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point of care coagulation

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https://www.readbyqxmd.com/read/29025378/transfusion-related-acute-lung-injury-trali-and-transfusion-associated-circulatory-overload-taco-in-liver-transplantation-a-case-report-and-focused-review
#1
Natalie K Smith, Sang Kim, Bryan Hill, Andrew Goldberg, Samuel DeMaria, Jeron Zerillo
Liver transplantation (LT) is a complex procedure in a patient with multi-organ system dysfunction and coagulation defects. The surgical procedure involves dissection, major vessel manipulation, and pathophysiologic effects of graft storage and reperfusion. As a result, LT frequently involves significant hemorrhage. Subsequent massive transfusion carries high risk of transfusion-associated complications. Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are the leading causes of transfusion associated mortality...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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/28969328/viscoelastometry-guided-fresh-frozen-plasma-infusion-for-postpartum-haemorrhage-obs2-an-observational-study
#3
P W Collins, R Cannings-John, D Bruynseels, S Mallaiah, J Dick, C Elton, A Weeks, J Sanders, N Aawar, J Townson, K Hood, J Hall, K Harding, R Gauntlett, R Collis
Background: Postpartum haemorrhage (PPH) can be exacerbated by haemostatic failure. Based on data from trauma studies, empirical infusions of fresh frozen plasma (FFP) are often given during severe PPH if coagulation tests are unavailable. This study observed a cohort of women with moderate/severe PPH in whom FFP infusion was guided by the use of viscoelastometric point-of-care testing (VE-POCT) and clinical assessment. Methods: Women were enrolled into this observational study when blood loss was measured or suspected to be about 1000 mL...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28963294/new-criteria-for-sepsis-induced-coagulopathy-sic-following-the-revised-sepsis-definition-a-retrospective-analysis-of-a-nationwide-survey
#4
Toshiaki Iba, Marcello Di Nisio, Jerrold H Levy, Naoya Kitamura, Jecko Thachil
OBJECTIVE: Recent clinical studies have shown that anticoagulant therapy might be effective only in specific at-risk subgroups of patients with sepsis and coagulation dysfunction. The definition of sepsis was recently modified, and as such, old scoring systems may no longer be appropriate for the diagnosis of sepsis-associated coagulopathy. The aim of this study was to evaluate prognostic factors in patients diagnosed with sepsis and coagulopathy according to the new sepsis definition and assess their accuracy in comparison with existing models...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28922264/validation-of-a-portable-coagulometer-for-routine-in-hospital-use-for-newborns
#5
Antonio E Jerez Calero, Dolores Fernández Jiménez, Manuel Molina Oya, Eduardo Narbona López, José Uberos Fernández
OBJECTIVES: To verify the reliability and clinical benefits of the coagulation tests made by a point of care device in newborn admitted to a neonatal unit. DESIGN: We made a statistical comparison between results obtained by the point of care device versus conventional laboratory analysis. SETTING: Level 3 neonatal unit. PATIENTS: Thirty-one infants admitted to the neonatal unit at the San Cecilio University Hospital (Granada, Spain) were recruited to this study...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28920906/clotchip-a-microfluidic-dielectric-sensor-for-point-of-care-assessment-of-hemostasis
#6
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/28844370/technology-is-there-sufficient-evidence-to-change-practice-in-point-of-care-management-of-coagulopathy
#7
REVIEW
Michael Fabbro, Anne M Winkler, Jerrold H Levy
Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evidence that algorithmic transfusion using point-of-care (POC) testing can reduce red cell and platelet transfusions and major bleeding after cardiac surgery. Integrating these tests during cardiac surgery and trauma management is especially important because these groups use the most blood products within a health system and the risks of transfusion are well documented...
October 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28835607/clinical-evaluation-of-whole-blood-prothrombin-time-pt-and-international-normalized-ratio-inr-using-a-laser-speckle-rheology-sensor
#8
Markandey M Tripathi, Satoru Egawa, Alexandra G Wirth, Diane M Tshikudi, Elizabeth M Van Cott, Seemantini K Nadkarni
Prothrombin time (PT) and the associated international normalized ratio (INR) are routinely tested to assess the risk of bleeding or thrombosis and to monitor response to anticoagulant therapy in patients. To measure PT/INR, conventional coagulation testing (CCT) is performed, which is time-consuming and requires the separation of cellular components from whole blood. Here, we report on a portable and battery-operated optical sensor that can rapidly quantify PT/INR within seconds by measuring alterations in the viscoelastic properties of a drop of whole blood following activation of coagulation with thromboplastin...
