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Rotational Thromboelastometry

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https://www.readbyqxmd.com/read/28988002/the-effect-of-sepsis-and-septic-shock-on-the-viscoelastic-properties-of-clot-quality-and-mass-using-rotational-thromboelastometry-a-prospective-observational-study
#1
Gareth R Davies, Matthew Lawrence, Suresh Pillai, Gavin M Mills, Robert Aubrey, Dafydd Thomas, Rhodri Williams, Keith Morris, Phillip Adrian Evans
PURPOSE: The study purpose was to define changes in coagulation across the sepsis spectrum using rotational thromboelastometry (ROTEM). METHODS: Sepsis patients were recruited on admission to the Emergency Department and Intensive Care Units of a large teaching hospital in Wales. ROTEM markers of clot development and fibrinolysis were determined, as well as standard coagulation markers. A healthy control group matched for age and gender was also recruited (n=44)...
October 2, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28980758/impact-of-four-direct-oral-anticoagulants-on-rotational-thromboelastometry-rotem
#2
L Seyve, C Richarme, B Polack, R Marlu
INTRODUCTION: Rotational Thromboelastometry (ROTEM) is a point of care method used to monitor coagulation during surgery and to guide transfusion strategies in patients presenting with severe bleeding. The aim of our study was to determine the impact of four direct oral anticoagulants (DOACs) on 3 commonly used ROTEM tests. METHODS: Whole blood samples from 20 healthy donors were spiked in vitro with apixaban, edoxaban, rivaroxaban or dabigatran at 5 different plasma concentrations (0-1000 ng/mL)...
October 5, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28938703/evaluation-of-thromboelastometry-parameters-as-predictive-markers-for-sinusoidal-obstruction-syndrome-in-patients-undergoing-allogeneic-stem-cell-transplantation-for-acute-leukaemia
#3
Joanna Rupa-Matysek, Lidia Gil, Ewelina Wojtasińska, Zuzanna Kanduła, Adam Nowicki, Magdalena Matuszak, Mieczysław Komarnicki
Hepatic sinusoidal obstruction syndrome (previously named veno-occlusive disease, SOS/VOD) is a serious complication of allogeneic stem cell transplantation (HSCT). Early identification of patients at risk of SOS/VOD may possibly improve the outcome and reduce mortality. Rotation thromboelastometry (ROTEM) is global assay allowing for the precise assessment of both bleeding and thrombotic conditions, however, its usefulness in patients undergoing HSCT for acute leukaemia has not been studied. We evaluated the thromboelastometry parameters in patients undergoing allogeneic HSCT for acute leukaemia to identify candidate biomarkers of SOS/VOD occurrence...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28920906/clotchip-a-microfluidic-dielectric-sensor-for-point-of-care-assessment-of-hemostasis
#4
Debnath Maji, Michael A Suster, Erdem Kucukal, Ujjal D S Sekhon, Anirban Sen Gupta, Umut A Gurkan, Evi X Stavrou, Pedram Mohseni
This paper describes the design, fabrication, and testing of a microfluidic sensor for dielectric spectroscopy of human whole blood during coagulation. The sensor, termed ClotChip, employs a three-dimensional, parallel-plate, capacitive sensing structure with a floating electrode integrated into a microfluidic channel. Interfaced with an impedance analyzer, the ClotChip measures the complex relative dielectric permittivity, ϵ Tr, of human whole blood in the frequency range of 40 Hz to 100 MHz. The temporal variation in the real part of the blood dielectric permittivity at 1 MHz features a time to reach a permittivity peak, Tpeak, as well as a maximum change in permittivity after the peak, ∆εr,max, as two distinct parameters of ClotChip readout...
