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Antifibrinolytic

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https://www.readbyqxmd.com/read/29215478/tranexamic-acid-for-lower-gi-hemorrhage-a-randomized-placebo-controlled-clinical-trial
#1
Stephen R Smith, David Murray, Peter G Pockney, Cino Bendinelli, Brian D Draganic, Rosemary Carroll
BACKGROUND: Lower GI hemorrhage is a common source of morbidity and mortality. Tranexamic acid is an antifibrinolytic that has been shown to reduce blood loss in a variety of clinical conditions. Information regarding the use of tranexamic acid in treating lower GI hemorrhage is lacking. OBJECTIVE: The aim of this trial was to determine the clinical efficacy of tranexamic acid when used for lower GI hemorrhage. DESIGN: This was a prospective, double-blind, placebo-controlled, randomized clinical trial...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29200009/antifibrinolytic-therapy-and-perioperative-considerations
#2
Jerrold H Levy, Andreas Koster, Quintin J Quinones, Truman J Milling, Nigel S Key
Fibrinolysis is a physiologic component of hemostasis that functions to limit clot formation. However, after trauma or surgery, excessive fibrinolysis may contribute to coagulopathy, bleeding, and inflammatory responses. Antifibrinolytic agents are increasingly used to reduce bleeding, allogeneic blood administration, and adverse clinical outcomes. Tranexamic acid is the agent most extensively studied and used in most countries. This review will explore the role of fibrinolysis as a pathologic mechanism, review the different pharmacologic agents used to inhibit fibrinolysis, and focus on the role of tranexamic acid as a therapeutic agent to reduce bleeding in patients after surgery and trauma...
December 4, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29194929/procarboxypeptidase-u-procpu-tafi-procpb2-in-cerebrospinal-fluid-during-ischemic-stroke-is-associated-with-stroke-progression-outcome-and-blood-brain-barrier-dysfunction
#3
Joachim C Mertens, Dorien Leenaerts, Raf Brouns, Sebastiaan Engelborghs, Margareta Ieven, Peter P De Deyn, Anne-Marie Lambeir, Dirk Hendriks
BACKGROUND: Procarboxypeptidase U (proCPU, TAFI, proCPB2), the zymogen of CPU which is a potent antifibrinolytic enzyme and a modulator of inflammation has previously been investigated in plasma of stroke patients, but so far, no information on the proCPU levels in cerebrospinal fluid (CSF) during acute ischemic stroke (AIS) is available. OBJECTIVES: This case-control observational study investigates proCPU in CSF of AIS patients compared with controls with an intact blood-brain barrier (BBB) and evaluates the relationship of CSF/plasma proCPU ratios with stroke parameters...
December 1, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29193211/is-tranexamic-acid-exposure-related-to-blood-loss-in-hip-arthroplasty-a-pharmacokinetic-pharmacodynamic-study
#4
Julien Lanoiselée, Paul J Zufferey, Edouard Ollier, Sophie Hodin, Xavier Delavenne
AIMS: Tranexamic acid (TXA) is an antifibrinolytic agent, decreasing blood loss in hip arthroplasty. The present study investigated the relationship between TXA exposure markers, including the time above the in vitro threshold reported for inhibition of fibrinolysis (10 mg l-1 ), and perioperative blood loss. METHODS: Data were obtained from a prospective, double-blind, parallel-arm, randomized superiority study in hip arthroplasty. Patients received a preoperative intravenous bolus of TXA 1 g followed by a continuous infusion of either TXA 1 g or placebo over 8 h...
October 26, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29189637/strategies-for-prevention-and-management-of-bleeding-following-pediatric-cardiac-surgery-on-cardiopulmonary-bypass-a-scoping-review
#5
Kristina Siemens, Dilanee P Sangaran, Beverley J Hunt, Ian A Murdoch, Shane M Tibby
OBJECTIVE: We aimed to systematically describe, via a scoping review, the literature reporting strategies for prevention and management of mediastinal bleeding post pediatric cardiopulmonary bypass surgery. DATA SOURCES: MEDLINE, EMBASE, PubMed, and Cochrane CENTRAL Register. STUDY SELECTION: Two authors independently screened publications from 1980 to 2016 reporting the effect of therapeutic interventions on bleeding-related postoperative outcomes, including mediastinal drain loss, transfusion, chest re-exploration rate, and coagulation variables...
November 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29183746/assessment-of-the-anti-snakebite-properties-of-extracts-of-aniba-fragrans-ducke-lauraceae-used-in-folk-medicine-as-complementary-treatment-in-cases-of-envenomation-by-bothrops-atrox
#6
Valéria Mourão de Moura, Noranathan da Costa Guimarães, Luana Travassos Batista, Luciana A Freitas-de-Sousa, Joanderson de Sousa Martins, Maria Carolina Scheffer de Souza, Patrícia D Oliveira de Almeida, Wuelton Marcelo Monteiro, Ricardo Bezerra de Oliveira, Maria Cristina Dos-Santos, Rosa Helena Veras Mourão
ETHNOPHARMACOLOGICAL RELEVANCE: Extracts of leaves and bark of Aniba fragrans are used as tea (decoction) to treat snakebites in communities in the Brazilian Amazon. The aqueous extract of the leaves of A. fragrans has been proven to be effective against Bothrops venom, but only when pre-incubated with the venom. This study sought to assess the potential of different types of extract of this species to inhibit the biological activities of Bothrops atrox venom (BaV) when used the same way as in folk medicine...
