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point of care coagulation

Katie Thorne, Harry McNaughton, Mark Weatherall
AIM: To assess time to coagulation screening results in patients presenting for potential stroke thrombolysis. METHODS: Retrospective cohort study of patients assessed for thrombolysis for stroke at Wellington Hospital between January and June 2014. We assessed time from presentation to receipt of laboratory specimen, processing time and total time from presentation to result availability; and whether times differed by receipt time. RESULTS: During the audit period, 97 unique patients, and 99 clinical episodes, were assessed for stroke thrombolysis...
November 9, 2016: Internal Medicine Journal
Lucia Mirabella, Antonella Cotoia, Giusj Colacicco, Livio Tullo, Potito Salatto, Giuseppina Mollica, Karim Mariano, Michele Dambrosio, Gilda Cinnella
BACKGROUND: Most data in the literature report reduced coagulation activities in the first few days of life with respect to adults and the effects of these differences must be considered when diagnosing and treating haemostatic disorders. Management of pediatric population is further complicated by the lack of age-related reference values and by unreliability of hemostatic tests currently used while an accurate interpretation of results are required to reduce the cases of inappropriate investigation...
November 18, 2016: Minerva Anestesiologica
K Venkatesh, P S Nair, D J Hoechter, H Buscher
Haemostatic perturbations are commonly seen in extracorporeal membrane oxygenation (ECMO) patients and remain a clinical challenge, contributing significantly to morbidity and mortality. The approach to anticoagulation monitoring and the management of bleeding varies considerably across ECMO centres. Routine laboratory tests have their limitations in terms of turnaround time and specificity of information provided. Newer point-of-care testing (POCT) for coagulation may overcome these issues, as it provides information about the entire coagulation pathway from clot initiation to lysis...
November 2016: Anaesthesia and Intensive Care
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
Nils Kunze-Szikszay, Lennart A Krack, Pauline Wildenauer, Saskia Wand, Tim Heyne, Karoline Walliser, Christopher Spering, Martin Bauer, Michael Quintel, Markus Roessler
BACKGROUND: Hyperfibrinolysis (HF) is a major contributor to coagulopathy and mortality in trauma patients. This study investigated (i) the rate of HF during the pre-hospital management of patients with multiple injuries and (ii) the effects of pre-hospital tranexamic acid (TxA) administration on the coagulation system. METHODS: From 27 trauma patients with pre-hospital an estimated injury severity score (ISS) ≥16 points blood was obtained at the scene and on admission to the emergency department (ED)...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
L Chow, A Carr, L MacKenzie, A Walker, D Archer, A Lee
BACKGROUND: Dalteparin is often used for prophylaxis or treatment of venous thromboembolism during pregnancy, yet there is no laboratory test to accurately reflect its clinical activity. Thromboelastography is a point-of-care monitor of whole blood coagulation. The aim of this study was to determine if serial doses of dalteparin added in vitro to whole blood samples from term, pregnant women are detectable as changes in thromboelastography parameters. METHODS: Thirty healthy parturients presenting for elective caesarean section were recruited...
December 2016: International Journal of Obstetric Anesthesia
Ji Young Kim, Yu Rim Shin, Hae Keum Kil, Mi Ran Park, Jong Wha Lee
BACKGROUND Rotational thromboelastometry (ROTEM®) is a point-of-care test for coagulation, enabling physicians to make a swift decision. The aim of this investigation was to establish reference intervals of thromboelastometric evaluation for coagulation in pediatric patients with congenital heart diseases (CHD). MATERIAL AND METHODS As baseline data, 3 assays of ROTEM® (INTEM, EXTEM, and FIBTEM) were measured after anesthesia induction. ROTEM® parameters were clotting time (CT), amplitude at 10 min (A10), clot formation time (CFT), a angle, maximal clot firmness (MCF), clot lysis index at 60 min (LI60), and maximal clot elasticity (MCE)...
October 6, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Ian Smith, Bronwyn L Pearse, Daniel J Faulke, Rishen Naidoo, Lisa Nicotra, Peter Hopkins, Elizabeth G Ryan
OBJECTIVE: Lung transplantation is associated with high rates of bleeding and frequent blood transfusion. The authors aimed to determine if point-of-care coagulation testing (POCCT) reduced transfusion requirements. DESIGN, SETTINGS, AND PARTICIPANTS: A before-and-after cohort analysis conducted at a single tertiary referral center. Ninety-three sequential adult patients between January 2010 and January 2014 undergoing isolated lung transplant without preoperative extracorporeal support were analyzed...
June 27, 2016: Journal of Cardiothoracic and Vascular Anesthesia
B N Nevitt, S K Chinnadurai, M K Watson, J N Langan, M J Adkesson
There are few reports of coagulation times in marsupial species. Blood samples collected from 14 Bennett's wallabies (Macropus rufogriseus) under anaesthesia during routine health assessments were analysed for prothrombin time (PT) and activated partial thromboplastin time (aPTT) using a point-of-care analyser (POC) (Abaxis VSPro®). The wallabies had an aPTT mean of 78.09 s and median of 78.1 s. The PT for all wallabies was greater than 35 s, exceeding the longest time measured on the POC. Although PT was significantly longer, aPTT was similar to the manufacturer's domestic canine reference range...
October 2016: Australian Veterinary Journal
K V Grooteman, E J M van Geenen, J P H Drenth
INTRODUCTION: Gastrointestinal angiodysplasias are an important cause of difficult-to-manage bleeding, especially in older patients. Endoscopic coagulation of angiodysplasias is the mainstay of treatment, but may be difficult for small bowel angiodysplasias because of the inability to reach them for endoscopic intervention. Some patients are red blood cell (RBC) transfusion dependent due to frequent rebleeding despite endoscopic treatment. In small cohort studies, octreotide appears to decrease the number of bleeding episodes in patients with RBC transfusion dependency due to gastrointestinal angiodysplasias...