September 12, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28911285/in-vitro-evaluation-of-the-effect-of-haemodilution-with-dextran-40-on-coagulation-profile-as-measured-by-thromboelastometry-and-multiple-electrode-aggregometry
#5
Pca Kam, Jpc Liou, Kxf Yang
We evaluated the effects of haemodilution with either dextran 40 or 0.9% normal saline on coagulation in vitro using rotational thromboelastometry (ROTEM®, Pentapharm Co., Munich, Germany) and multiple electrode aggregometry (Multiplate® Platelet Function Analyser, Dynabyte, Munich, Germany). Venous blood samples obtained from 20 healthy volunteers were diluted in vitro with dextran 40 or normal saline by 5%, 10% and 15%. Fibrinogen concentration, ROTEM-EXTEM® (screening test for the extrinsic coagulation pathway), FIBTEM® (an EXTEM-based assay of the fibrin component of clot) parameters including coagulation time, clot formation time, alpha angle, maximum clot firmness and lysis index were measured in the undiluted sample and at each level of haemodilution...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28862571/utility-of-intraoperative-rotational-thromboelastometry-in-thoracolumbar-deformity-surgery
#6
Jian Guan, Chad D Cole, Meic H Schmidt, Andrew T Dailey
OBJECTIVE Blood loss during surgery for thoracolumbar scoliosis often requires blood product transfusion. Rotational thromboelastometry (ROTEM) has enabled the more targeted treatment of coagulopathy, but its use in deformity surgery has received limited study. The authors investigated whether the use of ROTEM reduces transfusion requirements in this case-control study of thoracolumbar deformity surgery. METHODS Data were prospectively collected on all patients who received ROTEM-guided blood product management during long-segment (≥ 7 levels) posterior thoracolumbar fusion procedures at a single institution from April 2015 to February 2016...
September 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#7
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28837506/coagulopathy-in-children-with-liver-disease
#8
Patricia Sachi Kawada, Aisha Bruce, Patti Massicotte, Mary Bauman, Jason Yap
It was thought that a high International Normalized Ratio (INR) predicted bleeding in patients with chronic liver disease (CLD) and patients were 'autoanticoagulated'. Contrary to this belief, while patients with CLD experienced bleeding, they also developed thromboses. In the last decade, the prevailing literature challenged the idea that an elevated INR increased bleeding risk. The global assays of coagulation such as: thromboelastography (TEG)/rotational thromboelastometry (ROTEM) and thrombin generation assays (TGA) provide additional insight into coagulation processes...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28802634/individual-differences-in-heparin-sensitivity-and-their-effect-on-heparin-anticoagulation-during-arterial-vascular-surgery
#9
D Veerhoek, F Groepenhoff, M G J M van der Sluijs, J W B de Wever, J D Blankensteijn, A B A Vonk, C Boer, C F W Vermeulen
OBJECTIVES: To investigate whether a fixed heparin dose results in adequate heparinisation levels and consequent inhibition of haemostatic activation in all patients. METHODS: This prospective clinical pilot study included 24 patients undergoing arterial vascular surgery. Individual heparin responsiveness was assessed using the Heparin Dose Response (HDR) test, while the activated clotting time (ACT) and heparin concentration were measured to monitor the peri-procedural degree of anticoagulation...
October 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28800301/simultaneous-assessment-of-blood-coagulation-and-hematocrit-levels-in-dielectric-blood-coagulometry
#10
Yoshihito Hayashi, Marc-Aurèle Brun, Kenzo Machida, Seungmin Lee, Aya Murata, Shinji Omori, Hidetoshi Uchiyama, Yoshinori Inoue, Toshifumi Kudo, Takahiro Toyofuku, Masayuki Nagasawa, Isao Uchimura, Tomomasa Nakamura, Takeshi Muneta
BACKGROUND: In a whole blood coagulation test, the concentration of any in vitro diagnostic agent in plasma is dependent on the hematocrit level but its impact on the test result is unknown. OBJECTIVE: The aim of this work was to clarify the effects of reagent concentration, particularly Ca2+, and to find a method for hematocrit estimation compatible with the coagulation test. METHODS: Whole blood coagulation tests by dielectric blood coagulometry (DBCM) and rotational thromboelastometry were performed with various concentrations of Ca2+ or on samples with different hematocrit levels...
