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point of care coagulation

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https://www.readbyqxmd.com/read/29883040/management-of-postpartum-hemorrhage-how-to-improve-maternal-outcomes
#1
REVIEW
Dacia D C A Henriquez, Kitty W M Bloemenkamp, Johanna G van der Bom
Postpartum hemorrhage is the leading cause of maternal mortality and severe morbidity. Despite efforts to improve maternal outcomes, management of postpartum hemorrhage still faces at least four challenges, discussed in this review. First, current definitions for severe postpartum hemorrhage hamper early identification of women with high risk of adverse outcome. Adaptations to the definitions and the use of clinical tools such as shock index and early warning systems may facilitate this early identification...
June 8, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29864780/can-sequential-coagulation-monitoring-predict-major-haemorrhage-in-extremely-low-birth-weight-infants
#2
Margarita Thanhaeuser, Christoph Binder, Ulla Derhaschnig, Bernd Jilma, Margit Kornsteiner-Krenn, Mercedes Huber-Dangl, Andreas Repa, Alexandra Kreissl, Angelika Berger, Nadja Haiden
INTRODUCTION:  Bleeds such as intra-ventricular (IVH) and pulmonary haemorrhage (PH) are life-threatening events in extremely low birth weight (ELBW) infants. Serial coagulation monitoring by measuring the international normalized ratio (INR) with small volume samples might facilitate early diagnosis and possibly prevent major bleeds. MATERIALS AND METHODS:  This was a prospective longitudinal study performed in ELBW infants, who received serial INR monitoring by point of care testing during their first 30 days of life...
June 4, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29779622/anticoagulation-during-ecmo-in-neonatal-and-paediatric-patients
#3
Rebecca Barton, Vera Ignjatovic, Paul Monagle
Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and cardiac systems. Management of ECMO requires the use of systemic anticoagulation to prevent patient and circuit based thrombosis, which in turn increases the risk of haemorrhage. A number of coagulation tests, laboratory and point of care based, are used to monitor anticoagulation, however the evidence for correlation of the test results with level of anticoagulant and clinical outcomes in children remains poor...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29766129/is-thromboelastography-teg-based-resuscitation-better-than-empirical-1-1-transfusion
#4
Isaac W Howley, Elliott R Haut, Lenwoth Jacobs, Jonathan J Morrison, Thomas M Scalea
Thomboelastography (TEG) is a whole blood measure of coagulation which was originally described in the 1950s. However, it has only been in the last few decades that assays have become accessible and viable as a point-of-care test. Following the observation that hemorrhagic shock is associated with an intrinsic coagulopathy, TEG has been used as a method of diagnosing specific coagulation defects in order to direct individualized blood products resuscitation. An alternative transfusion strategy is the administration of fixed ratio products, a paradigm borne out of military experience...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29761633/verification-of-the-qlabs-international-normalized-ratio-point-of-care-device-for-monitoring-of-patients-attending-an-anticoagulation-clinic
#5
N Mbokota, E Schapkaitz, S Louw
INTRODUCTION: In the developing world, point-of-care (POC) testing for international normalized ratio (INR) plays an important role in the monitoring of patients on long-term warfarin therapy with limited access to healthcare ensuring safe and effective anticoagulation. A newly developed POC device for INR measurement by healthcare workers is the handheld qLabs POC device® (Micropoint Biotechnologies Incorporated, Guangdong, China). METHODS: The qLabs POC device® was evaluated in 262 patients attending an anticoagulation clinic with regards to accuracy and precision of the INR results...
