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Unfractionated heparin

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https://www.readbyqxmd.com/read/29790645/fibrinogen-prothrombin-time-derived-method-is-not-useful-in-patients-anticoagulated-with-low-molecular-weight-heparins-or-rivaroxaban
#1
C Duboscq, M Martinuzzo, J M Ceresetto, M Lopez, L Barrera, J Oyhamburu, G Stemmelin
BACKGROUND: Fibrinogen prothrombin time derived method (FIBPT-d) with photo-optical coagulometers is easy and economical. However, there are few reports on the behavior of this test on samples from patients anticoagulated with direct oral anticoagulants (DOACs) or low molecular weight heparin (LMWH). OBJECTIVE: To compare fibrinogen results obtained by Clauss method (FIB C) and FIBPT-d with two thromboplastins in anticoagulated patients. POPULATION: 295 consecutive anticoagulated patients: 99 vitamin K antagonist (VKA), 49 unfractionated heparin (UFH), 47 LMWH, 50 rivaroxaban and 50 dabigatran; and 100 healthy controls (NC)...
May 23, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29788841/heparin-induced-thrombocytopenia-complicating-extracorporeal-membrane-oxygenation-support-in-pediatric-patients-review-of-the-literature-and-alternative-anticoagulants
#2
Uri Pollak
Heparin-induced thrombocytopenia (HIT) is a prothrombotic, immune-mediated complication of unfractionated heparin (UFH) and low molecular weight heparin therapy. HIT is characterized by moderate thrombocytopenia 5-10 days after initial heparin exposure, detection of platelet-activating anti-platelet factor 4/heparin antibodies and an increased risk of venous and arterial thrombosis. Extracorporeal membrane oxygenation (ECMO) is a form of mechanical circulatory support used in critically ill patients with respiratory or cardiac failure...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788512/adequacy-of-fixed-dose-heparin-infusions-for-venous-thromboembolism-prevention-after-microsurgical-procedures
#3
Corinne M Bertolaccini, Ann Marie B Prazak, Jayant Agarwal, Isak A Goodwin, W Bradford Rockwell, Christopher J Pannucci
BACKGROUND:  In microvascular surgery, patients often receive unfractionated heparin infusions to minimize risk for microvascular thrombosis. Patients who receive intravenous (IV) heparin are believed to have adequate prophylaxis against venous thromboembolism (VTE). Whether a fixed dose of IV heparin provides detectable levels of anticoagulation, or whether the "one size fits all" approach provides adequate prophylaxis against VTE remains unknown. This study examined the pharmacodynamics of fixed-dose heparin infusions and the effects of real-time, anti-factor Xa (aFXa) level driven heparin dose adjustments...
May 22, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29780621/thromboembolism-prophylaxis-in-orthopaedics-an-update
#4
Dimitrios A Flevas, Panayiotis D Megaloikonomos, Leonidas Dimopoulos, Evanthia Mitsiokapa, Panayiotis Koulouvaris, Andreas F Mavrogenis
Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death.Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%.VTE prophylaxis methods are divided into mechanical and pharmacological...
April 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29779882/antithrombotic-therapy-strategy-for-cancer-associated-ischemic-stroke-a-case-series-of-26-patients
#5
Hiroyuki Naito, Tomohisa Nezu, Naohisa Hosomi, Shiro Aoki, Hiroki Ueno, Kazuhide Ochi, Hirofumi Maruyama
BACKGROUND: The risk of complications from thromboembolism is increased for patients with malignancy. Cancer-associated stroke is also a serious issue with regard to the management of patients with cancer because stroke incidence often causes disabilities that affect daily life and cancer treatment strategy. METHODS: Between March 2011 and September 2017, 328 patients with acute ischemic stroke were registered to our hospital. RESULTS: Of these patients, 26 (7...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29778734/association-between-maximal-activated-clotting-time-and-major-bleeding-complications-during-transradial-and-transfemoral-percutaneous-coronary-intervention
#6
David W Louis, Kevin Kennedy, Fabio V Lima, Samir Pancholy, J Dawn Abbott, Paul Gordon, Herbert D Aronow
OBJECTIVES: This study sought to determine whether higher maximal activated clotting time (ACT) during transradial (TR) percutaneous coronary intervention (PCI) is associated with greater bleeding risk. BACKGROUND: Higher maximal ACT during transfemoral (TF) PCI has been associated with a greater bleeding risk. It is unclear whether this relationship exists in the setting of TR PCI. METHODS: Among 14,637 patients undergoing TR or TF PCI with unfractionated heparin monotherapy, the study related maximal ACT to the risk of major bleeding...
