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Rotational Thromboelastometry

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https://www.readbyqxmd.com/read/28092924/evaluation-of-the-use-of-rotational-thromboelastometry-in-the-assessment-of-fxi-deficency
#1
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
#2
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
#3
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...
January 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/27994260/a-case-of-successful-thromboelastographic-guided-resuscitation-after-postpartum-hemorrhage-and-cardiac-arrest
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27940453/perioperative-management-of-the-bleeding-patient
#7
K Ghadimi, J H Levy, I J Welsby
Perioperative bleeding remains a major complication during and after surgery, resulting in increased morbidity and mortality. The principal causes of non-vascular sources of haemostatic perioperative bleeding are a preexisting undetected bleeding disorder, the nature of the operation itself, or acquired coagulation abnormalities secondary to haemorrhage, haemodilution, or haemostatic factor consumption. In the bleeding patient, standard therapeutic approaches include allogeneic blood product administration, concomitant pharmacologic agents, and increasing application of purified and recombinant haemostatic factors...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27911985/hemorrhagic-hemostatic-and-thromboelastometric-disorders-in-35-dogs-with-a-clinical-diagnosis-of-leptospirosis-a-prospective-study
#8
A Barthélemy, M Magnin, C Pouzot-Nevoret, J-M Bonnet-Garin, M Hugonnard, I Goy-Thollot
BACKGROUND: Leptospirosis in dogs is occasionally associated with a hemorrhagic syndrome, the pathophysiology of which is not fully understood. HYPOTHESIS/OBJECTIVES: To characterize hematologic, hemostatic, and thromboelastometric abnormalities in dogs with leptospirosis and to study their association with hemorrhagic diatheses and outcomes. ANIMALS: Thirty-five client-owned dogs. METHODS: A prospective observational single cohort study was conducted...
December 2, 2016: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/27892652/aliphatic-polyethers-with-sulfate-carboxylate-and-hydroxyl-side-groups-do-they-show-anticoagulant-properties
#9
Jagadeesh Malineni, Smriti Singh, Sabine Tillmann, Helmut Keul, Martin Möller
There is increasing interest in the synthesis of low molecular weight heparin and heparan sulfate mimetic polymers because of their various potential biomedical applications. The functional activity of heparin and heparan sulfate is believed to arise from the presence of a number of functional groups, such as hydroxyl, carboxylate and sulfate groups. The design and synthesis of novel heparin-mimetic polymers with a particular functionality poses a formidable challenge and requires carefully control of the selective conversion of functional groups on the polymer chain...
November 28, 2016: Macromolecular Bioscience
https://www.readbyqxmd.com/read/27891624/quarantine-versus-pathogen-reduced-plasma-coagulation-factor-content-and-rotational-thromboelastometry-coagulation
#10
Oliver M Theusinger, David Goslings, Jan-Dirk Studt, Brigitte Brand-Staufer, Burkhardt Seifert, Donat R Spahn, Beat M Frey
BACKGROUND: Different types of fresh-frozen plasma (FFP) exist, and the concentrations of plasma proteins vary between individuals and blood groups. Furthermore, processing may also influence the content. Quarantine-stored plasma (qFFP) and plasma that was pathogen-reduced using blood-safety (Intercept) technology (piFFP) were analyzed regarding procoagulant and anticoagulant hemostasis proteins, including endogenous thrombin (thrombin-generation) potential (ETP). MATERIALS AND METHODS: Thirty-five samples of each type of FFP were analyzed using only male Blood Group O donors...