September 12, 2016: BMJ Open
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
Nicole D Zantek, Catherine P Hayward, Trevor G Simcox, Kristi J Smock, Peihong Hsu, Elizabeth M Van Cott
OBJECTIVES: To assess the state of current practice in coagulation laboratories regarding three pressing issues: staffing, handling Ebola specimens, and testing/billing for tests that measure direct oral anticoagulants (DOAC). METHODS: A survey and analysis of specialized coagulation laboratories in North America was conducted. RESULTS: Approximately 4,000 special coagulation tests-per-technologist-per-year was rated as either a "good" staffing level or "adequate-but-ideally-need-more" employees...
September 2016: American Journal of Clinical Pathology
M I Meesters, G Kuiper, A B A Vonk, S A Loer, C Boer
Point-of-care coagulation monitoring can be used for the guidance of haemostasis management. However, the influence of time on point-of-care prothrombin time testing following protamine administration after cardiopulmonary bypass has not been investigated. Bland-Altman and error grid analysis were used to analyse the level of agreement between prothrombin time measurements from point-of-care and laboratory tests before cardiopulmonary bypass, and then 3 min, 6 min and 10 min after protamine administration. Prothrombin times were expressed as International Normalised Ratios...
October 2016: Anaesthesia
Shigeo Iijima, Toru Baba, Daizo Ueno, Akira Ohishi
INTRODUCTION: Early infants are at risk of vitamin K (VK) deficiency-associated bleeding unless they receive VK prophylaxis. A coagulation screening test might be necessary to detect prophylactic failure, but it is rarely conducted owing to the difficulty of blood sampling. CoaguChek XS is a portable, point-of-care (POC) coagulation analyzer that determines international normalized ratios (INRs) using only small volumes of blood. Although POC tests assessing INR have become widespread for adults, studies have not been performed in early infancy...
September 2016: Thrombosis Research
A Iorio, A M Barbara, F Bernardi, D Lillicrap, M Makris, F Peyvandi, F Rosendaal
Aim The scope of this recommendation is to provide guidance for reporting of inhibitor cases in previously treated patients (PTPs) with hemophilia A. This guidance is intended to improve transparency and completeness of reporting of observed events; it does not cover planning, executing or analyzing original studies aimed at the assessment of inhibitor rates. Recommendation We recommend that for each case of inhibitor development reported in a published paper, a paragraph or a table is included in the main publication reporting as a minimum the underlined data fields in Table ...
August 2016: Journal of Thrombosis and Haemostasis: JTH
Zida Li, Xiang Li, Brendan McCracken, Yue Shao, Kevin Ward, Jianping Fu
Whole blood coagulation testing provides valuable diagnostic information on diseases such as bleeding disorders, heart attack, deep venous thrombosis, etc. On page 3926, J. Fu and co-workers develop a miniaturized hemoretractometer to measure clot contraction upon blood coagulation with good reproducibility and robustness. This device design shows great application potential in point-of-care testing. Photo credit: David Peyer from University of Michigan.
August 2016: Small
Jae-Suk Lee, Makoto Kaibara, Edgar A O'Rear
BACKGROUND: Devices gauging viscoelastic properties of blood during coagulation like the thromboelastograph support fundamental research as well as point of care needs. Associated fibrinolysis data are based on endogenous species or plasminogen activator added to a homogeneous sample prior to clot formation. Digestion in a monolithic structure differs from the physical situation of thrombolytic therapy where surface reactions dominate. OBJECTIVE: This study aims to develop rheological testing for heterogeneous phase fibrinolysis...
July 29, 2016: Biorheology
Niels Straub, Ekaterina Bauer, Seema Agarwal, Patrick Meybohm, Kai Zacharowski, Alexander A Hanke, Christian F Weber
BACKGROUND: The economic effects of Point-of-Care (POC) coagulation testing including Multiple Electrode Aggregometry (MEA) with the Multiplate device have not been examined. METHODS: A health economic model with associated clinical endpoints was developed to calculate the effectiveness and estimated costs of coagulation analyses based on standard laboratory testing (SLT) or POC testing offering the possibility to assess platelet dysfunction using aggregometric measures...
2016: Clinical Laboratory
Hanne Berg Ravn, Jo Bnding Andreasen, Anne-Mette Hvas
Developmental haemostasis has been well documented over the last 3 decades and age-dependent reference ranges have been reported for a number of plasmatic coagulation parameters. With the increasing use of whole blood point-of-care tests like rotational thromboelastometry (ROTEM) and platelet function tests, an evaluation of age-dependent changes is warranted for these tests as well. We obtained blood samples from 149 children, aged 1 day to 5.9 years, and analysed conventional plasmatic coagulation tests, including activated partial prothrombin time, prothrombin time, and fibrinogen (functional)...
July 27, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Ariane Willems, Veaceslav Savan, David Faraoni, Andrée De Ville, Laurence Rozen, Anne Demulder, Philippe Van der Linden
OBJECTIVE: Protamine is used to neutralize heparin after patient separation from cardiopulmonary bypass (CPB). Different bedside tests are used to monitor the adequacy of heparin neutralization. For this study, the interchangeability of the activated coagulation time (ACT) and thromboelastometry (ROTEM; Tem Innovations GmbH, Basel, Switzerland) clotting time (CT) ratios in children undergoing cardiac surgery was assessed. DESIGN: Single-center, retrospective, cohort study between September 2010 and January 2012...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
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