May 11, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29778730/activated-clotting-time-during-unfractionated-heparin-supported-coronary-intervention-is-access-site-the-new-piece-of-the-puzzle
#7
EDITORIAL
Marco Valgimigli, Giuseppe Gargiulo
No abstract text is available yet for this article.
May 11, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29769167/impact-of-sex-on-comparative-outcomes-of-bivalirudin-versus-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-undergoing-invasive-management-a-pre-specified-analysis-of-the-matrix-trial
#8
Giuseppe Gargiulo, Bruno R da Costa, Enrico Frigoli, Cataldo Palmieri, Marco Stefano Nazzaro, Camillo Falcone, Armando Liso, Carlo Vigna, Fabio Abate, Marco Comeglio, Roberto Diletti, Gabriele Gabrielli, Emilio Di Lorenzo, Pietro Mazzarotto, Marco Zimarino, Claudio Moretti, Antonio Colombo, Carlo Penzo, Giampaolo Pasquetto, Salvatore Brugaletta, Fabio Ferrari, Gavino Casu, Vincenzo Guiducci, Antonio Dellavalle, Francesco Liistro, Ciro Mauro, Arnoud W J Van't Hof, Elmir Omerovic, Salvatore Curello, Jose Maria de la Torre Hernandez, Stefano De Servi, Flavia Belloni, Stephan Windecker, Marco Valgimigli
AIMS: To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS: In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29769165/radial-hemostasis-is-facilitated-with-a-potassium-ferrate-hemostatic-patch-the-statseal-with-tr-band-assessment-trial-stat
#9
Arnold H Seto, William Rollefson, Mitul P Patel, William M Suh, David M Tehrani, Jacqueline A Nguyen, Daniel G Amador, Omid Behnamfar, Vinisha Garg, Mauricio G Cohen
AIMS: Hemostasis is a limiting factor for discharge after uncomplicated transradial procedures. The potassium ferrate hemostatic patch (PFHP) may serve as an adjunct to the air-bladder TR band (TRB) and allow expedited deflation of the TRB. METHODS AND RESULTS: Prospective multicenter randomized controlled trial comparing radial hemostatic protocols. Deflation of the TRB was attempted at 40 minutes with PFHP and at 120 minutes without the PFHP. The primary outcome was time to full deflation of the TRB with hemostasis...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29768983/anticoagulation-monitoring-under-ecmo-support-a-comparative-study-between-the-activated-coagulation-time-and-the-anti-xa-activity-assay
#10
Clément Delmas, Aemilia Jacquemin, Fanny Vardon-Bounes, Bernard Georges, Felipe Guerrero, Nicolas Hernandez, Bertrand Marcheix, Thierry Seguin, Vincent Minville, Jean-Marie Conil, Stein Silva
PURPOSE: Extra Corporeal Membrane Oxygenation (ECMO) is used in cases of severe respiratory and/or circulatory failure over periods of several days to several weeks. Its circuitry requires a closely monitored anticoagulation therapy that is empirically supported by activated clotting time (ACT)-a method often associated with large inter- and intraindividual variability. We aimed to compare the measurement of heparin activity with ACT and the direct measurement of the heparin activity (anti-Xa) in a large ECMO population...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29768323/efficacy-and-risks-of-anticoagulation-for-cerebral-venous-thrombosis
#11
Weilin Xu, Liansheng Gao, Tao Li, Anwen Shao, Jianmin Zhang
BACKGROUND AND PURPOSE: Cerebral venous thrombosis (CVT) is a rare but life-threatening disease. Timely and proper treatments are the keys in saving patients' life and preventing from permanent neurological deficits. We performed this network meta-analysis to evaluate the role of anticoagulation in CVT, especially for the patients accompanied with hemorrhagic stroke. METHODS: PubMed, Embase, Web of Science, Cochrane Database, and Chinese Biomedical (CBM) databases were searched comprehensively to select eligible articles (up to 30 June 2017)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764542/-unfractionated-heparin-ameliorates-lipopolysaccharide-induced-expressions-of-nitric-oxide-and-reactive-oxygen-species-in-renal-microvascular-endothelial-cells
#12
Xin Li, Yingjian Liang, Xiaojuan Zhang, Xiaochun Ma