November 25, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29135529/acute-coronary-artery-thrombus-after-tranexamic-acid-during-total-shoulder-arthroplasty-in-a-patient-with-coronary-stents-a-case-report
#7
Kathryn H Bridges, Sylvia H Wilson
Tranexamic Acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29131074/tranexamic-acid-failed-to-reverse-the-anticoagulant-effect-and-bleeding-by-an-oral-direct-factor-xa-inhibitor-edoxaban
#8
Yuko Honda, Taketoshi Furugohri, Yoshiyuki Morishima
BACKGROUND/AIMS: Agents to reverse the anticoagulant effect of edoxaban, an oral direct factor Xa inhibitor, would be desirable in emergency situations. The aim of this study is to determine the effect of tranexamic acid, an antifibrinolytic agent, on the anticoagulant activity and bleeding by edoxaban in rats. METHODS: A supratherapeutic dose of edoxaban (3 mg/kg) was intravenously administered to rats. Three minutes after dosing, tranexamic acid (100 mg/kg) was given intravenously...
November 3, 2017: Pharmacology
https://www.readbyqxmd.com/read/29126600/effect-of-treatment-delay-on-the-effectiveness-and-safety-of-antifibrinolytics-in-acute-severe-haemorrhage-a-meta-analysis-of-individual-patient-level-data-from-40%C3%A2-138-bleeding-patients
#9
Angèle Gayet-Ageron, David Prieto-Merino, Katharine Ker, Haleema Shakur, François-Xavier Ageron, Ian Roberts
BACKGROUND: Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. METHODS: We did an individual patient-level data meta-analysis of randomised trials done with more than 1000 patients that assessed antifibrinolytics in acute severe bleeding. We identified trials done between Jan 1, 1946, and April 7, 2017, from MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PubMed, Popline, and the WHO International Clinical Trials Registry Platform...
November 7, 2017: Lancet
https://www.readbyqxmd.com/read/29099345/coagulation-management-during-liver-transplantation-use-of-fibrinogen-concentrate-recombinant-activated-factor-vii-prothrombin-complex-concentrate-and-antifibrinolytics
#10
Jonathan H Chow, Khang Lee, Ezeldeen Abuelkasem, Obi R Udekwu, Kenichi A Tanaka
Coagulation management, and transfusion practice in liver transplantation (LT) have been evolving in the recent years due to better understanding of coagulation abnormalities in end-stage liver disease, and clinical management of LT patients. Avoidance of allogeneic blood components is feasible in some patients, but multi-modal coagulation therapies may be necessary in others who develop complex coagulopathy due to hemorrhage, hemodilution, hypothermia, and acid-base disturbances. Transfusions of plasma and cryoprecipitate remain to be the mainstay therapy for procoagulant factor replacement during LT...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29094532/antifibrinolytics-lysine-analogues-for-the-prevention-of-bleeding-in-people-with-haematological-disorders
#11
Patrick Phillips
The mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and healthcare professionals who deliver, lead or research nursing care. The CNCF produces Cochrane Corner columns, summaries of recent nursing-care-relevant Cochrane Reviews that are regularly published in collaborating nursing-related journals. Information on the processes CNCF has developed can be accessed at: cncf...
November 1, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29074352/-safety-and-efficacy-of-intravenous-tranexamic-acid-in-endoscopic-transurethral-resections-in-urology-prospective-randomized-trial
#12
A Jendoubi, A Malouch, A Bouzouita, Y Riahi, H Necib, S Ghedira, M Houissa
BACKGROUND: Endoscopic urological procedures (transurethral resection of the prostate TURP/transurethral resection of bladder tumor TURBT) are not without risk of significant bleeding. This risk is due to the vascular nature of the tissues and their high levels of fibrinolytic enzymes in the tissues and urine. This study was conducted to evaluate the safety and efficacy of the antifibrinolytic agent tranexamic acid (TXA) in reducing blood loss in patients undergoing TURP/TURBT and transfusion requirement...
October 23, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/29066488/can-tranexamic-acid-reduce-blood-loss-during-major-cardiac-surgery-a-pilot-study
#13
Frances Compton, Amer Wahed, Igor Gregoric, Biswajit Kar, Amitava Dasgupta, Hlaing Tint
We examined the effectiveness of tranexamic acid in preventing intraoperative blood loss during major cardiac surgery. Out of initial 81 patients undergoing major cardiac surgery (both coronary artery bypass and valve repair procedures) at our teaching hospital, sixty-seven patients were selected for this study. We compared estimated blood loss, decrease in percent hemoglobin and hematocrit following surgery between two groups of patients (none of them received any blood product during surgery), one group receiving no tranexamic acid (n=17) and another group receiving tranexamic acid (n=25)...