August 8, 2017: Biorheology
https://www.readbyqxmd.com/read/28795966/the-coagulation-profile-of-end-stage-liver-disease-and-considerations-for-intraoperative-management
#11
Katherine T Forkin, Douglas A Colquhoun, Edward C Nemergut, Julie L Huffmyer
The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging...
August 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28758557/thromboelastometry-versus-rotational-thromboelastography-in-cardiac-surgery
#12
Ahmed Zaky
Evidence exists on the morbiduty and mortality associated with both massive blood loss and transfusion in cardiac surgical patients. Monitoring of the vesicoelastic properties of blood using rotational thromboelastometry and thromboelsatography (TEG) has been a major step towards ameliorating the risks associated with these 2 evils by providing trageted goal-directed blood product resuscitation. Point of care ROTEM and TEG overcome many of the current limitatons of conventional laboratory coagulation testing...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28754139/evidence-of-altered-haemostasis-in-an-ovine-model-of-venovenous-extracorporeal-membrane-oxygenation-support
#13
Margaret R Passmore, Yoke L Fung, Gabriela Simonova, Samuel R Foley, Sara D Diab, Kimble R Dunster, Michelle M Spanevello, Charles I McDonald, John-Paul Tung, Natalie M Pecheniuk, Karen Hay, Kiran Shekar, John F Fraser
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a life-saving modality used in the management of cardiopulmonary failure that is refractory to conventional medical and surgical therapies. The major problems clinicians face are bleeding and clotting, which can occur simultaneously. To discern the impact of pulmonary injury and ECMO on the host's haemostatic response, we developed an ovine model of smoke-induced acute lung injury (S-ALI) and ECMO. The aims of this study were to determine if the ECMO circuit itself altered haemostasis and if this was augmented in a host with pulmonary injury...
July 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28750471/modulation-of-the-activated-protein-c-pathway-in-severe-haemophilia-a-patients-the-effects-of-thrombomodulin-and-a%C3%A2-factor-v-stabilizing-fab
#14
D F Brophy, E J Martin, B M Mohammed, J C Barrett, J G Kuhn, M E Nolte, B Wiinberg, H L Holmberg, J Lund, R Salbo, E K Waters
INTRODUCTION: The thrombomodulin (TM)/activated protein C (APC) system is a key regulator of haemostasis, limiting amplification and propagation of the formed blood clot to the injury site. Dampening APC's inhibition of factor V (FV) and factor VIII (FVIII) may be a future strategy in developing next-generation therapeutic targets for haemophilia treatment. AIMS: To determine ex vivo the respective concentration-dependent effects of TM and a FV-stabilizing Fab on the APC regulatory pathway in severe FVIII-deficient blood and plasma...
July 27, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28746233/preoperative-thromboelastometry-for-the-prediction-of-increased-chest-tube-output-in-cardiac-surgery-a-retrospective-study
#15
Waldemar Gozdzik, Barbara Adamik, Grzegorz Wysoczanski, Anna Gozdzik, Maciej Rachwalik, Tomasz Skalec, Andrzej Kübler
Bleeding following cardiac surgery is a serious event with potentially life-threatening consequences. Preoperative recognition of coagulation abnormalities and detection of cardiopulmonary bypass (CPB) related coagulopathy could aid in the start of preventive treatment strategies that minimize perioperative blood loss. Most algorithms that analyze thromboelastometry coagulation tests in elective cardiac surgery do not include test results performed before surgery. We evaluated preoperative rotational thromboelastometry test results for their ability to predict blood loss during and after cardiac surgery...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28714298/effect-of-sugammadex-on-coagulation-as-detected-by-rotational-thromboelastometry-in-morbidly-obese-patients
#16
Michele Carron, Diana Bertini, Tancredi Prandini, Francesca Fanton, Mirto Foletto, Carlo Ori, Egle Perissinotto, Paolo Simioni
BACKGROUND: Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). METHODS: Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (n = 30/group) at the end of surgery under desflurane anesthesia...