OBJECTIVE: To observe the effect of heparin on the cellular morphology and the expressions of nitric oxide (NO) and reactive oxygen species (ROS) in renal microvascular endothelial cells (RMVECs) stimulated by lipopolysaccharide (LPS). METHODS: The three step gradient screen method was used to primarily culture rat RMVECs, and the 3rd and 4th generation cells with excellent growth were collected. The cells were divided into blank control group, 10 mg/L LPS treatment group and 2...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29749915/continuous-infusion-of-low-dose-unfractionated-heparin-after-aneurysmal-subarachnoid-hemorrhage-a-preliminary-study-of-cognitive-outcomes
#13
Robert F James, Nicolas K Khattar, Zaid S Aljuboori, Paul S Page, Elaine Y Shao, Lacey M Carter, Kimberly S Meyer, Michael W Daniels, John Craycroft, John R Gaughen, M Imran Chaudry, Shesh N Rai, D Erik Everhart, J Marc Simard
OBJECTIVE Cognitive dysfunction occurs in up to 70% of aneurysmal subarachnoid hemorrhage (aSAH) survivors. Low-dose intravenous heparin (LDIVH) infusion using the Maryland protocol was recently shown to reduce clinical vasospasm and vasospasm-related infarction. In this study, the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive changes in aSAH patients treated with the Maryland LDIVH protocol compared with controls. METHODS A retrospective analysis of all patients treated for aSAH between July 2009 and April 2014 was conducted...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29746315/antithrombin-during-extracorporeal-membrane-oxygenation-in-adults-national-survey-and-retrospective-analysis
#14
Giacomo E Iapichino, Alessandro Protti, Davide T Andreis, Mauro Panigada, Andrea Artoni, Cristina Novembrino, Antonio Pesenti, Luciano Gattinoni
The impact of antithrombin replacement during extracorporeal membrane oxygenation (ECMO) in adults remains unclear. This work comprises a survey, showing that antithrombin is routinely supplemented in many Italian ECMO-Centers, and a retrospective analysis on 66 adults treated with veno-venous ECMO and unfractionated heparin at our Institution. Twenty-four to 72 h after the beginning of ECMO, antithrombin activity was ≤70% in 47/66 subjects and activated partial thromboplastin time (aPTT) ratio was <1...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29742703/nebulized-heparin-and-n-acetylcysteine-for-smoke-inhalational-injury-a-case-report
#15
Umair Ashraf, Bharat Bajantri, Gabriella Roa-Gomez, Sindhaghatta Venkatram, Amanda Cantin, Gilda Diaz-Fuentes
RATIONALE: Every year, ∼40,000 people suffer burn-related injuries in the United States. Despite recent advances, the odds of dying from exposure to fire, flames, or smoke are one in ∼1500. Smoke inhalation causes injury to the airways via a complex physiological process, and the treatment is mainly supportive. Many recent interventions aim to decrease the formation of fibrin casts, the main cause of airway damage in these patients. Among these, treatment with a combination of nebulized heparin and N-acetylcysteine (NAC) has shown benefit...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29733637/anticoagulant-properties-of-poly-sodium-2-acrylamido-2-methylpropanesulfonate-based-di-and-triblock-polymers
#16
Bartlomiej Kalaska, Kamil Kamiński, Joanna Miklosz, Keita Nakai, Shin-Ichi Yusa, Dariusz Pawlak, Maria Nowakowska, Andrzej Mogielnicki, Krzysztof Szczubiałka
Di- and triblock copolymers with low dispersity of molecular weight were synthesized using radical addition-fragmentation chain transfer polymerization. The copolymers contained anionic poly(sodium 2-acrylamido-2-methylpropanesulfonate) (PAMPS) block as an anticoagulant component. The block added to lower the toxicity was either poly(ethylene glycol) (PEG) or poly(2-(methacryloyloxy)ethyl phosphorylcholine) (PMPC). The polymers prolonged clotting times both in vitro and in vivo. The influence of the polymer architecture and composition on the efficacy of anticoagulation and safety parameters was evaluated...