September 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28993489/civilian-and-military-doctors-knowledge-of-tranexamic-acid-txa-use-in-major-trauma-a-comparison-study
#14
Jonathan Blair Thomas Herron, R French, A D Gilliam
INTRODUCTION: Tranexamic acid (TXA) administration within the recommended time of 3 hours has been demonstrated to improve outcomes following trauma. The aim of this study was to identify potential knowledge gaps in the administration of TXA in order to target further educational training in those doctors responsible for the management of acute trauma. METHODS: 104 military and 852 civilian doctors were invited to complete a four-item web-based questionnaire pertaining to the indications, dose, side effects and evidence base for TXA administration in trauma...
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28987273/tranexamic-acid-impairs-hippocampal-synaptic-transmission-mediated-by-gamma-aminobutyric-acid-receptor-type-a
#15
Hedwig Irl, Stephan Kratzer, Stefan Schwerin, Eberhard Kochs, Manfred Blobner, Gerhard Schneider, Gerhard Rammes, Rainer Haseneder
High-dose application of tranexamic acid (TXA), a widely used antifibrinolytic drug, can cause seizures in patients undergoing surgery. Mechanistically, seizures are considered to arise from an imbalance between inhibitory and excitatory synaptic transmission, whose main transmitters are gamma-aminobutyric acid (GABA) and glutamate. In the present study, we investigated the effects of TXA on neuronal excitability and synaptic transmission in the hippocampus, a structure that plays a pivotal role in human epilepsy...
October 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28980475/comparison-of-oral-and-intravenous-tranexamic-acid-for-prevention-of-perioperative-blood-loss-in-total-knee-and-total-hip-arthroplasty
#16
Mary Alice Gortemoller, Bryan Allen, Rochelle Forsyth, Kimberly Theiss, Kristal Cunningham, Calvin Tucker
BACKGROUND: Tranexamic acid (TA) is an antifibrinolytic agent that prevents perioperative blood loss in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). This benefit has been established with the intravenous (IV) dosage form, but there is limited evidence evaluating oral TA in this setting. OBJECTIVE: To compare the effect of oral versus IV TA on perioperative blood loss in those undergoing TKA or THA. METHODS: In this single-centered retrospective chart review, participants at least 18 years of age who received IV or oral TA from a single surgeon who performed their THA or TKA were included...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28976426/blood-conservation-using-tranexamic-acid-is-not-superior-to-epsilon-aminocaproic-acid-after-total-knee-arthroplasty
#17
RANDOMIZED CONTROLLED TRIAL
Clifford Kent Boese, Leslie Centeno, Ryan W Walters
BACKGROUND: Epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA) are synthetic amino acid derivatives that interfere with fibrinolysis, promoting hemostasis by pharmacological means. Although both drugs have been shown to decrease blood loss with a minimal risk of thromboembolic adverse events following cardiac and vascular surgery, we are aware of only 1 published trial that directly compared the antifibrinolytic effects of EACA with those of TXA after total knee arthroplasty (TKA)...
October 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28972200/fibrinogen-modified-sodium-alginate-as-a-scaffold-material-for-skin-tissue-engineering
#18
Elena V Solovieva, Alexander Yu Fedotov, Vasily E Mamonov, Vladimir S Komlev, Andrey A Panteleyev
In search for a new pro-angiogenic scaffold material suitable for skin bioengineering and grafting therapy, we have fabricated a number of composite sodium alginate (AG) - fibrinogen (FG) sponge scaffolds using the freeze-drying approach. Thrombin was added to drive FG/fibrin conversion, while ε-aminocapronic acid (εAc) was used as antifibrinolytic component. The slow rates of scaffold biodegradation were achieved by using Ca2+ and Mg2+ cations as cross-linking agents. The novel thrombin-modified AG-FG scaffolds with highly interconnected porous structure were evaluated using scanning electron microscopy, tensile testing and pycnometric analysis...
October 3, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28940923/blood-conservation-in-cardiac-surgery
#19
REVIEW
G Blaudszun, A Butchart, A A Klein
This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia...
September 21, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28939033/epsilon-aminocaproic-acid-to-reduce-blood-loss-and-transfusion-after-total-hip-and-total-knee-arthroplasty
#20
Juliann C Hobbs, Ian J Welsby, Cynthia L Green, Ishwori B Dhakal, Samuel S Wellman
BACKGROUND: Total hip and knee arthroplasty (THA and TKA) are associated with significant blood loss and some patients require postoperative blood transfusion. While tranexamic acid has been studied extensively among this population, we tested the hypothesis that epsilon aminocaproic acid (EACA) can reduce blood loss and transfusion after joint arthroplasty. METHODS: In April 2014, our Veterans Affairs Medical Center introduced a protocol to administer EACA during THA and TKA...
August 24, 2017: Journal of Arthroplasty
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