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Hyperfibrinolysis

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https://www.readbyqxmd.com/read/29771870/hyperfibrinolysis-is-an-important-cause-of-early-hemorrhage-in-patients-with-acute-promyelocytic-leukemia
#1
Yu-Hua Song, Chun Qiao, Li-Chan Xiao, Run Zhang, Hua - Lu
BACKGROUND The objective of the current study was to guide the early clinical treatment strategies by assessing the recovery of abnormal coagulation in acute promyelocytic leukemia (APL) patients during induction therapy. MATERIAL AND METHODS Retrospective analysis was performed in 112 newly-diagnosed patients with APL during induction treatment. RESULTS The early death (ED) rate in our study was 5.36% and the main cause was fetal hemorrhage. The presence of bleeding symptoms was significantly correlated with low platelet and fibrinogen levels...
May 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29743762/thromboelastographic-analysis-of-hemostatic-abnormalities-in-dengue-patients-admitted-in-a-multidisciplinary-intensive-care-unit-a-cross-sectional-study
#2
V K Sureshkumar, Deepak Vijayan, Shamim Kunhu, Zuhail Mohamed, Sujith Thomas, Muraleedharan Raman
Background: Dengue fever is an important tropical infection causing significant mortality. The pathophysiology of hematological abnormalities in dengue remains poorly studied. In this study, we analyzed the hematological abnormalities by thromboelastography (TEG). Methods: This cross-sectional study evaluated complicated dengue patients with TEG. Thromboelastographic variables were categorized into six patterns: factor deficiency, platelet dysfunction, enzymatic hypercoagulability, combined enzymatic and platelet hypercoagulability, primary fibrinolysis, and secondary hyperfibrinolysis...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29724147/characteristics-of-fibrinolytic-disorders-in-acute-promyelocytic-leukemia
#3
Ping Wang, Yingmei Zhang, Huiyuan Yang, Wenyi Hou, Bo Jin, Jinxiao Hou, Haitao Li, Hongli Zhao, Jin Zhou
OBJECTIVES: Catastrophic hemorrhage remains the main cause of acute promyelocytic leukemia (APL) treatment failure. This study was aimed to study the pathogenesis of coagulopathy in patients with APL. METHODS: Multiple procoagulant and profibrinolytic parameters in plasma and peripheral leukocytes from 24 patients with newly diagnosed APL accompanied by coagulopathy before and after arsenic trioxide (ATO) treatment were evaluated. RESULTS: Prior to the treatment, the patients had elevated D-dimer and decreased fibrinogen levels...
May 4, 2018: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/29723894/anxiety-related-bleeding-and-thrombosis
#4
Silvia Hoirisch-Clapauch
Anxiety, a normal response to stressful situations, is characterized by increased levels of factor VIII, fibrinogen, and von Willebrand factor, and by enhanced platelet aggregability. One would expect acute anxiety to be a prothrombotic state, but since acute mental stress induces tissue plasminogen activator (tPA) release from endothelial and chromaffin cells, fibrinolysis counteracts procoagulant stimuli. It could be said that procoagulant changes accompanying the fight-or-flight response reduce the risk of bleeding in case of potential injuries, while activation of fibrinolysis counteracts activation of hemostasis to prevent intravascular thrombus formation before injuries occur...
May 3, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29717984/effect-of-tranexamic-acid-on-intra-and-postoperative-haemorrhage-in-dogs-with-surgically-treated-hemoperitoneum
#5
N Sigrist, L Olgiati, R S Jud Schefer
Tranexamic acid (TXA) is an antifibrinolytic drug that is used for uncontrolled bleeding of various origin. This retrospective study investigated the effect of tranexamic acid administration on bleeding tendency in dogs with surgically managed hemoperitoneum. Thirty dogs were treated with (TXA group) and 25 dogs without (CTR group) tranexamic acid prior to surgery. Various parameters (decrease in haematocrit, number of transfusions, shock index and changes in abdominal fluid accumulation) were used for characterization of bleeding tendency and compared between groups...
May 2018: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29710026/-embolic-stroke-immediately-after-initial-administration-of-intravitreal-aflibercept
#6
Hironori Mizutani, Yuichiro Inatomi, Takaomi Singu, Makoto Nakajima, Toshiro Yonehara, Yukio Ando
A 72-year-old man was admitted to our hospital because of right upper limb monoplegia 8 hours after the initial intravitreal injection of aflibercept, which is an inhibitor of vascular endothelial growth factor. Magnetic resonance diffusion-weighted images showed recent ischemic lesions in the left corona radiata and the right superior frontal gyrus. Laboratory findings showed mild hyperfibrinolysis. A patent foramen ovale was diagnosed on transesophageal echocardiography; however, lower-extremity ultrasonography did not detect deep vein thrombosis...