May 14, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29761077/anatomical-cadaver-study-of-endolaryngeal-vascularization-focus-on-the-glottis-supraglottis-and-subglottis-from-the-transoral-microsurgical-point-of-view
#6
Pietro Perotti, Marco Ferrari, Nausica Montalto, Davide Lancini, Alberto Paderno, Fabiola Incandela, Barbara Buffoli, Luigi Fabrizio Rodella, Cesare Piazza
Introduction: Carbon dioxide laser coagulation during transoral laser microsurgery (TLM) for laryngeal cancer allows control of bleeding from vessels smaller than 0.5 mm. Therefore, larger arteries and veins must be carefully managed by clipping and/or monopolar cautery. The aim of this paper is to detail endolaryngeal vascular anatomy and identify areas of possible bleeding during TLM. Methods: We performed an anatomical study on a series of 11 fresh-frozen human cadavers...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29757137/reversal-of-apixaban-induced-alterations-in-haemostasis-by-different-coagulation-factor-concentrates-in-patients-after-hip-or-knee-replacement-surgery
#7
Katrin Schmidt, Kerstin Krüger, Elisabeth Langer, Martin Schmutzler, Elke Johnen, Klaus D Wernecke, Christian Von Heymann, Mareike K Körber
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) with a specific inhibition of activated factor X (FXa). In case of bleeding or need of urgent surgery a direct antidote is not yet available. Off-label application of non-specific haemostatic agents, such as prothrombin complex concentrate (PCC) and recombinant FVIIa (rFVIIa), has been reported to reverse the effects of apixaban in in vitro and animal studies. The aim of this study is to measure the reversal potential of PCC and rFVIIa in patients with prophylactic apixaban concentrations...
May 11, 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29707780/diagnostic-performance-of-prothrombin-time-point-of-care-to-detect-acute-traumatic-coagulopathy-on-admission-experience-of-522-cases-in-trauma-center
#8
Pauline Deras, Jibril Nouri, Orianne Martinez, Emmanuelle Aubry, Xavier Capdevila, Jonathan Charbit
BACKGROUND: Early identification of acute traumatic coagulopathy is a key challenge during initial management to determine whether to initiate early hemostatic support. We assessed the performance of prothrombin time (PT) at point-of-care in trauma patients to detect moderate and severe coagulopathy on admission. STUDY DESIGN AND METHODS: All admitted consecutive trauma patients were analyzed retrospectively between April 2014 and July 2015. PT was measured on admission with both a PT point-of-care device (PTr-CGK) and a standard coagulation test (PTr-STD)...
April 29, 2018: Transfusion
https://www.readbyqxmd.com/read/29652744/clinical-pearls-part-3-anaesthetic-management-of-abnormally-invasive-placentation
#9
Vinod Patil, Gamunu Ratnayake, Galina Fastovets, D S Wijayatilake
PURPOSE OF REVIEW: Abnormal placentation is a clinical condition seen increasingly in the pregnant population. It is associated with significant morbidity and mortality, which may be mitigated through robust multidisciplinary care for these patients. The role of maternal critical care for these patients has largely been ignored in the literature. RECENT FINDINGS: Advances in pharmacological management of bleeding with recent publications of large multicentre trials in addition to new technologies in the management of massive obstetric haemorrhage (MOH) have revolutionized the management of abnormal placentation...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29605581/hematological-complications-in-children-subjected-to-extracorporeal-membrane-oxygenation
#10
M J Santiago, C Gómez, I Magaña, V Muñoz, P Saiz, A Sánchez, J López-Herce
OBJECTIVES: To analyze the hematological complications and need for transfusions in children receiving extracorporeal life support (ECLS). DESIGN: A retrospective study was carried out. SETTING: A pediatric intensive care unit. PATIENTS: Children under 18 years of age treated with ECLS between September 2006 and November 2015. INTERVENTIONS: None. VARIABLES OF INTEREST: Patient and ECLS characteristics, anticoagulation, hematological and coagulation parameters, transfusions and clinical course...
