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Hyperfibrinolysis

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https://www.readbyqxmd.com/read/29129499/d-dimer-predicts-bleeding-complication-in-out-of-hospital-cardiac-arrest-resuscitated-with-extracorporeal-membrane-oxygenation
#1
Takayuki Otani, Hirotaka Sawano, Tomoaki Natsukawa, Reiko Matsuoka, Tetsufumi Nakashima, Motonori Takahagi, Yasuyuki Hayashi
PURPOSE: In out-of-hospital cardiac arrest (OHCA) patients resuscitated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO), known as extracorporeal cardiopulmonary resuscitation (ECPR), bleeding is a common complication. The purpose of this study was to assess the risk factors for bleeding complications in ECPR patients. METHODS: We retrospectively analyzed the data for OHCA patients admitted to our hospital and resuscitated with ECPR between October 2009 and December 2016...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110832/thromboelastometric-profile-and-acute-coagulopathy-of-the-polytraumatized-patient-clinical-and-prognostic-implications
#2
Antònia Bonet, Zoilo Madrazo, Maylin Koo, Israel Otero, Montserrat Mallol, Irene Macia, Luciano Ramirez, Antoni Sabaté
INTRODUCTION: About 25-35% of polytraumatized patients have a profound alteration of hemostasis on arrival at the hospital (acute traumatic coagulopathy [CAT]). Viscoelastic tests (ROTEM(®)) measure the hemostatic capacity and provide an early detection of CAT. The objectives of this study are to describe the initial thromboelastogram of these patients and to determine the prevalence of CAT according to predefined thromboelastographic profiles. METHODS: Single-center, observational, prospective study in polytraumatic patients...
October 27, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29099334/viscoelastic-monitoring-to-guide-hemostatic-resuscitation-in-liver-transplantation-surgery
#3
Kevin P Blaine, Tetsuro Sakai
Coagulopathic bleeding must be anticipated during liver transplantation (LT) surgery. Patients with end-stage liver disease (ESLD) often present with disease-related hematologic disturbances, including the loss of hepatic procoagulant and anticoagulant clotting factors and thrombocytopenia. Transplantation surgery itself presents additional hemostatic changes, including hyperfibrinolysis. Viscoelastic monitoring (VEM) is often used to provide targeted, personalized hemostatic therapies for complex bleeding states including cardiac surgery and major trauma...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29078874/14-day-thawed-plasma-retains-clot-enhancing-properties-and-inhibits-tpa-induced-fibrinolysis
#4
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Raymond Shepherd-Singh, Angela Sauaia, Gregory R Stettler, Geoffrey R Nunns, Christopher C Silliman
BACKGROUND: Plasma-first resuscitation attenuates trauma-induced coagulopathy (TIC); however, the logistics of plasma-first resuscitation require thawed plasma (TP) be readily available due to the obligatory thawing time of fresh frozen plasma (FFP). The current standard is storage of TP for up to 5 days at 4°C, based on factor levels at outdate, for use in patients at risk for TIC, but there remains a 2.2% outdated wastage rate. However, the multitude of plasma proteins in attenuating TIC remains unknown...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29059118/early-haemorrhage-control-and-management-of-trauma-induced-coagulopathy-the-importance-of-goal-directed-therapy
#5
Jakob Stensballe, Hanne H Henriksen, Pär I Johansson
PURPOSE OF REVIEW: The aim of this study was to discuss the recent developments in trauma-induced coagulopathy and the evolvement of goal-directed therapy. RECENT FINDINGS: Mortality from major trauma continues to be a worldwide problem, and massive haemorrhage remains a major cause in 40% of potentially preventable trauma deaths. Development of trauma-induced coagulopathy challenges 25-35% of the patients further increasing trauma mortality. The pathophysiology of coagulopathy in trauma reflects at least two distinct mechanisms: Acute traumatic coagulopathy, consisting of endogenous heparinization, activation of the protein C pathway, hyperfibrinolysis and platelet dysfunction, and resuscitation associated coagulopathy...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29034235/coagulofibrinolytic-changes-in-patients-with-post-cardiac-arrest-syndrome