November 27, 2016: Transfusion
https://www.readbyqxmd.com/read/27889194/usefulness-of-thromboelastography-in-the-detection-and-management-of-tissue-plasminogen-activator-associated-hyperfibrinolysis
#11
Francesca Rosafio, Laura Vandelli, Guido Bigliardi, Francesco Cavallieri, Maria Luisa Dell'Acqua, Livio Picchetto, Andrea Zini
Rotation thromboelastometry is a viscoelastometric method that provides a rapid assessment of a patient's hemostatic processes in emergency settings, allowing prompt identification of specific coagulation abnormalities. Its results thus might guide targeted replacement therapy in hemorrhagic conditions, in case of platelet or coagulation factor deficiency, or hyperfibrinolysis, which is difficult to identify otherwise. Although currently used in emergency and traumatic surgery, there are limited data about thromboelastometry in ischemic stroke, particularly in monitoring the coagulative response to recombinant tissue plasminogen activator after intravenous thrombolysis (IVT)...
November 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27882572/a-paired-comparison-of-thawed-and-liquid-plasma
#12
Lucy Backholer, Laura Green, Sian Huish, Sean Platton, Michael Wiltshire, Heidi Doughty, Elinor Curnow, Rebecca Cardigan
BACKGROUND: To make plasma readily available to treat major hemorrhage, some centers are internationally using either thawed plasma (TP) or "never-frozen" liquid plasma (LP). Despite the routine use of both, there are limited data comparing the two. The hemostatic properties of LP were evaluated and compared to TP in a paired study. STUDY DESIGN AND METHODS: Two ABO-matched plasma units were pooled and split to produce 1 unit for LP and 1 unit for TP. Samples of TP and LP, stored at 2 to 6°C, were tested for a range of coagulation factors, thrombin generation, and rotational thromboelastometry...
November 23, 2016: Transfusion
https://www.readbyqxmd.com/read/27862691/evaluation-of-the-use-of-global-haemostasis-assays-to-monitor-treatment-in-factor-xi-deficiency
#13
G N Pike, A M Cumming, J Thachil, C R M Hay, J Burthem, P H B Bolton-Maggs
INTRODUCTION: Previous guidelines recommend that FXI:C levels should be used to monitor FXI replacement in factor XI (FXI) deficiency. However, FXI:C levels do not correlate with bleeding tendency in this disorder and may not be the optimal test by which to monitor and determine further treatment in the postoperative period. AIM: To assess whether the thrombin generation assay (TGA) and rotational thromboelastometry can be used to monitor FXI replacement peri-operatively in FXI deficiency and to determine if changes in FXI:C levels correlate with changes in thrombin generation and clot formation parameters following treatment with solvent-detergent fresh frozen plasma (SD-FFP)...
November 8, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27849854/212-ecmo-and-cardiac-assist-devices-rotational-thromboelastometry-guided-coagulation-monitoring
#14
Dorothea Rosenberger, Heather Henry
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27815579/extracorporeal-membrane-oxygenation-improves-coagulopathy-in-an-experimental-traumatic-hemorrhagic-model
#15
M Larsson, P Forsman, P Hedenqvist, A Östlund, J Hultman, A Wikman, L Riddez, B Frenckner, M Bottai, C-M Wahlgren
PURPOSE: Hemorrhage is the most common cause of preventable death after trauma. Coagulopathy plays a central role in uncontrolled bleeding and is caused by multiple factors. Extracorporeal Membrane Oxygenation (ECMO) is an established treatment for patients with respiratory failure and has in recent years also been used in severely injured trauma patients with cardiopulmonary failure and coexisting bleeding shock. The aim of this study was to evaluate the effect of ECMO on hypothermia, acidosis, and coagulopathy in a traumatic hemorrhagic rabbit model...
November 4, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27785858/a-prospective-diagnostic-accuracy-study-evaluating-rotational-thromboelastometry-and-thromboelastography-in-100-patients-with-von-willebrand-disease
#16
D E Schmidt, A Majeed, M Bruzelius, J Odeberg, M Holmström, A Ågren
INTRODUCTION: Rotational thromboelastometry (ROTEM(®) ) and thromboelastography (TEG(®) ) are increasingly used in the perioperative and emergency assessment of bleeding tendencies. The diagnostic value of ROTEM and TEG for von Willebrand disease (VWD) remains to be established. AIM: To investigate whether ROTEM and TEG can discriminate patients with VWD from healthy controls. METHODS: Rotational thromboelastometry and TEG whole blood coagulation profiles were compared between VWD patients (n = 100) and healthy controls (n = 89)...
