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Regional anticoagulation

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https://www.readbyqxmd.com/read/28632284/benefits-and-risks-of-antithrombotic-therapy-in-essential-thrombocythemia-a-systematic-review
#1
Derek K Chu, Christopher M Hillis, Darryl P Leong, Sonia S Anand, Deborah M Siegal
Background: Patients with essential thrombocythemia (ET) are at high risk for both thrombosis and hemorrhage. Purpose: To evaluate the risks and benefits of antithrombotic therapy in adults with ET. Data Sources: Multiple databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, through 4 March 2017. Study Selection: Randomized and observational studies of antiplatelet or anticoagulant therapy, published in any language and reporting thrombotic or hemorrhagic events...
June 27, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#2
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28618127/regional-citrate-anticoagulation-in-membrane-based-plasma-exchange-safety-efficacy-and-effect-on-calcium-balance
#3
Daniel Christiadi, Chari Mercado, Richard Singer
AIM: To assess the efficacy, safety and calcium balance of a membrane based regional citrate anticoagulation plasma exchange protocol METHODS: This was an observational, prospective, single center study of membrane separation plasma exchange using regional citrate anticoagulation. It was performed using a fixed dose pre-filter citrate infusion that was based on the plasma flow rate. Patients received a post filter calcium infusion which was modified during treatment based on systemic ionized calcium monitoring...
June 15, 2017: Nephrology
https://www.readbyqxmd.com/read/28614119/pump-priming-practices-and-anticoagulation-in-cardiac-surgery-results-from-the-global-cardiopulmonary-bypass-survey
#4
Lachlan F Miles, Timothy G Coulson, Carlos Galhardo, Florian Falter
BACKGROUND: Regional patterns of practice in cardiopulmonary bypass remain poorly understood with conflicting evidence regarding the best choices in pump priming preferences with respect to colloid and crystalloid and different types of fluid within these categories. In light of the variation in the literature, we hypothesized there would be considerable regional differences in cardiopulmonary bypass practice, particularly with respect to the type of fluid used to prime the extracorporeal circuit...
June 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28594321/pharmacogenomics-in-asia-a-systematic-review-on-current-trends-and-novel-discoveries
#5
Hazel Xiaohui Ang, Sze Ling Chan, Levana L Sani, Clarissa Bernice Quah, Liam R Brunham, Boon Ooi Patrick Tan, Michael D Winther
While early pharmacogenomic studies have primarily been carried out in Western populations, there has been a notable increase in the number of Asian studies over the past decade. We systematically reviewed all pharmacogenomic studies conducted in Asia published before 2016 to highlight trends and identify research gaps in Asia. We observed that pharmacogenomic research in Asia was dominated by larger developed countries, notably Japan and Korea, and mainly driven by local researchers. Studies were focused on drugs acting on the CNS, chemotherapeutics and anticoagulants...
June 8, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28592490/functional-analyses-yield-detailed-insight-into-the-mechanism-of-thrombin-inhibition-by-the-antihemostatic-salivary-protein-ce5-from-anopheles-gambiae
#6
Luciano Pirone, Jorge Ripoll-Rozada, Marilisa Leone, Raffaele Ronca, Fabrizio Lombardo, Gabriella Fiorentino, John F Andersen, Pedro José Barbosa Pereira, Bruno Arcà, Emilia Pedone
Saliva of blood-feeding arthropods carries several antihemostatic compounds whose physiological role is to facilitate successful acquisition of blood. The identification of novel natural anticoagulants and the understanding of their mechanism of action may offer opportunities for designing new antithrombotics disrupting blood clotting. We report here an in depth structural and functional analysis of the anophelin family member cE5, a salivary protein from the major African malaria vector Anopheles gambiae that specifically tightly and quickly binds and inhibitss thrombin...
June 7, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28580572/the-impact-of-low-molecular-weight-heparin-on-obstetric-outcomes-among-unexplained-recurrent-miscarriages-complicated-with-methylenetetrahydrofolate-reductase-gene-polymorphism
#7
Orkun Cetin, Erbil Karaman, Numan Cim, Deniz Dirik, Hanim Guler Sahin, Erdal Kara, Ramazan Esen
OBJECTIVES: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism. MATERIAL AND METHODS: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28578542/citrate-versus-heparin-anticoagulation-in-continuous-renal-replacement-therapy-in-small-children
#8
Paulien A M A Raymakers-Janssen, Marc Lilien, Ingrid A van Kessel, Esther S Veldhoen, Roelie M Wösten-van Asperen, Josephus P J van Gestel
BACKGROUND: Citrate is preferred over heparin as an anticoagulant in adult continuous renal replacement therapy (CRRT). However, its potential adverse effects and data on use in CRRT in infants and toddlers is limited. We conducted a prospective study on using citrate in CRRT in critically ill small children. METHODS: Children who underwent CRRT with the smallest filter in our PICU between November 2011 and November 2016 were included. Both heparin and citrate were applied according to a strict protocol...