#6
REVIEW
Takeshi Wada
Whole-body ischemia and reperfusion due to cardiac arrest and subsequent return of spontaneous circulation constitute post-cardiac arrest syndrome (PCAS), which consists of four syndromes including systemic ischemia/reperfusion responses and post-cardiac arrest brain injury. The major pathophysiologies underlying systemic ischemia/reperfusion responses are systemic inflammatory response syndrome and increased coagulation, leading to disseminated intravascular coagulation (DIC), which clinically manifests as obstruction of microcirculation and multiple organ dysfunction...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28918481/fibrinolysis-in-trauma-a-review
#7
REVIEW
M J Madurska, K A Sachse, J O Jansen, T E Rasmussen, J J Morrison
Fibrinolytic dysregulation is an important mechanism in traumatic coagulopathy. It is an incompletely understood process that consists of a spectrum ranging from excessive breakdown (hyperfibrinolysis) and the shutdown of fibrinolysis. Both hyperfibrinolysis and shutdown are associated with excess mortality and post-traumatic organ failure. The pathophysiology appears to relate to endothelial injury and hypoperfusion, with several molecular markers identified in playing a role. Although there are no universally accepted diagnostic tests, viscoelastic studies appear to offer the greatest potential for timely identification of patients presenting with fibrinolytic dysregulation...
September 16, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28902964/plasmatic-coagulation-and-fibrinolysis-in-healthy-and-otostrongylus-affected-northern-elephant-seals-mirounga-angustirostris
#8
Sarrah Kaye, Shawn Johnson, Carlos Rios, Daniel J Fletcher
BACKGROUND: Prepatent Otostrongylus arteritis results in hemorrhagic diathesis in free-ranging Northern elephant seals (Mirounga angustirostris) attributed to aberrant larval migration of the lungworm, Otostrongylus circumlitus. Clinical signs are often nonspecific, including lethargy, anorexia, and blepharospasm, but can progress to spontaneous frank hemorrhage and death within 72 hours of onset. Previously published case reports describe coagulopathy with prolonged PT and APTT, normal to elevated platelet counts, normal antithrombin concentrations, and low concentrations of fibrinogen degradation products...
September 13, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28874237/-drowning-induced-hyperfibrinolytic-disseminated-intravascular-coagulation
#9
Andreas Lund Hattesen, Henrik Karsten Berg, Lars Folkersen, Anne-Mette Hvas
This article summarizes the current knowledge of drowning-induced hyperfibrinolytic disseminated intravascular coagulation. Drowning induces respiratory failure with ensuing cardiac arrest, hypoxaemia and ischaemia. A coagulopathy is induced by ischaemia, acidosis and hypothermia, and clinically the patient develops uncontrolled bleeding due to hyperfibrinolysis. A rapid diagnostic approach is required to recognize this hyperfibrinolytic state, since initiation of treatment with antifibrinolytics and fibrinogen concentrate may bring this life-threatening condition to cessation...
August 28, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28837538/human-neutrophil-elastase-mediates-fibrinolysis-shutdown-through-competitive-degradation-of-plasminogen-and-generation-of-angiostatin
#10
Christopher D Barrett, Hunter B Moore, Anirban Banerjee, Christopher C Silliman, Ernest E Moore, Michael B Yaffe
BACKGROUND: A subset of trauma patients undergo fibrinolysis shutdown rather than pathologic hyperfibrinolysis, contributing to organ failure. The molecular basis for fibrinolysis shutdown in trauma is incompletely understood. Elastase released from primed/activated human neutrophils (HNE) has historically been described as fibrin(ogen)olytic. However, HNE can also degrade plasminogen (PLG) to angiostatin (ANG), retaining the Kringle domains but not the proteolytic function, and could thereby compete for generation of active plasmin by tPA...