July 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28698333/research-protocol-for-platelets-in-out-of-hospital-cardiac-arrest-an-observational-case-controlled-feasibility-study-to-assess-coagulation-and-platelet-function-abnormalities-with-rotem-following-out-of-hospital-cardiac-arrest-pohcar
#17
Agnieszka Skorko, Matthew Thomas, Andrew Mumford, Thomas Johnson, Elinor Griffiths, Rosemary Greenwood, Jonathan Benger
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) has an annual incidence of approximately 60 000 in the UK. Less than 10% of those who receive resuscitation survive to hospital discharge. For OHCA of a presumed cardiac cause, the optimal antiplatelet therapy is currently unknown. Previous studies indicate that a procoagulopathic state exists postcardiac arrest which may contribute to the formation of thrombi and contribute to poor outcomes. However, the administration of antiplatelet therapies needs to be balanced against the increased risk of bleeding that these individuals face...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28688660/impact-of-tranexamic-acid-on-coagulation-and-inflammation-in-murine-models-of-traumatic-brain-injury-and-hemorrhage
#18
Ryan M Boudreau, Mark Johnson, Rosalie Veile, Lou Ann Friend, Holly Goetzman, Timothy A Pritts, Charles C Caldwell, Amy T Makley, Michael D Goodman
BACKGROUND: Posttraumatic coagulopathy and inflammation can exacerbate secondary cerebral damage after traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown clinically to reduce mortality in hemorrhaging and head-injured trauma patients and has the potential to mitigate secondary brain injury with its reported antifibrinolytic and antiinflammatory properties. We hypothesized that TXA would improve posttraumatic coagulation and inflammation in a murine model of TBI alone and in a combined injury model of TBI and hemorrhage (TBI/H)...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28651441/the-effect-of-ex-vivo-factor-xiii-supplementation-on-clot-formation-in-blood-samples-from-cardiac-and-scoliosis-surgery-patients
#19
Caroline Shams Hakimi, Malin S Carling, Emma C Hansson, Helena Brisby, Camilla Hesse, Vladimir Radulovic, Anders Jeppsson
Excessive perioperative bleeding remains a substantial problem. Factor XIII (FXIII) contributes to clot stability, and it has therefore been suggested that supplementation with FXIII concentrate may improve perioperative hemostasis. We evaluated the effects of increasing doses of FXIII, alone or in combination with fibrinogen or platelet concentrate, in blood samples from 2 considerably different groups of surgical patients: cardiac and scoliosis surgery patients. Whole-blood samples were collected immediately after operation from cardiac and scoliosis surgery patients...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28644135/evaluation-of-thromboelastometry-parameters-as-predictive-markers-for-sinusoidal-obstruction-syndrome-in-patients-undergoing-allogeneic-stem-cell-transplantation-for-acute-leukaemia
#20
Joanna Rupa-Matysek, Lidia Gil, Ewelina Wojtasińska, Zuzanna Kanduła, Adam Nowicki, Magdalena Matuszak, Mieczysław Komarnicki
Hepatic sinusoidal obstruction syndrome (previously named veno-occlusive disease, SOS/VOD) is a serious complication of allogeneic stem cell transplantation (HSCT). Early identification of patients at risk of SOS/VOD may possibly improve the outcome and reduce mortality. Rotation thromboelastometry (ROTEM) is global assay allowing for the precise assessment of both bleeding and thrombotic conditions, however, its usefulness in patients undergoing HSCT for acute leukaemia has not been studied.We evaluated the thromboelastometry parameters in patients undergoing allogeneic HSCT for acute leukaemia to identify candidate biomarkers of SOS/VOD occurrence...
June 15, 2017: Oncotarget
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