June 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28578343/filter-size-not-the-anticoagulation-method-is-the-decisive-factor-in-continuous-renal-replacement-therapy-circuit-survival
#9
Monika Miklaszewska, Przemysław Korohoda, Katarzyna Zachwieja, Krzysztof Kobylarz, Constantinos J Stefanidis, Alina Sobczak, Dorota Drożdż
BACKGROUND/AIM: As continuous renal replacement therapy (CRRT) has emerged as a standard therapy in pediatric intensive care units (PICU), many related issues that may have an impact on circuit survival have gained in importance. Objective of the study was an evaluation of factors associated with circuit survival, including anticoagulation (ACG). METHODS: Retrospective study that included 40 patients, who in total received 7636 hours of CRRT during 150 sessions (84 filters, 4260 hours with heparin anticoagulation (Hep-ACG); 66 filters, 3376 hours with regional citrate anticoagulation (RCA))...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28564626/pesticide-incidence-in-poisoned-baits-a-10-year-report
#10
Mario Chiari, Cristina Cortinovis, Nicoletta Vitale, Mariagrazia Zanoni, Elena Faggionato, Alberto Biancardi, Francesca Caloni
The incidence of pesticides in poisoned baits recovered from 2005 to 2014 in Italian northern regions of Emilia Romagna and Lombardy was analysed. A total of 956 baits tested positive for pesticides during the study period. In 9.3% (n=89) of the baits analysed more than one toxic compound was present. Insecticides (53.2%) proved to be the pesticides most commonly involved followed by rodenticides (34.3%), molluscicides (12.3%) and herbicides (0.2%). Among insecticides, the anticholinesterases (organophosphates and carbamates) were the most frequently detected (59...
May 28, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28562574/incidence-and-risk-factors-of-deep-venous-thrombosis-following-arthroscopic-posterior-cruciate-ligament-reconstruction
#11
Dongyang Chen, Qiangqiang Li, Zhen Rong, Yao Yao, Zhihong Xu, Dongquan Shi, Qing Jiang
The objective of this study was to identify the incidence and associated risk factors for deep venous thrombosis (DVT) after arthroscopic posterior cruciate ligament (PCL) reconstruction.This study included 128 patients who underwent arthroscopic PCL reconstruction. Venography was performed on the operated leg 3 days postoperatively. The patients were divided into 2 groups based on whether they had DVT. A correlation analysis was performed to determine the factors associated with DVT.Of all the 128 patients, 28 patients (21...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28558081/stroke-prevention-in-atrial-fibrillation-focus-on-latin-america
#12
Ayrton R Massaro, Gregory Y H Lip
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with an estimated prevalence of 1-2% in North America and Europe. The increased prevalence of AF in Latin America is associated with an ageing general population, along with poor control of key risk factors, including hypertension. As a result, stroke prevalence and associated mortality have increased dramatically in the region. Therefore, the need for effective anticoagulation strategies in Latin America is clear. The aim of this review is to provide a contemporary overview of anticoagulants for stroke prevention...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28538441/hyperlactatemia-lactate-kinetics-and-prediction-of-citrate-accumulation-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation
#13
Dmytro Khadzhynov, Annette Dahlinger, Christin Schelter, Harm Peters, Detlef Kindgen-Milles, Klemens Budde, Lukas Johannes Lehner, Fabian Halleck, Oliver Staeck, Torsten Slowinski
OBJECTIVES: Citrate accumulation is a major complication of regional citrate anticoagulation during continuous renal replacement therapy. We studied the prediction of citrate accumulation during continuous veno-venous hemodialysis with regional citrate anticoagulation by initial lactate concentrations and lactate kinetics. DESIGN: A retrospective follow-up analysis from a cohort of critically ill patients. SETTING: Mixed medical-surgical ICUs at a university hospital...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28536932/thromboprophylaxis-in-extracorporeal-circuits-current-pharmacological-strategies-and-future-directions
#14
REVIEW
Gail M Annich, Oshri Zaulan, Megan Neufeld, Deborah Wagner, Melissa M Reynolds
The development of extracorporeal devices for organ support has been a part of medical history and progression since the late 1900s. These types of technology are primarily used and developed in the field of critical care medicine. Unfractionated heparin, discovered in 1916, has really been the only consistent form of thromboprophylaxis for attenuating or even preventing the blood-biomaterial reaction that occurs when such technologies are initiated. The advent of regional anticoagulation for procedures such as continuous renal replacement therapy and plasmapheresis have certainly removed the risks of systemic heparinization and heparin effect, but the challenges of the blood-biomaterial reaction and downstream effects remain...