August 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28798852/flow-reproducibility-of-whole-blood-and-other-bodily-fluids-in-simplified-no-reaction-lateral-flow-assay-devices
#9
H Li, D Han, M A Hegener, G M Pauletti, A J Steckl
The "no reaction" lateral flow assay (nrLFA) uses a simplified LFA structure with no conjugate pad and no stored reagents. In the nrLFA, the capillary-based transport time or distance is the key indicator, rather than the outcome of a biochemical reaction. Hence, the calibration and reproducibility of the nrLFA device are critical. The capillary flow properties of several membrane types (nitrocellulose, nylon, cellulose acetate, polyethersulfone, and polyvinylidene difluoride) are evaluated. Flow rate evaluations of MilliporeSigma Hi-Flow™ Plus (HF075, HF135 and HF180) nitrocellulose membranes on nrLFA are performed using bodily fluids (whole blood, blood plasma, and artificial sweat)...
March 2017: Biomicrofluidics
https://www.readbyqxmd.com/read/28771571/optical-sensing-of-anticoagulation-status-towards-point-of-care-coagulation-testing
#10
Diane M Tshikudi, Markandey M Tripathi, Zeinab Hajjarian, Elizabeth M Van Cott, Seemantini K Nadkarni
Anticoagulant overdose is associated with major bleeding complications. Rapid coagulation sensing may ensure safe and accurate anticoagulant dosing and reduce bleeding risk. Here, we report the novel use of Laser Speckle Rheology (LSR) for measuring anticoagulation and haemodilution status in whole blood. In the LSR approach, blood from 12 patients and 4 swine was placed in disposable cartridges and time-varying intensity fluctuations of laser speckle patterns were measured to quantify the viscoelastic modulus during clotting...
2017: PloS One
https://www.readbyqxmd.com/read/28758562/thromboelastrography-teg-is-still-relevant-in-the-21st-century-as-a-point-of-care-test-for-monitoring-coagulation-status-in-the-cardiac-surgical-suite
#11
Antonio Hernandez Conte, Deena Perotti, Lauren Farac
Since their introduction into clinical practice in the early 1960s, viscoelastic point-of-care (POC) testing-thromboelastrography (TEG) and thromboelastrometry (ROTEM)-has become increasingly popular in intensive care units, operating rooms, and emergency room settings. As TEG has been an established POC viscoelastic testing modality for many years, there has been more research and analysis of its utility and ability to reduce transfusions in the general, cardiac, and liver surgical sectors compared with ROTEM...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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/28752476/bleeding-risk-with-invasive-procedures-in-patients-with-cirrhosis-and-coagulopathy
#14
REVIEW
Nekisa Zakeri, Emmanuel A Tsochatzis
PURPOSE OF REVIEW: Previous perceptions of cirrhosis as a hypocoagulable state have resulted in empirical blood product transfusions prior to invasive procedures. We evaluate procedure-related bleeding risks in patients with cirrhosis, assess the utility of conventional and newer global coagulation tests, and explore evidence surrounding prophylactic transfusion strategies. RECENT FINDINGS: Recent literature supports the concept of a rebalanced, albeit fragile, haemostasis equilibrium in cirrhosis, with a potential hypercoagulable tendency in stable patients...
