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Rotational Thromboelastometry

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https://www.readbyqxmd.com/read/28549672/rotational-thromboelastometry-predicts-increased-bleeding-after-off-pump-coronary-bypass-surgery
#1
Sarah Soh, Young-Lan Kwak, Jong-Wook Song, Kyung-Jong Yoo, Hee-Jung Kim, Jae-Kwang Shim
BACKGROUND: We aimed to investigate the ability of rotational thromboelastometry (ROTEM) thresholds for coagulopathy to predict increased perioperative blood loss in off-pump coronary artery bypass graft surgery (OPCABG) and its association with transfusion requirement. METHODS: The data of 303 patients undergoing OPCABG were retrospectively analyzed. Perioperative blood loss and transfusion requirement were compared according to the presence of abnormal ROTEM thresholds, which were tested after anesthesia induction and heparin reversal...
May 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28540073/viscoelastic-testing-inside-and-beyond-the-operating-room
#2
REVIEW
Liang Shen, Sheida Tabaie, Natalia Ivascu
Hemorrhage is a major contributor to morbidity and mortality during the perioperative period. Current methods of diagnosing coagulopathy have various limitations including long laboratory runtimes, lack of information on specific abnormalities of the coagulation cascade, lack of in vivo applicability, and lack of ability to guide the transfusion of blood products. Viscoelastic testing offers a promising solution to many of these problems. The two most-studied systems, thromboelastography (TEG) and rotational thromboelastometry (ROTEM), offer similar graphical and numerical representations of the initiation, formation, and lysis of clot...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28498944/assessment-of-standard-laboratory-tests-and-rotational-thromboelastometry-for-the-prediction-of-postoperative-bleeding-in-liver-transplantation
#3
T M Dötsch, D Dirkmann, D Bezinover, M Hartmann, J W Treckmann, A Paul, F H Saner
Background.: Perioperative bleeding remains a major challenge in liver transplantation. We aimed to compare standard laboratory tests with thromboelastometry (ROTEM ® ) with regard to their ability to predict postoperative non-surgical bleeding. Methods.: Data from 243 adult liver transplant recipients from January 2012 to May 2014 were evaluated retrospectively. Upon admission to the intensive care unit, coagulation status was assessed using standard laboratory tests [prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, and platelet count] and ROTEM ® whole blood coagulation assays...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28497841/effect-of-fluid-resuscitation-with-balanced-solutions-on-platelets-in-vitro-simulation-of-20-volume-substitution
#4
Łukasz J Krzych, Piotr F Czempik
BACKGROUND: Fluid resuscitation in massive bleeding may cause coagulation disorders by dilution of platelets and clotting factors or by the definite influence on theirfunction. The aim of this study was to investigate the effects of balanced crystalloid and colloid solutions on platelets (PLT) in vitro using complex assessment of coagulation. METHODS: The study group was comprised of 32 American Society of Anesthesiologists physical status class I male volunteers, aged 21-35 (29 ± 4) years, weighting 59-103 (81...
May 12, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28488956/introduction-of-thromboelastometry-guided-administration-of-fresh-frozen-plasma-is-associated-with-decreased-allogeneic-blood-transfusions-and-post-operative-blood-loss-in-cardiopulmonary-bypass-surgery
#5
Junko Ichikawa, Takahito Marubuchi, Keiko Nishiyama, Mitsuharu Kodaka, Klaus Görlinger, Makoto Ozaki, Makiko Komori
BACKGROUND: Cardiac surgery is frequently associated with excessive blood loss requiring multiple blood transfusions which are, in turn, associated with increased morbidity and mortality. We evaluated the effectiveness of rotational thromboelastometry (ROTEM(®))-guided administration of fresh-frozen plasma (FFP) with regards to blood loss, transfusion requirements, and major post-operative complications. MATERIALS AND METHODS: Coagulation management in 68 prospective patients undergoing cardiac surgery with cardiopulmonary bypass was based on a treatment algorithm guided by ROTEM(®) measurements...
