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Rotational Thromboelastometry

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https://www.readbyqxmd.com/read/28317031/effect-of-tranexamic-acid-on-coagulation-and-fibrinolysis-in-women-with-postpartum-haemorrhage-woman-etac-protocol-and-statistical-analysis-plan-for-a-randomized-controlled-trial
#1
Haleema Shakur, Bukola Fawole, Modupe Kuti, Oladapo Olayemi, Adenike Bello, Olayinka Ogunbode, Taiwo Kotila, Chris O Aimakhu, Sumaya Huque, Meghann Gregg, Ian Roberts
Background: Postpartum haemorrhage (PPH) is a leading cause of maternal death. Tranexamic acid has the potential to reduce bleeding and a large randomized controlled trial of its effect on maternal health outcomes in women with PPH (The WOMAN trial) is ongoing. We will examine the effect of tranexamic acid on fibrinolysis and coagulation in a subset of WOMAN trial participants. Methods. Adult women with clinically diagnosed primary PPH after vaginal or caesarean delivery are eligible for inclusion in the WOMAN trial...
December 16, 2016: Wellcome Open Res
https://www.readbyqxmd.com/read/28306521/reference-ranges-of-thromboelastometry-in-healthy-full-term-and-pre-term-neonates
#2
Rozeta Sokou, Leontini Foudoulaki-Paparizos, Theodore Lytras, Aikaterini Konstantinidi, Martha Theodoraki, Ioannis Lambadaridis, Antonis Gounaris, Serena Valsami, Marianna Politou, Argyri Gialeraki, Georgios K Nikolopoulos, Nicoletta Iacovidou, Stefanos Bonovas, Argirios E Tsantes
BACKGROUND: Rotational thromboelastometry (ROTEM) is an attractive method for rapid evaluation of hemostasis in neonates. Currently, no reference values exist for ROTEM assays in full-term and pre-term neonates. Our aim was to establish reference ranges for standard extrinsically activated ROTEM assay (EXTEM) in arterial blood samples of healthy full-term and pre-term neonates. METHODS: In the present study, EXTEM assay was performed in 198 full-term (≥37 weeks' gestation) and 84 pre-term infants (<37 weeks' gestation) using peripheral arterial whole blood samples...
March 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28304315/using-antifibrinolytics-in-the-peripartum-period-concern-for-a-hypercoagulable-effect
#3
H K Ahmadzia, E L Lockhart, S M Thomas, I J Welsby, M R Hoffman, A H James, A P Murtha, G K Swamy, C A Grotegut
INTRODUCTION: Although antifibrinolytic agents are used to prevent and treat hemorrhage, there are concerns about a potential increased risk for peripartum venous thromboembolism. We sought to determine the impact of tranexamic acid and ɛ-aminocaproic acid on in vitro clotting properties in pregnancy. METHODS: Blood samples was obtained from healthy pregnant, obese, and preeclamptic pregnant women (n = 10 in each group) prior to delivery as well as from healthy non-pregnant controls (n = 10)...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28240645/point-of-care-monitoring-for-the-management-of-trauma-induced-bleeding
#4
Alexander A Hanke, Hauke Horstmann, Michaela Wilhelmi
PURPOSE OF REVIEW: Knowledge of trauma-induced coagulopathy has been grown in the past and point-of-care suitable devices for coagulation testing have been introduced. Methodology and clinical application of different systems for point-of-care coagulation monitoring are shown with a focus on thrombelastography as measured by TEG, rotational thromboelastometry as measured by ROTEM and impedance aggregometry as measured by the multiplate analyser and ROTEM platelet. RECENT FINDINGS: Two different methods for point-of-care coagulation assessment are available: viscoelastic tests (ROTEM, TEG) and impedance aggregometry...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28236302/pathogen-inactivation-treatment-of-plasma-and-platelet-concentrates-and-their-predicted-functionality-in-massive-transfusion-protocols
#5
Ahmad F Arbaeen, Peter Schubert, Katherine Serrano, Cedric J Carter, Brankica Culibrk, Dana V Devine
BACKGROUND: Trauma transfusion packages for hemorrhage control consist of red blood cells, plasma, and platelets at a set ratio. Although pathogen reduction improves the transfusion safety of platelet and plasma units, there is an associated reduction in quality. This study aimed to investigate the impact of riboflavin/ultraviolet light-treated plasma or platelets in transfusion trauma packages composed of red blood cell, plasma, and platelet units in a ratio of 1:1:1 in vitro by modeling transfusion scenarios for trauma patients and assessing function by rotational thromboelastometry...
