment. One hundred and twenty TB patients aged 15-60 years and 120 apparently healthy (control) subjects age andgender-matched were studied...
June 30, 2018: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
Susan A Maroney, Julie A Peterson, Wes Zwifelhofer, Nicholas D Martinez, Ke Yan, Rachel S Bercovitz, Ronald K Woods, Alan E Mast
BACKGROUND:  Neonates undergoing cardiopulmonary bypass (CPB) surgery to correct congenital heart defects often experience excessive bleeding. Exposure of blood to artificial materials during CPB may activate coagulation, complement and inflammatory pathways. In addition, the surgical stress placed on the haemostatic system may result in cross-activation of other plasma proteolytic cascades, which could further complicate physiological responses to the surgical procedure and post-operative recovery...
August 7, 2018: Thrombosis and Haemostasis
Divyansh Gulati, Alex Novak, Simon J Stanworth
Haemostatic abnormalities are common in the critically ill or bleeding patient, including haemorrhage-related coagulopathies, disseminated intravascular coagulation and thrombocytopenia, among other pathologies. In this article we aim to outline some of the causes of these clotting abnormalities, highlighting recent advancements in knowledge and new insights into their clinical management, with the aim of optimising diagnostic and therapeutic strategies.
August 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Gethin Boyle, Agnieszka Kuffel, Kiran Parmar, Kirsty Gibson, Megan Smith, Aidan Grehan, Beverley J Hunt, David J Chambers
BACKGROUND: Cardiac surgery using cardiopulmonary bypass (CPB) is associated with a coagulopathy due to haemodilution, thrombocytopenia and platelet dysfunction and the activation of coagulation and fibrinolysis, despite the use of large doses of unfractionated heparin. Conventional red cell salvage may exacerbate post-operative bleeding as plasma containing haemostatic factors is discarded. We hypothesized that a novel cell salvage device (HemoSep) may attenuate haemostatic changes associated with red cell salvage...
August 1, 2018: Perfusion
Sonal Srivastava, Reeta Mahey, Garima Kachhawa, Neerja Bhatla, Ashish Datt Upadhyay, Alka Kriplani
OBJECTIVE: To compare the efficacy and safety of intramyometrial vasopressin plus rectal misoprostol with intramyometrial vasopressin alone to reduce blood loss during laparoscopic myomectomy. STUDY DESIGN: A randomized, single-blind, controlled trial was conducted at All India Institute of Medical Sciences, New Delhi, India. Sixty women with symptomatic leiomyoma scheduled for laparoscopic myomectomy were recruited for the study. Thirty women received intramyometrial vasopressin plus rectal misoprostol (30 min before procedure) (Group I) and 30 women received intramyometrial vasopressin alone (Group II) during laparoscopic myomectomy...
July 5, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
L Torkildsen, M A Bishop, J W Barr, M B Pashmakova
OBJECTIVES: To compare thawing times of fresh frozen canine plasma between a 37 °C warm water bath, running water bath and dry plasma thawer and compare haemostatic protein stability after thawing in a warm water bath or dry plasma thawer. MATERIALS AND METHODS: To measure thawing times, a 240-mL bag of frozen plasma was thawed in warm water bath, running water bath or dry plasma thawer-10 times for each method. To evaluate stability of haemostatic proteins, fresh canine donor plasma samples were split into 120-mL bags and 3-mL control aliquots before freezing...
July 26, 2018: Journal of Small Animal Practice
Marjolein P A Brekelmans, Rahat A Abdoellakhan, Luuk J J Scheres, Joseph S Biedermann, Barbara A Hutten, Karina Meijer, Hugo Ten Cate, Menno V Huisman, Marieke J H A Kruip, Saskia Middeldorp, Michiel Coppens
<AbstractText Label="Background" NlmCategory="UNASSIGNED">Vitamin K antagonists (VKA) are used for the treatment of thromboembolism. Patients with severe VKA-associated bleeding require immediate restoration of haemostasis. Clinical studies on the effect of prothrombin complex concentrate (PCC) are heterogeneous with respect to outcome of bleeding. Objective: To evaluate the clinical outcome of patients treated with PCC for VKA-associated bleeding. Methods: We performed a cohort study of consecutive patients who received PCC for VKA-related bleeding in five Dutch hospitals...
January 2018: Research and practice in thrombosis and haemostasis
Andrew D Mumford, Jessica Harris, Zoe Plummer, Kurtis Lee, Veerle Verheyden, Barnaby C Reeves, Chris A Rogers, Gianni D Angelini, Gavin J Murphy
<AbstractText Label="Background" NlmCategory="UNASSIGNED">Coagulopathic bleeding is common after cardiac surgery and is associated with increased morbidity, mortality and healthcare costs. Implementation of blood management algorithms in which patients with severe bleeding undergo near-patient coagulation testing results in less overall bleeding and transfusion. However, it is unknown whether there is additional value from pre-emptive near-patient testing to predict whether severe bleeding will occur...
October 2017: Research and Practice in Thrombosis and Haemostasis
E K Zadow, M J Adams, S S X Wu, C M Kitic, I Singh, A Kundur, N Bost, A N B Johnston, J Crilly, A C Bulmer, S L Halson, J W Fell
PURPOSE: Compression socks are frequently used in the treatment and prevention of lower-limb pathologies; however, when combined with endurance-based exercise, the impact of compression socks on haemostatic activation remains unclear. OBJECTIVES: To investigate the effect of wearing compression socks on coagulation and fibrinolysis following a marathon. METHODS: Sixty-seven participants [43 males (mean ± SD: age: 46.7 ± 10.3 year) and 24 females (age: 40...