March 23, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28486277/evaluation-of-recombinant-factor-viii-fc-eloctate-activity-by-thromboelastometry-in-a-multicenter-phase-3-clinical-trial-and-correlation-with-bleeding-phenotype
#6
Frank Driessler, Maricel G Miguelino, Glenn F Pierce, Robert T Peters, Jurg M Sommer
: The aim of this study was to compare the hemostatic efficacy of recombinant factor VIII Fc (rFVIIIFc) (Eloctate) and Advate by ex-vivo rotation thromboelastometry (ROTEM) of whole blood and to explore potential ROTEM parameters that may be more predictive of a patient's bleeding tendency than plasma FVIII activity. Thirteen clinical sites were selected to perform ROTEM on freshly collected blood samples from 44 patients in the phase 3 study for rFVIIIFc, including 16 patients undergoing sequential pharmacokinetic assessment of Advate and rFVIIIFc...
May 8, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28480552/hyperfibrinolysis-and-hypofibrinogenemia-diagnosed-with-rotational-thromboelastometry-in-dogs-naturally-infected-with-angiostrongylus-vasorum
#7
N E Sigrist, N Hofer-Inteeworn, R Jud Schefer, C Kuemmerle-Fraune, M Schnyder, A P N Kutter
BACKGROUND: The pathomechanism of Angiostrongylus vasorum infection-associated bleeding diathesis in dogs is not fully understood. OBJECTIVE: To describe rotational thromboelastometry (ROTEM) parameters in dogs naturally infected with A. vasorum and to compare ROTEM parameters between infected dogs with and without clinical signs of bleeding. ANIMALS: A total of 21 dogs presented between 2013 and 2016. METHODS: Dogs with A...
May 7, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28478688/gene-delivery-of-activated-factor-vii-using-alternative-aav-serotype-improves-hemostasis-in-hemophiliac-mice-with-fviii-inhibitors-and-aav-neutralizing-antibodies
#8
Junjiang Sun, Baolai Hua, R Jude Samulski, Chengwen Li
While therapeutic expression of coagulation factors from adeno-associated virus (AAV) vectors has been successfully achieved in patients with hemophilia, neutralizing antibodies to the vector and inhibitory antibodies to the transgene severely limit efficacy. Indeed, approximately 40% of mice transduced with human Factor VIII using the AAV8 serotype developed inhibitory antibodies to Factor VIII (FVIII inhibitor), as well as extremely high titers (≥ 1:500) of neutralizing antibodies to AAV8. To correct hemophilia in these mice we used AAV9, a serotype with low in vitro cross-reactivity (≤ 1:5) to anti-AAV8, to deliver mouse activated Factor VII (mFVIIa)...
May 6, 2017: Human Gene Therapy
https://www.readbyqxmd.com/read/28473975/increased-clot-formation-in-the-absence-of-increased-thrombin-generation-in-patients-with-peripheral-arterial-disease-a-case-control-study
#9
Marie-Claire F Kleinegris, Joke Konings, Jan W Daemen, Yvonne Henskens, Bas de Laat, Henri M H Spronk, Arina J Ten Cate-Hoek, Hugo Ten Cate
BACKGROUND: In peripheral arterial disease (PAD), activation of the hemostatic system may contribute to atherosclerosis progression and atherothrombotic events. OBJECTIVE: This case-control study assesses the overall coagulation status in PAD patients by evaluating coagulation markers in combination with thrombin generation potential, whole blood (WB) clot formation, and fibrinolysis. METHODS: In blood from 40 PAD patients (n = 20 with cardiovascular event within 1 year after initial diagnosis, n = 20 without) and 40 apparently healthy controls, thrombin generation was determined in WB and platelet-poor plasma...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28457980/reversal-of-trauma-induced-coagulopathy-using-first-line-coagulation-factor-concentrates-or-fresh-frozen-plasma-retic-a-single-centre-parallel-group-open-label-randomised-trial
#10
Petra Innerhofer, Dietmar Fries, Markus Mittermayr, Nicole Innerhofer, Daniel von Langen, Tobias Hell, Gottfried Gruber, Stefan Schmid, Barbara Friesenecker, Ingo H Lorenz, Mathias Ströhle, Verena Rastner, Susanne Trübsbach, Helmut Raab, Benedikt Treml, Dieter Wally, Benjamin Treichl, Agnes Mayer, Christof Kranewitter, Elgar Oswald
BACKGROUND: Effective treatment of trauma-induced coagulopathy is important; however, the optimal therapy is still not known. We aimed to compare the efficacy of first-line therapy using fresh frozen plasma (FFP) or coagulation factor concentrates (CFC) for the reversal of trauma-induced coagulopathy, the arising transfusion requirements, and consequently the development of multiple organ failure. METHODS: This single-centre, parallel-group, open-label, randomised trial was done at the Level 1 Trauma Center in Innsbruck Medical University Hospital (Innsbruck, Austria)...