September 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28747069/a-proposal-of-the-modification-of-japanese-society-on-thrombosis-and-hemostasis-jsth-disseminated-intravascular-coagulation-dic-diagnostic-criteria-for-sepsis-associated-dic
#15
Toshiaki Iba, Marcello Di Nisio, Jecko Thachil, Hideo Wada, Hidesaku Asakura, Koichi Sato, Daizoh Saitoh
Sepsis-associated disseminated intravascular coagulation (DIC) carries a high risk of death. Thus, a simple tool to quickly establish DIC diagnosis is required. The purpose of this study was to introduce the simple and reliable tool for the prediction of outcome in patients with sepsis complicated by coagulopathy. We investigated the performance of simplified Japanese Society on Thrombosis and Hemostasis (JSTH) DIC diagnostic criteria. In this study, we conducted a retrospective, multicenter survey in 107 general emergency and critical care centers in secondary and tertiary care hospitals...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28745251/-using-thromboelastography-to-measure-coagulation-following-massive-blood-loss
#16
M C A Müller, G A E Ponjee
Thromboelastography is becoming increasingly important for diagnosing coagulation disorders in patients with massive blood loss. This whole-blood measurement provides information about the speed of clot formation, clot strength, and degree of fibrinolysis. The result can be used as a basis for making a faster and better choice of a suitable blood product for the patient with severe blood loss. This technique can be carried out simply and quickly as a rapid test ('point-of-care test') or in a central laboratory...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28723173/laser-scribed-graphene-electrodes-for-aptamer-based-biosensing
#17
Christoph Fenzl, Pranati Nayak, Thomas Hirsch, Otto S Wolfbeis, Husam N Alshareef, Antje J Baeumner
Graphene as a transducer material has produced some of the best-performing sensing approaches to date opening the door toward integrated miniaturized all-carbon point-of-care devices. Addressing this opportunity, laser-scribed graphene (LSG) electrodes are demonstrated here as highly sensitive and reliable biosensor transducers in blood serum analysis. These flexible electrodes with large electrochemical surface areas were fabricated using a direct-write laser process on polyimide foils. A universal immobilization approach is established by anchoring 1-pyrenebutyric acid to the graphene and subsequently covalently attaching an aptamer against the coagulation factor thrombin as an exemplary bioreceptor to the carboxyl groups...
May 26, 2017: ACS Sensors
https://www.readbyqxmd.com/read/28695382/point-of-care-coagulation-monitoring-first-clinical-experience-using-a-paper-based-lateral-flow-diagnostic%C3%A2-device
#18
Michael A Hegener, Hua Li, Daewoo Han, Andrew J Steckl, Giovanni M Pauletti
Vitamin K antagonists such as warfarin are the most widely used class of oral anticoagulants. Due to a narrow therapeutic window, patients on warfarin require regular monitoring. Self-testing using point-of-care (POC) diagnostic devices is available, but cost makes this monitoring method beyond reach for many. The main objective of this research was to assess the clinical utility of a low-cost, paper-based lateral flow POC diagnostic device developed for anticoagulation monitoring without the need for a separate electronic reader...
September 2017: Biomedical Microdevices
https://www.readbyqxmd.com/read/28693359/coagulation-monitoring-correlation-with-heparin-dose-in-pediatric-extracorporeal-life-support
#19
Katie Moynihan, Kerry Johnson, Lahn Straney, Christian Stocker, Ben Anderson, Prem Venugopal, John Roy
OBJECTIVES: Extracorporeal Life Support (ECLS) risks thrombotic and hemorrhagic complications. Optimal anti-coagulation monitoring is controversial. We compared coagulation tests evaluating the heparin effect in pediatric ECLS. METHODS: A retrospective study of children (<18yrs) undergoing ECLS over 12 months in a tertiary pediatric intensive care unit (PICU). Variables included anti-Factor Xa activity (anti-Xa), activated partial thromboplastin time (aPTT), activated clotting time (ACT) and thromboelastogram (TEG(®)6s) parameters: ratio and delta reaction (R) times (the ratio and difference, respectively, between R times in kaolin assays with and without heparinase)...
July 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28691336/management-algorithms-for-cervical-cancer-screening-and-precancer-treatment-for-resource-limited-settings
#20
Partha Basu, Filip Meheus, Youssef Chami, Roopa Hariprasad, Fanghui Zhao, Rengaswamy Sankaranarayanan
Management algorithms for screen-positive women in cervical cancer prevention programs have undergone substantial changes in recent years. The WHO strongly recommends human papillomavirus (HPV) testing for primary screening, if affordable, or if not, then visual inspection with acetic acid (VIA), and promotes treatment directly following screening through the screen-and-treat approach (one or two clinic visits). While VIA-positive women can be offered immediate ablative treatment based on certain eligibility criteria, HPV-positive women need to undergo subsequent VIA to determine their eligibility...
July 2017: International Journal of Gynaecology and Obstetrics
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