March 29, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29577222/-establishment-of-comprehensive-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients
#11
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the comprehensive prediction model of acute gastrointestinal injury (AGI) grades of critically ill patients. METHODS: From April 2015 to November 2015, the binary channel gastrointestinal sounds (GIS) monitor system which has been developed and verified by the research group was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of Chinese PLA General Hospital. Also, the AGI grades (Grande I(-IIII(, the higher the level, the heavier the gastrointestinal dysfunction) were evaluated...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29525246/evaluation-and-management-of-aortic-stenosis-for-the-emergency-clinician-an-evidence-based-review-of-the-literature
#12
Michael Gottlieb, Brit Long, Alex Koyfman
INTRODUCTION: Aortic stenosis is a common condition among older adults that can be associated with dangerous outcomes, due to both the disease itself and its influence on other conditions. OBJECTIVE: This review provides an evidence-based summary of the current emergency department (ED) evaluation and management of aortic stenosis. DISCUSSION: Aortic stenosis refers to significant narrowing of the aortic valve and can be caused by calcific disease, congenital causes, or rheumatic valvular disease...
March 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29485284/carbon-nanotube-strain-sensor-based-hemoretractometer-for-blood-coagulation-testing
#13
Zida Li, Yize Wang, Xufeng Xue, Brendan McCracken, Kevin Ward, Jianping Fu
Coagulation monitoring is essential for perioperative care and thrombosis treatment. However, existing assays for coagulation monitoring have limitations such as a large footprint and complex setup. In this work, we developed a miniaturized device for point-of-care blood coagulation testing by measuring dynamic clot retraction force development during blood clotting. In this device, a blood drop was localized between a protrusion and a flexible force-sensing beam to measure clot retraction force. The beam was featured with micropillar arrays to assist the deposition of carbon nanotube films, which served as a strain sensor to achieve label-free electrical readout of clot retraction force in real time...
March 23, 2018: ACS Sensors
https://www.readbyqxmd.com/read/29474346/level-of-agreement-between-laboratory-and-point-of-care-prothrombin-time-in-patients-after-stopping-or-continuation-of-acenocoumarol-anticoagulation-a-comparison-of-diagnostic-accuracy
#14
Elisabeth A J de Vos, Yolien J Hagen, Michael I Meesters, Nada Osmanovic, Christa Boer, Marcel A de Leeuw
BACKGROUND: Procedures requiring optimisation of the coagulation status of patients using vitamin K antagonists are frequently postponed due to the late availability of laboratory international normalised ratio (INR) test results. A point-of-care (POC) alternative may facilitate early decision-making in peri-operative patients. OBJECTIVES: To assess the level of agreement between the POC-INR and the laboratory INR in patients who continue or stop vitamin K antagonists to determine whether the POC test may be a good alternative to the laboratory INR...
February 22, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29444563/recent-update-on-coagulation-management-and-hemostatic-therapies-in-liver-transplantation
#15
Ezeldeen Abuelkasem, Kenichi A Tanaka, Raymond M Planinsic
Liver transplantation is an ever-evolving field and understanding coagulation management and hemostatic therapies is essential for good outcomes. In this review, we discuss current monitoring tools available in the operating room and the hemostatic agents available to control hemostasis. Multifactorial coagulation defects are discussed and point-of care monitoring is reviewed to guide selection of hemostatic agents when indicated.
February 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29433148/international-council-for-standardization-in-haematology-icsh-recommendations-for-laboratory-measurement-of-direct-oral-anticoagulants
#16
Robert C Gosselin, Dorothy M Adcock, Shannon M Bates, Jonathan Douxfils, Emmanuel J Favaloro, Isabelle Gouin-Thibault, Cecilia Guillermo, Yohko Kawai, Edelgard Lindhoff-Last, Steve Kitchen
This guidance document was prepared on behalf of the International Council for Standardization in Haematology (ICSH) for providing haemostasis-related guidance documents for clinical laboratories. This inaugural coagulation ICSH document was developed by an ad hoc committee, comprised of international clinical and laboratory direct acting oral anticoagulant (DOAC) experts. The committee developed consensus recommendations for laboratory measurement of DOACs (dabigatran, rivaroxaban, apixaban and edoxaban), which would be germane for laboratories assessing DOAC anticoagulation...