July 24, 2018: European Journal of Applied Physiology
Clémence Merlen, Nichan Zourikian, Arnaud Bonnefoy, Evemie Dubé, Catherine Thibeault, Jean St-Louis, Georges-Etienne Rivard
: The primary objective was to assess the effect of ABO blood group on von Willebrand factor (VWF) rise induced by four bouts of moderate-intensity physical activity, on pharmacokinetics of a B-domain-deleted recombinant FVIII (BDD-rFVIII), and haemostatic parameters in severe haemophilia A patients with a null mutation. The secondary objective was to compare the response to exercise according to infused product type in a subgroup of patients who previously participated to the same exercise protocol, while treated with a full length recombinant FVIII (FL-rFVIII)...
July 19, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Steve Kitchen, Ulrich Geisen, Janos Kappelmayer, Peter Quehenberger, Anna Lowe, Robert Jones, Gabrielle Miles, Jana G Boehm, Gergely Rozsnyai
INTRODUCTION: New laboratory methods to measure haemostatic function require careful assessment before routine use. We evaluated the analytical performance of four new coagulation assays for the measurement of fibrinogen by Clauss assay, prothrombin time-derived fibrinogen, thrombin time and D-dimer levels. METHODS: The four assays were evaluated on the cobas t 711 and cobas t 511 analysers at four centres in Europe. Analytical performance and method comparisons with other commercially available assays were performed according to Clinical and Laboratory Standards Institute guidelines (EP09-A3, EP05-A3) using residual anonymized human sodium citrate (3...
July 22, 2018: International Journal of Laboratory Hematology
Hunter B Moore, Ernest E Moore, Michael P Chapman, Kevin McVaney, Gary Bryskiewicz, Robert Blechar, Theresa Chin, Clay Cothren Burlew, Fredric Pieracci, F Bernadette West, Courtney D Fleming, Arsen Ghasabyan, James Chandler, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Plasma is integral to haemostatic resuscitation after injury, but the timing of administration remains controversial. Anticipating approval of lyophilised plasma by the US Food and Drug Administration, the US Department of Defense funded trials of prehospital plasma resuscitation. We investigated use of prehospital plasma during rapid ground rescue of patients with haemorrhagic shock before arrival at an urban level 1 trauma centre. METHODS: The Control of Major Bleeding After Trauma Trial was a pragmatic, randomised, single-centre trial done at the Denver Health Medical Center (DHMC), which houses the paramedic division for Denver city...
July 28, 2018: Lancet
Adrienne Lee, Man-Chiu Poon
Platelets are a critical component for effecting hemostasis and wound healing. Disorders affecting any platelet pathway mediating adhesion, activation, aggregation and procoagulant surface exposure can result in a bleeding diathesis. Specific diagnosis even with advanced techniques which are unavailable to most centers is often difficult. Inherited platelet function disorders therefore represent a heterogeneous and complex collection of disorders with a spectrum of bleeding severity, from relatively mild (and easily missed or misdiagnosed) to severe bleeding phenotype with salient diagnostic features...
July 19, 2018: Transfusion and Apheresis Science
Paul Monagle
Since Maureen Andrew began systematically describing thrombosis in children in 1994, there has been surprisingly slow process in advancing our knowledge in terms of diagnosis, prevention and treatment of thrombosis in children. There are a variety of reasons for this slow progress. Overwhelmingly the low incidence of thrombosis in children has been a major barrier. Second, the developmental, age related, changes in haemostasis mean that the physiology of haemostasis in children, and the interaction of the haemostatic system with anticoagulant drugs is constantly changing...
July 14, 2018: Thrombosis Research
Gertrude J Nieuwenhuijs-Moeke, Tamar A J van den Berg, Stephan J L Bakker, Marius C van den Heuvel, Michel M R F Struys, Ton Lisman, Robert A Pol
To prevent renal graft thrombosis in kidney transplantation, centres use different perioperative anticoagulant strategies, based on various risk factors. In our centre, patients transplanted preemptively are considered at increased risk of renal graft thrombosis compared to patients who are dialysis-dependent at time of transplantation. Therefore these patients are given a single dose of 5000 IU unfractionated heparin intraoperatively before clamping of the vessels. We questioned whether there is a difference in haemostatic state between preemptively and non-preemptively transplanted patients and whether the distinction in intraoperative heparin administration used in our center is justified...
2018: PloS One
Jan Pluta, Barbara Nicińska, Michał Ciurzyński, Janusz Trzebicki
BACKGROUND: Platelets are responsible for primary haemostasis. Patients with suspected platelet dysfunction require prompt clinical assessment when qualifying for emergency surgical procedures. The purpose of this article is to present our experience in platelet function assessment using whole-blood multiple electrode aggregometry (MEA) in various clinical conditions. CASE REPORTS: Retrospective analysis of three patients with thrombocytopathy associated with normal platelet counts was performed using standard laboratory tests complemented by MEA...
July 16, 2018: Anaesthesiology Intensive Therapy
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