February 24, 2017: Transfusion
https://www.readbyqxmd.com/read/28219085/fibrinolysis-in-trauma-myth-reality-or-something-in-between
#6
Mark Walsh, Jacob Shreve, Scott Thomas, Ernest Moore, Hunter Moore, Daniel Hake, Tim Pohlman, Patrick Davis, Victoria Ploplis, Andres Piscoya, Julie Wegner, John Bryant, Anton Crepinsek, James Lantry, Forest Sheppard, Francis Castellino
The emphasis on fibrinolysis as an important contributor to trauma-induced coagulopathy (TIC) has led to a debate regarding the relative clinical significance of fibrinolysis in the setting of trauma. The debate has centered on two camps. The one camp defines fibrinolysis in trauma by standard coagulation tests as well as fibrin split products, D-dimers, and plasmin/antiplasmin levels. This camp favors a more liberal use of tranexamic acid and attributes more significance to hyperfibrinolysis in TIC. The other camp favors a definition of fibrinolysis based on the viscoelastic tests (VET), rotational thromboelastometry (ROTEM), and thromboelastography (TEG)...
March 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28219084/diagnosis-and-treatment-of-hyperfibrinolysis-in-trauma-a-european-perspective
#7
Lewis S Gall, Karim Brohi, Ross A Davenport
Fibrinolysis activation occurs almost universally after severe trauma. Systemic hyperfibrinolysis is a key component of acute traumatic coagulopathy and associated with poor clinical outcomes, although controversy exists over optimal treatment strategies. The mechanistic drivers and dynamics of fibrinolytic activation in response to injury and trauma resuscitation are currently unclear. Furthermore, therapeutic triggers are compounded by the lack of a sensitive and rapid diagnostic tool, with discrepancy between hyperfibrinolysis diagnosed by viscoelastic hemostatic assays versus biomarkers for fibrinolysis...
March 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28178148/monitoring-the-hemostasis-with-rotation-thromboelastometry-in-patients-with-acute-stemi-on-dual-antiplatelet-therapy-first-experiences
#8
Matej Samoš, Lucia Stančiaková, Lukáš Duraj, František Kovář, Marián Fedor, Radoslava Šimonová, Tomáš Bolek, Peter Galajda, Ján Staško, Peter Kubisz, Marián Mokáň
Rotation thromboelastometry (ROTEM) is a viscoelastometric point-of-care-test for the complex evaluation of changes in hemostasis, performed in whole blood. However, no prospective study evaluating the efficacy of the antiplatelet therapy using ROTEM was performed.Fifty-six patients (34 men, 22 women, mean age 67.75 years, and age range 34-88 years) with acute ST-elevation myocardial infarction (STEMI), treated with dual antiplatelet therapy, undergoing urgent coronary angiography and percutaneous coronary intervention (PCI) of culprit coronary lesion were included...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28166379/reference-values-for-rotational-thromboelastometry-rotem-in-clinically-healthy-cats
#9
Charlotte Marly-Voquer, Barbara Riond, Rahel Jud Schefer, Annette P N Kutter
OBJECTIVE: To establish reference intervals for rotational thromboelastometry (ROTEM) using feline blood. DESIGN: Prospective study. SETTING: University teaching hospital. ANIMALS: Twenty-three clinically healthy cats between 1 and 15 years. INTERVENTION: For each cat, whole blood was collected via jugular or medial saphenous venipuncture, and blood was placed into a serum tube, a tube containing potassium-EDTA, and tubes containing 3...