March 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29430275/engineering-a-simple-lateral-flow-device-for-animal-blood-coagulation-monitoring
#17
Hua Li, Daewoo Han, Giovanni M Pauletti, Andrew J Steckl
Increasing numbers of animals are diagnosed with thromboembolism, requiring anticoagulation treatment to prevent thrombotic events. Frequent and periodic coagulation monitoring is critical to ensure treatment effectiveness and patient safety by limiting blood coagulation ability within the desired therapeutic range. Point-of-care diagnostics is an ideal candidate for frequent coagulation monitoring due to rapid test results and no need for laboratory setting. This article reports the first utilization of no-reaction lateral flow assay (nrLFA) device for simple and low-cost animal blood coagulation monitoring in resource-limited setting...
January 2018: Biomicrofluidics
https://www.readbyqxmd.com/read/29407620/point-of-care-testing-poct-to-assess-drug-concentration-in-patients-treated-with-non-vitamin-k-antagonist-oral-anticoagulants-noacs
#18
S Padayattil Jose, A Banzato, P Carraro, A Haleh, K Rossi, G Nante, G Denas, G Zoppellaro, V Pengo
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) do not need routine laboratory monitoring but measurement of drug concentration is important in emergency conditions. Specific laboratory tests are not readily available or not implemented in every hospital. Point-of-Care Tests (POCT) may bridge this gap and be used as a bedside solution. OBJECTIVES: Feasibility of POCT to assess plasma levels of dabigatran, rivaroxaban and apixaban. PATIENTS/METHODS: Activated Coagulation Time-Low Range (ACT - LR) using a portable Hemochron Signature Elite for dabigatran and prothrombin time (expressed as INR) by Coaguchek XS Pro for rivaroxaban and apixaban were obtained at trough and peak in 136 consecutive patients taking NOACs (70 on dabigatran, 45 on rivaroxaban and 20 on apixaban)...
March 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29395816/a-comparative-study-of-point-of-care-prothrombin-time-in-cardiopulmonary-bypass-surgery
#19
Shihoko Okabayashi, Satoru Ogawa, Kenichi A Tanaka, Takashi Nishiyama, Shusuke Takeshita, Yoshinobu Nakayama, Yasufumi Nakajima, Teiji Sawa, Toshiki Mizobe
OBJECTIVE: Point-of-care (POC) devices allow for prothrombin time/international normalized ratio (PT/INR) testing in whole blood (WB) and timely administration of plasma or prothrombin complex concentrate during cardiopulmonary bypass surgery. This study evaluated the sensitivities of a new POC PT test, a dry-hematology method with heparin neutralization technology (DRIHEMATO PT-S [DRI PT-S]; A&T Corporation, Kanagawa, Japan), and compared it with other POC tests currently available...
December 29, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29363781/advanced-hemophilic-arthropathy-sensitivity-of-soft-tissue-discrimination-with-musculoskeletal-ultrasound
#20
Annette von Drygalski, Randy E Moore, Sonha Nguyen, Richard F W Barnes, Lena M Volland, Tudor H Hughes, Jiang Du, Eric Y Chang
OBJECTIVES: Point-of-care musculoskeletal ultrasound (US) is increasingly used by hemophilia providers to guide management; however, pathologic tissue differentiation with US is uncertain. We sought to determine the extent to which point-of-care musculoskeletal US can identify and discriminate pathologic soft tissue changes in hemophilic arthropathy. METHODS: Thirty-six adult patients with hemophilia A/B were prospectively enrolled. Point-of-care musculoskeletal US examinations were performed on arthropathic joints (16 knees, 10 ankles, and 10 elbows) using standard views by a musculoskeletal US-trained and certified hematologist, who recorded abnormal intra-articular soft tissue accumulation...
January 24, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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