April 27, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28457516/relevance-of-hemolysis-induced-tissue-factor-expression-on-monocytes-in-soft-clot-formation-in-alcohol-containing-blood
#11
Masatoshi Nakata, Shogo Kasuda, Katsuya Yuui, Risa Kudo, Katsuhiko Hatake
The fluidity of cadaveric blood is an important characteristic in the post-mortem examination of cases of asphyxial death. Although it is empirically known that soft blood clots are present in cadaveric blood containing alcohol, the relationship between such clots and blood alcohol is unclear. We addressed this issue through in vitro studies using blood collected from healthy volunteers. Assessment of global hemostasis by rotational thromboelastometry revealed that ethanol treatment enhanced the procoagulant activity of whole blood...
March 2017: Legal Medicine
https://www.readbyqxmd.com/read/28452886/platelet-transfusions-reduce-fibrinolysis-but-do-not-restore-platelet-function-during-trauma-hemorrhage
#12
Paul Vulliamy, Scarlett Gillespie, Lewis S Gall, Laura Green, Karim Brohi, Ross A Davenport
INTRODUCTION: Platelets play a critical role in hemostasis with aberrant function implicated in trauma-induced coagulopathy. However, the impact of massive transfusion protocols on platelet function during trauma hemorrhage is unknown. The aim of this study was to characterize the effects of platelet transfusion on platelet aggregation and fibrinolytic markers during hemostatic resuscitation. METHODS: Trauma patients enrolled into the prospective Activation of Coagulation and Inflammation in Trauma (ACIT) study between January 2008 and November 2015 who received at least four units of packed red blood cells (PRBCs) were included...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28443944/the-role-of-thromboelastometry-in-the-assessment-and-treatment-of-coagulopathy-in-liver-transplant-patients
#13
Raffael Pereira Cezar Zamper, Thiago Chaves Amorim, Luiz Guilherme Villares da Costa, Flávio Takaoka, Ary Serpa
Perioperative monitoring of coagulation is vital to assess bleeding risks, diagnose deficiencies associated with hemorrhage, and guide hemostatic therapy in major surgical procedures, such as liver transplantation. Routine static tests demand long turnaround time and do not assess platelet function; they are determined on plasma at a standard temperature of 37°C; hence these tests are ill-suited for intraoperative use. In contrast, methods which evaluate the viscoelastic properties of whole blood, such as thromboelastogram and rotational thromboelastometry, provide rapid qualitative coagulation assessment and appropriate guidance for transfusion therapy...
April 20, 2017: Einstein
https://www.readbyqxmd.com/read/28439440/a-comparison-of-the-effects-of-20-mannitol-and-3-nacl-on-coagulation-parameters-in-vitro-using-rotem-a-prospective-randomized-crossover-study
#14
Achmet Ali, Bilge Şencan, Pulat Akın Sabancı, Demet Altun, Aylin Tetik, Lerzan Recep Doğan, İbrahim Özkan Akıncı
OBJECTIVE: The aim of the present study is to compare the effect of 20% mannitol and 3% NaCl on blood coagulation in vitro using rotational thromboelastometry (ROTEM). METHODS: Twenty-millilitre blood samples were obtained from 15 volunteers. In each group, 2 mL blood samples were collected into both polypropylene tubes and EDTA tubes for ROTEM and hemogram analysis. After sampling, blood samples were diluted with test solutions. Group C (control): Only blood, Group M (mannitol): 7% vol 20% mannitol concentration in the blood, Group hypertonic saline (HS): 7% vol 3% hypertonic saline (NaCl) in the blood, Group M/H (mannitol and hydroxyethyl starch solutions [HES]): 6% vol 20% mannitol concentration and 8% vol HES in the blood and Group HS/H (hypertonic saline and HES): 6% vol 3% hypertonic saline concentration and 8% vol HES in the blood...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28437457/tissue-factor-dependent-coagulation-activation-by-heme-a-thromboelastometry-study
#15
Gleice Regina de Souza, Bidossessi Wilfried Hounkpe, Maiara Marx Luz Fiusa, Marina Pereira Colella, Joyce M Annichino-Bizzacchi, Fabiola Traina, Fernando Ferreira Costa, Erich Vinicius De Paula
Heme has been characterized as potent trigger of inflammation. In hemostasis, although heme has been shown to both induce and inhibit different compartments of hemostasis, its net effect on the hemostatic balance, and the biological relevance of these effects remain to be determined. Herein we evaluated the effect of heme on hemostasis using a global assay able to generate clinically relevant data in several other complex hemostatic diseases. Citrated whole blood samples from healthy participants were stimulated by heme or vehicle and incubated for 4h at 37°C...