March 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28164657/stability-of-non-activated-rotational-thromboelastometry-assay-in-time-of-citrated-blood-appropriate-time-interval-for-analysis
#10
Miroslav Durila, Silvie Sevcikova, Tomas Vymazal
BACKGROUND: Activated methods of thromboelastometry such as EXTEM and INTEM are routinely used in management of severe bleeding. However, sometimes the patient is bleeding despite the normal values of EXTEM/ INTEM. Non-activated thromboelastometry (NATEM) is the most sensitive to coagulopathy and shows pathologic results in such cases. However, it is necessary to find an appropriate time interval between blood sampling and NATEM analysis as the results are strongly influenced by time...
November 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28131428/a-new-intraoperative-protocol-for-reducing%C3%A2-perioperative-transfusions-in%C3%A2-cardiac-surgery
#11
J Hunter Mehaffey, Sarah A Schubert, Michael G Gelvin, Eric J Charles, Robert B Hawkins, Lily E Johnston, Gorav Ailawadi, Irving L Kron, Leora T Yarboro
BACKGROUND: Perioperative anemia and blood product transfusion increases short-term and long-term morbidity and mortality during cardiac surgery. We hypothesized that streamlined cardiopulmonary bypass circuit and rotational thromboelastometry (ROTEM) would reduce blood product usage and improve outcomes. METHODS: All patients with Society of Thoracic Surgeons risk scores at our institution from January 2013 to June 2015 were included. Individuals were chronologically stratified into 2 groups according to institutional changes to a streamlined bypass circuit and ROTEM-guided transfusion...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28114828/rotational-thromboelastometry-rotem-guided-treatment-of-an-afghanistan-viper-envenomation-at-a-nato-military-hospital
#12
Paul J D Roszko, Michael J Kavanaugh, Martin L Boese, Jason J Longwell, Angela S Earley
No abstract text is available yet for this article.
March 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28103832/thromboelastometry-analysis-of-thrombocytopenic-dengue-patients-a-cross-sectional-study
#13
Felipe Maia de Toledo Piza, Thiago Domingos Corrêa, Alexandre Rodrigues Marra, João Carlos Campos Guerra, Roseny Dos Reis Rodrigues, Andrea Aparecida Rocco Villarinho, Valdir Fernandes de Aranda, Sandra Christina Pereira Lima Shiramizo, Maria Roza de Jesus de Lima, Esper Georges Kallas, Alexandre Biasi Cavalcanti
BACKGROUND: Dengue virus infection (DVI) is a prevalent and potentially fatal viral disease associated with coagulopathy. So far, the coagulation profile of DVI patients with thrombocytopenia has not been assessed through a viscoelastic test such as rotational thromboelastometry. We aimed to describe the prevalence and characteristics of coagulation abnormalities in dengue fever outpatients with thrombocytopenia, addressed by both rotational thromboelastometry and conventional coagulation tests...
January 19, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28098662/management-of-a-patient-with-antiphospholipid-syndrome-undergoing-aortic-valve-replacement-using-the-hepcon-hemostasis-management-system-plus-and-rotational-thromboelastometry-a-case-report
#14
Yuriko Samejima, Mitsuharu Kodaka, Junko Ichikawa, Tetsu Mori, Kazuyoshi Ando, Keiko Nishiyama, Makiko Komori
A 72-year-old woman with antiphospholipid syndrome underwent aortic valve replacement. Her preoperative activated partial thromboplastin time was 61.7 seconds and activated clotting time was 219 seconds. During cardiopulmonary bypass, the Hepcon Hemostasis Management System (HMS) Plus determined the heparin dose needed to maintain whole-body heparin at 3 U/mL. After cardiopulmonary bypass, 100 mg of protamine was administered based on heparin-protamine neutralization, and the activated clotting time decreased...