August 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28830477/hyperfibrinolysis-in-severe-isolated-traumatic-brain-injury-may-occur-without-tissue-hypoperfusion-a-retrospective-observational-multicentre-study
#11
Mineji Hayakawa, Kunihiko Maekawa, Shigeki Kushimoto, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogura, Tetsuya Matsuoka, Toshifumi Uejima, Naoto Morimura, Hiroyasu Ishikura, Akiyoshi Hagiwara, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Daisuke Kudo, Takashi Kanemura, Takayuki Shibusawa, Shintaro Furugori, Yoshihiko Nakamura, Atsushi Shiraishi, Kiyoshi Murata, Gou Mayama, Arino Yaguchi, Shiei Kim, Osamu Takasu, Kazutaka Nishiyama
BACKGROUND: Hyperfibrinolysis is a critical complication in severe trauma. Hyperfibrinolysis is traditionally diagnosed via elevated D-dimer or fibrin/fibrinogen degradation product levels, and recently, using thromboelastometry. Although hyperfibrinolysis is observed in patients with severe isolated traumatic brain injury (TBI) on arrival at the emergency department (ED), it is unclear which factors induce hyperfibrinolysis. The present study aimed to investigate the factors associated with hyperfibrinolysis in patients with isolated severe TBI...
August 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28826407/disseminated-intravascular-coagulation-with-increased-fibrinolysis-during-the-early-phase-of-isolated-traumatic-brain-injury
#12
Takeshi Wada, Satoshi Gando, Kunihiko Maekaw, Kenichi Katabami, Hisako Sageshima, Mineji Hayakawa, Atsushi Sawamura
BACKGROUND: There is evidence to demonstrate that the coagulopathy which occurs in patients with traumatic brain injury coincides with disseminated intravascular coagulation (DIC). We hypothesized that DIC with increased fibrinolysis during the early stage of isolated traumatic brain injury (iTBI) affects the outcome of the patients and that hypoperfusion contributes to hyperfibrinolysis in the DIC. METHODS: This retrospective study included 92 patients with iTBI who were divided into DIC and non-DIC groups according to the Japanese Association Acute Medicine DIC scoring system...
August 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28755903/tranexamic-acid-is-associated-with-increased-mortality-in-patients-with-physiological-fibrinolysis
#13
Hunter B Moore, Ernest E Moore, Benjamin R Huebner, Gregory R Stettler, Geoffrey R Nunns, Peter M Einersen, Christopher C Silliman, Angela Sauaia
BACKGROUND: Tranexamic acid (TXA) administration after trauma has not been proven to improve survival in the United States. Trauma patients were presented to the hospital with a spectrum of fibrinolytic activity, in which physiological levels of fibrinolysis are associated with the lowest mortality. We hypothesize that trauma patients who present to the hospital with physiological levels of fibrinolysis will have increased mortality if they receive TXA. MATERIALS AND METHODS: Severely injured trauma patients, followed prospectively from 2014 to 2016, were included in the analysis...
May 8, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28734018/influence-of-cryoprecipitate-factor-xiii-and-fibrinogen-concentrate-on-hyperfibrinolysis
#14
Melissa M Cushing, Meghann M Fitzgerald, Rebecca M Harris, Lars M Asmis, Thorsten Haas
BACKGROUND: Hyperfibrinolysis is a potentially life-threatening condition associated with poor clot integrity and excessive bleeding. Although antifibrinolytics are an effective treatment, more liberal use of these drugs may lead to a prothrombotic risk, and an earlier and potentially safer treatment option would be desirable. Hyperfibrinolysis has been shown to be attenuated by in vitro supplementation of purified human Factor (F)XIII concentrate. Cryoprecipitate represents an alternative source of FXIII and the only approved source of concentrated FXIII in some countries...