October 26, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27779583/model-of-trauma-induced-coagulopathy-including-hemodilution-fibrinolysis-acidosis-and-hypothermia-impact-on-blood-coagulation-and-platelet-function
#17
Boris Shenkman, Ivan Budnik, Yulia Einav, Hagit Hauschner, Mykhaylo Andrejchin, Uriel Martinowitz
BACKGROUND: Trauma-induced coagulopathy (TIC) is commonly seen among patients with severe injury. The dynamic process of TIC is characterized by variability of the features of the disease. METHODS: A model of TIC was created. Hemodilution was produced by mixing the blood with 40% TRIS/saline solution, fibrinolysis by treating the blood with 160 ng/mL tPA, acidosis by adding 1.2 mg/mL lactic acid achieving pH 7.0-7.1, and hypothermia by running the assay at 31 °C...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27777753/coagulative-safety-of-epidural-catheters-after-major-upper-gastrointestinal-surgery-advanced-and-routine-coagulation-analysis-in-38-patients
#18
Owain Thomas, Hampus Rein, Karin Strandberg, Ulf Schött
BACKGROUND: The risk of spinal haematoma in patients receiving epidural catheters is estimated using routine coagulation tests, but guidelines are inconsistent in their recommendations on what to do when results indicate slight hypocoagulation. Postoperative patients are prone to thrombosis, and thromboelastometry has previously shown hypercoagulation in this setting. We aimed to better understand perioperative haemostasis by comparing results from routine and advanced tests, hypothesizing that patients undergoing major upper gastrointestinal surgery would be deficient in vitamin K-dependent coagulation factors because of malnutrition, or hypocoagulative because of accumulation of low molecular weight heparin (LMWH)...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27776919/ischemic-stroke-in-a-patient-with-moderate-to-severe-inherited-factor-vii-deficiency
#19
Manasa Reddy, Bernard Tawfik, Chakri Gavva, Sean Yates, Nicole De Simone, Sandra L Hofmann, Siayareh Rambally, Ravi Sarode
Thrombosis is known to occur in patients with rare inherited bleeding disorders, usually in the presence of a thrombotic risk factor such as surgery and/or factor replacement therapy, but sometimes spontaneously. We present the case of a 72-year-old African American male diagnosed with congenital factor VII (FVII) deficiency after presenting with ischemic stroke, presumably embolic, in the setting of atherosclerotic carotid artery stenosis. The patient had an international normalized ratio (INR) of 2.0 at presentation, with FVII activity of 6% and normal Extem clotting time in rotational thromboelastometry...
December 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27766635/procoagulant-profile-in-patients-with-immune-thrombocytopenia
#20
María T Álvarez-Román, Ihosvany Fernández-Bello, Víctor Jiménez-Yuste, Mónica Martín-Salces, Elena G Arias-Salgado, María I Rivas Pollmar, Raúl Justo Sanz, Nora V Butta
Despite their low platelet count some immune thrombocytopenia (ITP) patients seldom bleed, indicating the presence of factors to compensate thrombocytopenia. Moreover, ITP patients may have an increased risk for thrombosis. These facts suggest the presence of procoagulant mechanisms that have not been clarified yet. The aim of this study was to identify these possible factors. Moreover, the utility of rotational thromboelastometry (ROTEM(®) ) to test haemostasis in these patients was also evaluated. Patients with ITP presented a procoagulant profile due to an increased amount of platelet- and red cell-microparticles, an increased resistance to protein C and the formation of a clot more resistant to fibrinolysis due to augmented levels of plasminogen activator inhibitor-1, which might reflect an endothelial damage/activation in ITP patients...
December 2016: British Journal of Haematology
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