March 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28092924/evaluation-of-the-use-of-rotational-thromboelastometry-in-the-assessment-of-fxi-deficency
#15
G N Pike, A M Cumming, J Thachil, C R M Hay, P H B Bolton-Maggs, J Burthem
INTRODUCTION: The absence of a reliable clinical test to predict bleeding tendency leaves factor XI (FXI)-deficient individuals at risk of overtreatment or under treatment. AIM: To assess whether rotational thromboelastometry has value in detection of FXI deficiency and identification of bleeding tendency. METHODS: Thromboelastometry was measured in whole blood and platelet-rich plasma (PRP) samples containing corn trypsin inhibitor (CTI) from controls (n = 50) and FXI-deficient individuals (n = 93) at tissue factor (TF) 0...
January 16, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28079789/the-impact-of-irrigating-fluid-absorption-on-blood-coagulation-in-patients-undergoing-transurethral-resection-of-the-prostate-a-prospective-observational-study-using-rotational-thromboelastometry
#16
Hyun-Jung Shin, Hyo-Seok Na, Young-Tae Jeon, Hee-Pyoung Park, Sun-Woo Nam, Jung-Won Hwang
Although endoscopic transurethral resection of the prostate (TURP) is a well-established procedure as a treatment for benign prostatic hyperplasia, its complications remain a concern. Among these, coagulopathy may be caused by the absorption of irrigating fluid. This study aimed to evaluate such phenomenon using a rotational thromboelastometry (ROTEM).A total of 20 patients undergoing TURP participated in this study. A mixture of 2.7% sorbitol-0.54% mannitol solution and 1% ethanol was used as an irrigating fluid, and fluid absorption was measured via the ethanol concentration in expired breath...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28052313/thromboelastography-teg-or-rotational-thromboelastometry-rotem-to-monitor-haemostatic-treatment-in-bleeding-patients-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#17
REVIEW
A Wikkelsø, J Wetterslev, A M Møller, A Afshari
Coagulopathy and severe bleeding are associated with high mortality. We evaluated haemostatic treatment guided by the functional viscoelastic haemostatic assays, thromboelastography or rotational thromboelastometry in bleeding patients. We searched for randomised, controlled trials irrespective of publication status, publication date, blinding status, outcomes published or language from date of inception to 5 January 2016 in six bibliographic databases. We included 17 trials (1493 participants), most involving cardiac surgery...
April 2017: Anaesthesia
https://www.readbyqxmd.com/read/27994260/a-case-of-successful-thromboelastographic-guided-resuscitation-after-postpartum-hemorrhage-and-cardiac-arrest
#18
M Hurwich, D Zimmer, E Guerra, E Evans, T Shire, M Abernathy, J T Shreve, G R Kolettis, M T McCurdy, F J Castellino, M Walsh
Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG)...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27984521/buprenorphine-analgesia-leads-to-coagulopathy-and-increased-plasma-fibrinogen-in-healthy-rats-implications-for-small-animal-research
#19
Maddison J Griffin, Hayley L Letson, Geoffrey P Dobson
INTRODUCTION: Buprenorphine is the recommended analgesic for post-surgical pain and associated stress in small animal research. Our aim was to examine the effect of isoflurane anesthesia and buprenorphine analgesia on blood coagulation in the rat using rotational thromboelastometry (ROTEM). METHODS: Adult male Sprague Dawley rats were randomly assigned to one of four groups (n = 6): 1) Baseline (Thiobarb anesthesia), 2) 5% Isoflurane anesthesia, 3) Isoflurane-buprenorphine (0...
December 14, 2016: Shock
https://www.readbyqxmd.com/read/27956672/rotation-thromboelastometry-velocity-curve-predicts-blood-loss-during-liver-transplantation
#20
L A Tafur, P Taura, A Blasi, J Beltran, G Martinez-Palli, J Balust, J C Garcia-Valdecasas
BACKGROUND: Patients undergoing liver transplantation (LT) have a high risk of bleeding. The goal of this study was to assess whether the first derivative of the velocity waveform (V-curve) generated by whole blood rotation thromboelastometry (ROTEM(®)) can predict blood loss during LT. METHODS: Preoperative V-curve parameters were retrospectively evaluated in 198 patients. Patients were divided into quartiles based on blood loss: low (LBL) in the first quartile and high (HBL) in the higher quartiles...
December 2016: British Journal of Anaesthesia
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