May 7, 2018: Biomacromolecules
https://www.readbyqxmd.com/read/29719300/unfractionated-heparin-alleviates-human-lung-endothelial-barrier-dysfunction-induced-by-high-mobility-group-box-1-through-regulation-of-p38-gsk3%C3%AE-snail-signaling-pathway
#17
Zhenggang Luan, Bo Hu, Lei Wu, Shanzi Jin, Xiaochun Ma, Jun Zhang, Aiping Wang
BACKGROUND/AIMS: The high mobility group box 1 (HMGB1) has been regarded as an important inflammatory mediator. Previous studies showed the involvement of HMGB1 protein in the dysfunction of endothelial barrier function during acute lung injury. However, the molecular mechanism remains unclear. METHODS: In this study, we used recombinant human HMGB1 (rhHMGB1) and HMGB1 plasmid to treat human pulmonary microvascular endothelial cell (HPMECs). We examined endothelial permeability by measuring TEER value and HRP flux...
April 26, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29717364/acute-promyelocytic-leukemia-cell-adhesion-to-vascular-endothelium-is-reduced-by-heparins
#18
Alfonso Vignoli, Marina Marchetti, Anna Falanga
Adhesion of acute promyelocytic leukemia (APL) cells to endothelial cells (EC) is among the mechanisms of the APL-associated coagulopathy, responsible for early hemorrhagic deaths in affected patients. We compared the effects of dalteparin and enoxaparin, two low-molecular-weight heparins (LMWH), and unfractionated heparin (UFH), on APL NB4 adhesion to micro- (HMEC-1) and macro-vascular EC (HUVEC), in resting and interleukin-1β (IL-1β)-stimulated conditions. The heparin effect on EC adhesion molecule (ICAM-1, VCAM-1, E-selectin) expression was also assessed...
May 1, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29710022/-a-case-of-bilateral-cervical-internal-carotid-artery-dissection-following-herpes-zoster-of-the-trigeminal-nerve
#19
Mariko Iwasa, Yohei Mima, Aya Ito, Yuko Abe, Naoko Ueda, Ryoichi Otsubo
A 62 year-old man, who was taking prednisolone for nephrotic syndrome, was diagnosed with herpes zoster of the trigeminal nerve and treated with oral valacyclovir. One month later, he reported pain from the right side of the head and vomiting. MRI revealed an acute infarction in the right frontal lobe and dissection of the internal carotid artery of the right cervix. Trauma or other potential triggers were not observed. In consideration of the preceding condition of varicella zoster virus infection, acyclovir was administered in addition to unfractionated heparin, but an intramural hematoma emerged in the left internal carotid artery...
April 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29709361/partial-thromboplastin-time-is-more-predictive-of-bleeding-than-anti-xa-levels-in-heparinized-pediatric-patients-after-cardiac-surgery
#20
Olubunmi O Oladunjoye, Lynn A Sleeper, Asha G Nair, Cameron C Trenor, Christina VanderPluym, John N Kheir, Sitaram M Emani
OBJECTIVES: Anticoagulation with unfractionated heparin (UFH) after pediatric cardiac surgery can be monitored using either activated partial thromboplastin time (aPTT) or anti-factor Xa activity (anti-Xa). However, correlation of bleeding with either of these laboratory values has not been established. We sought to determine the correlation between bleeding events and aPTT and anti-Xa in patients who undergo anticoagulation after congenital heart surgery. METHODS: We prospectively studied pediatric patients treated with UFH after cardiac surgery over an 11-month period...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
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