2017: PloS One
https://www.readbyqxmd.com/read/28431870/the-effect-of-hypertonic-saline-and-mannitol-on-coagulation-in-moderate-traumatic-brain-injury-patients
#16
Haifeng Wang, Hongshi Cao, Xiaohong Zhang, Liang Ge, Li Bie
BACKGROUND: Hyperosmolar therapy, using either hypertonic saline (HTS) or mannitol (MT), is considered the treatment of choice for intracranial hypertension, a disorder characterized by high intracranial pressure (ICP). However, hyperosmolar agents have been postulated to impair coagulation and platelet function. The aim of this study was to identify whether HTS and MT could affect coagulation in moderate traumatic brain injury (TBI) patients. METHODS: In this prospective and randomized double-blind study, we included adult patients with moderate TBI...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28406726/role-of-heterotrimeric-g-proteins-in-platelet-activation-and-clot-formation-in-platelets-treated-with-integrin-%C3%AE-iib%C3%AE-3-inhibitor
#17
Ivan Budnik, Boris Shenkman, Hagit Hauschner, Isaac Zilinsky, Naphtali Savion
Mechanisms of platelet activation are triggered by thrombin, adenosine diphosphate (ADP), epinephrine, thromboxane A2, and other soluble agonists which induce signaling via heterotrimeric Gαq, Gαi, and Gα12/13 proteins. We have undertaken a study addressing the contribution of these G proteins to platelet activation and clot formation in the presence of eptifibatide, thus excluding outside-in signaling provided by integrin αIIbβ3-fibrinogen engagement. Selective and combined activation of the G proteins was achieved by using combinations of platelet agonists and inhibitors...
April 13, 2017: Platelets
https://www.readbyqxmd.com/read/28403868/the-use-of-viscoelastic-haemostatic-assays-in-goal-directing-treatment-with-allogeneic-blood-products-a-systematic-review-and-meta-analysis
#18
REVIEW
Mathilde Fahrendorff, Roberto S Oliveri, Pär I Johansson
BACKGROUND: Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfusion requirements and mortality...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28393783/coagulopathies-in-cyanotic-cardiac-patients-an-analysis-with-three-point-of-care-testing-devices-thromboelastography-rotational-thromboelastometry-and-sonoclot-analyzer
#19
Vandana Bhardwaj, Poonam Malhotra, Suruchi Hasija, Ujjwal Kumar Chowdury, Neha Pangasa
INTRODUCTION: In the last few years, viscoelastic point-of-care (POC) coagulation devices such as thromboelastography (TEG), rotational thromboelastometry (ROTEM), and Sonoclot (SON) analyzer have been increasingly used in major surgeries for timely assessment and management of coagulopathies. The aim of the present study was to evaluate coagulation profile of cyanotic cardiac patients with TEG, ROTEM, and SON analyzer. In addition, we assessed the correlation of standard laboratory coagulation tests and postoperative chest drain output (CDO) with the parameters of POC testing devices...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28362128/a-pilot-study-on-the-applicability-of-thromboelastometry-in-detecting-brain-tumour-induced-hypercoagulation
#20
Erik Jansohn, Johan Bengzon, Thomas Kander, Ulf Schött
Patients with intracranial tumours have an increased risk of venous thromboembolism, particularly during the first month after neurosurgery. A proposed explanation for this increased risk, are procoagulant tumour-derived substances, such as tissue factor, usually measured in peripheral blood. The aim of the present study is to investigate whether a rotational thromboelastometry (ROTEM) can measure the procoagulative activity of tumour tissue. The study included 21 patients who were undergoing a craniotomy and complete tumour resection after written consent and ethical approval were obtained...
March 31, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
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