October 2017: Transfusion
https://www.readbyqxmd.com/read/28727139/effect-of-solvent-detergent-treated-pooled-plasma-on-fibrinolysis-in-reconstituted-whole-blood
#15
Nicholas H Saadah, Pieter F van der Meer, Herm Jan M Brinkman, Dirk de Korte, Ido J Bontekoe, Herbert H Korsten, Rutger A Middelburg, Johanna G van der Bom, Martin R Schipperus
BACKGROUND: Hyperfibrinolysis has been observed in patients heavily transfused with solvent/detergent-treated pooled plasma (S/D plasma). We compared coagulation and fibrinolytic variables in blood containing S/D plasma with blood containing fresh-frozen plasma (FFP), with and without α2-antiplasmin or tranexamic acid (TXA) supplementation. STUDY DESIGN AND METHODS: Whole blood samples were reconstituted from red blood cells, platelet (PLT) concentrates, and varying mixtures of FFP and S/D plasma...
October 2017: Transfusion
https://www.readbyqxmd.com/read/28687976/annexin-a2-s100a10-heterotetramer-is-upregulated-by-pml-rar%C3%AE-fusion-protein-and-promotes-plasminogen-dependent-fibrinolysis-and-matrix-invasion-in-acute-promyelocytic-leukemia
#16
Dan Huang, Yan Yang, Jian Sun, Xiaorong Dong, Jiao Wang, Hongchen Liu, Chengquan Lu, Xueyu Chen, Jing Shao, Jinsong Yan
Aberrant expression of annexin A2-S100A10 heterotetramer (AIIt) associated with PML/RARα fusion protein causes lethal hyperfibrinolysis in acute promyelocytic leukemia (APL), but the mechanism is unclear. To facilitate the investigation of regulatory association between ANXA2 and promyelocytic leukemia/retinoic acid receptor a (PML/RARα) fusion protein, this work was performed to determine the transcription start site of ANXA2 promoter with rapid amplification of 5'-cDNA ends analysis. Zinc-induced U937/PR9 cells expressed PML/RARα fusion protein, and resultant increases in ANXA2 transcripts and translational expressions of both ANXA2 and S100A10, while S100A10 transcripts remained constitutive...
September 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28671065/association-between-ascites-and-primary-hyperfibrinolysis-a-cohort-study-in-210-dogs
#17
Andrea Zoia, Michele Drigo, Paolo Simioni, Marco Caldin, Christine J Piek
Coagulation profiles were determined in 70 dogs with ascites, 70 healthy control dogs and 70 sick control dogs without ascites. Dogs with ascites were divided into four sub-groups based on the pathophysiology of fluid formation. Coagulation profile, serum C-reactive protein and frequency of discordant plasma fibrin-fibrinogen degradation products and D-dimer assay results, suggesting primary hyperfibrinolysis, were compared between groups. Within the ascites group, 10 samples of ascitic fluid were transudates due to decreased osmotic pressure, 18 were transudates due to increased hydrostatic pressure, 13 were exudates and 29 were haemorrhagic...
May 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#18
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28617706/fulminant-hyperfibrinolysis-diagnosed-by-rotational-thromboelastometry
#19
John S McNeil, Amanda M Kleiman
No abstract text is available yet for this article.
November 2017: Anesthesiology
https://www.readbyqxmd.com/read/28602219/tranexamic-acid-leads-to-paradoxical-coagulation-changes-during-cardiac-surgery-a-pilot-rotational-thromboelastometry-study
#20
Rajiv Sharma, Hayley L Letson, Samuel Smith, Geoffrey P Dobson
BACKGROUND: Tranexamic acid (TXA) is increasingly used during major surgery with the goal to reduce excessive bleeding, transfusion requirements, and reexploration. Our aim was to examine the effect of TXA on coagulation at different times during cardiac surgery using rotational thromboelastometry. MATERIALS AND METHODS: Nineteen adult males (EuroSCORE 4-5) were recruited consecutively for first-time cardiopulmonary bypass (CPB) surgery. Ten patients received TXA at anesthesia and nine received no TXA...
September 2017: Journal of Surgical Research
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