May 23, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28535516/citrate-anticoagulation-during-continuous-renal-replacement-therapy
#15
Davide Ricci, Laura Panicali, Maria Grazia Facchini, Elena Mancini
During extracorporeal dialysis, some anticoagulation strategy is necessary to prevent the coagulation of blood. Heparin has historically been used as an anticoagulant because of its efficacy combined with low cost. However, a variable incidence of hemorrhagic complications (5-30%) has been documented in patients undergoing continuous renal replacement therapy (CRRT) with heparin as an anticoagulant. Citrate has anticoagulation properties secondary to its ability to chelate calcium, which is necessary for the coagulation cascade...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28526159/anticoagulation-and-neuraxial-peripheral-anesthesia
#16
REVIEW
Mudit Kaushal, Ryan E Rubin, Alan D Kaye, Karina Gritsenko
Novel anticoagulants (NAGs) have emerged as the preferred alternatives to vitamin K antagonists. In patients being considered for regional anesthesia, these drugs present a layer of complexity in the preprocedure evaluation. There are no established tests to monitor anticoagulant activity and our experience is short with these drugs. These authors believe it is important to review the relevant hematology, orthopedics, and anesthesiology literature to provide a valuable reference for the clinician who is met with these challenges...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526151/novel-anticoagulant-agents-in-the-perioperative-setting
#17
REVIEW
Allyson Lemay, Alan D Kaye, Richard D Urman
An increasing number of oral anticoagulants have become available over the past decade. Each of these agents has differing implications on both regional and neuraxial anesthetic techniques. This article describes the pharmacology, pharmacokinetics, and pharmacodynamics of the most commonly used novel oral anticoagulants (NOACs). It also outlines recent guidelines for the use of NOACs in the perioperative setting, especially with regard to neuraxial anesthesia.
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28509350/high-sodium-continuous-veno-venous-hemodialysis-with-regional-citrate-anticoagulation-and-online-dialysate-generation-in-patients-with-acute-liver-failure-and-cerebral-edema
#18
Tamim Hamdi, Lenar Yessayan, Jerry Yee, Balazs Szamosfalvi
INTRODUCTION: Acute liver failure is associated with a high mortality rate. Induction of plasma hypertonicity with mannitol or hypertonic saline remains the cornerstone in the management of resultant cerebral edema. Significant disadvantages of this approach include poor or unpredictable control of serum sodium concentration and volume expansion, among others. METHODS: We used high sodium continuous veno-venous hemodialysis with regional citrate anticoagulation and online dialysate generation to accurately control the serum sodium in eleven patients with acute liver failure, renal failure, and cerebral edema...
May 16, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28493216/appropriateness-of-oral-anticoagulants-for-the-long-term-treatment-of-atrial-fibrillation-in-older-people-results-of-an-evidence-based-review-and-international-consensus-validation-process-oac-forta-2016
#19
REVIEW
Martin Wehling, Ronan Collins, Victor M Gil, Olivier Hanon, Roland Hardt, Martin Hoffmeister, Pedro Monteiro, Terence J Quinn, Dieter Ropers, Giuseppe Sergi, Freek W A Verheugt
BACKGROUND: Age appropriateness of anticoagulants for stroke prevention in atrial fibrillation is uncertain. OBJECTIVE: To review oral anticoagulants for the treatment of atrial fibrillation in older (age >65 years) people and to classify appropriate and inappropriate drugs based on efficacy, safety and tolerability using the Fit-fOR-The-Aged (FORTA) classification. METHODS: We performed a structured comprehensive review of controlled clinical trials and summaries of individual product characteristics to assess study and total patient numbers, quality of major outcome data and data of geriatric relevance...
May 10, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28492441/residual-enoxaparin-activity-anti-xa-levels-and-concerns-about-the-american-society-of-regional-anesthesia-and-pain-medicine-anticoagulation-guidelines
#20
Daryl S Henshaw, James D Turner, Daniel J Forest, Garrett R Thompson, Robert S Weller
Currently, the American Society of Regional Anesthesia and Pain Medicine (ASRA) anticoagulation guidelines recommend that before the performance of a neuraxial procedure a minimum of 24 hours should elapse following a treatment dose of enoxaparin (1 mg/kg twice daily or 1.5 mg/kg once daily). The guidelines have since their inception also consistently recommended against the routine use of anti-Xa level monitoring for patients receiving enoxaparin. However, we noted in our clinical practice that anti-Xa levels were frequently still elevated despite patients meeting the time-based recommendation for treatment dose enoxaparin...
July 2017: Regional Anesthesia and Pain Medicine
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