April 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29683829/harmful-or-physiologic-diagnosing-fibrinolysis-shutdown-in-a-trauma-cohort-with-rotational-thromboelastometry
#7
J Carolina Gomez-Builes, Sergio A Acuna, Bartolomeu Nascimento, Fabiana Madotto, Sandro B Rizoli
BACKGROUND: Despite its central role in early trauma coagulopathy, abnormal fibrinolysis continues to be poorly understood. Excessive fibrinolysis is a known contributor to mortality. Recent studies with thromboelastography (TEG) suggest decreased fibrinolysis (or shutdown) may be just as harmful. Considering the broad use of 2 different viscoelastic assays, which are not interchangeable, we proposed for the first time to define and characterize fibrinolysis shutdown using rotational thromboelastometry (ROTEM)...
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29675813/computational-model-for-hyperfibrinolytic-onset-of-acute-traumatic-coagulopathy
#8
Tie Bo Wu, Sheng Wu, Matthew Buoni, Thomas Orfeo, Kathleen Brummel-Ziedins, Mitchell Cohen, Linda Petzold
The onset of acute traumatic coagulopathy in trauma patients exacerbates hemorrhaging and dramatically increases mortality. The disease is characterized by increased localized bleeding, and the mechanism for its onset is not yet known. We propose that the fibrinolytic response, specifically the release of tissue-plasminogen activator (t-PA), within vessels of different sizes leads to a variable susceptibility to local coagulopathy through hyperfibrinolysis which can explain many of the clinical observations in the early stages from severely injured coagulopathic patients...
April 19, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29665524/primary-hyperfibrinolysis-facts-and-fancies
#9
REVIEW
Massimo Franchini, Pier Mannuccio Mannucci
Fibrinolysis is a complex process that controls both hemostasis and thrombosis. The regulation of the fibrinolytic system is mediated through a wide array of cofactors and inhibitors that maintain the hemostatic balance in a delicate equilibrium. As a consequence, disturbances in the fibrinolysis pathway are associated with various disease states, ranging from thrombotic to hemorrhagic clinical phenotypes. In particular, a number of inherited and acquired disorders are associated with an enhanced fibrinolysis leading to a bleeding tendency that in some cases may be life-threatening...
April 12, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29628664/7-5-nacl-resuscitation-leads-to-abnormal-clot-fibrinolysis-after-severe-hemorrhagic-shock-and-its-correction-with-7-5-nacl-adenosine-lidocaine-and-mg-2
#10
Hayley Louise Letson, Geoffrey Phillip Dobson
Background: Hyperfibrinolysis is a common complication of hemorrhagic shock. Our aim was to examine the effect of small-volume 7.5% NaCl adenosine, lidocaine, and Mg2+ (ALM) on fibrinolysis in the rat model of hemorrhagic shock. Methods: Rats were anesthetized and randomly assigned to one of four groups: (1) baseline, (2) shock, (3) 7.5% NaCl controls, and (4) 7.5% NaCl ALM. Animals were bled for 20 min (42% blood loss) and left in shock for 60 min before resuscitation with 0...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29621008/incidence-and-clinical-significance-of-hyperfibrinolysis-during-living-donor-liver-transplantation
#11
Eun-Hee Kim, Justin S Ko, Mi-Sook Gwak, Suk-Koo Lee, Gaab-Soo Kim
: We evaluated the incidence and clinical significance of hyperfibrinolysis during living donor liver transplantation (LDLT) using viscoelastic coagulation tests. We retrospectively reviewed adult LDLT recipients from February 2010 to February 2015. Hyperfibrinolysis was defined when clot lysis index [LY60 = (MA - A60)/MA × 100, %] was less than 85, where A60 is the clot amplitude at 60 min after maximum amplitude (MA) occurred. Viscoelastic coagulation tests were performed six times (T1: immediately after anesthetic induction, T2: end of preanhepatic phase, T3: 1 h after anhepatic phase, T4: 5 min after reperfusion, T5: 1 h after reperfusion, and T6: 3 h after reperfusion)...
April 4, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29615381/hyperfibrinolysis-diagnosed-with-rotational-thromboelastometry-and-treated-with-tranexamic-acid-in-a-dog-with-acute-traumatic-coagulopathy
#12
B Muri, P Schmierer, A Schwarz, N Sigrist
A 4-year old male Australian Cattle Dog involved in a road traffic accident was presented with severe polytrauma to the Small Animal Clinic, University of Zurich. He was presented in hemorrhagic shock, with an initial lactate of 10.3mmol/l and ongoing bleeding from multiple injury sites. Acute traumatic coagulopathy diagnosed with ROTEM within one hour after accident showed marked hypocoagulation and hyperfibrinolysis. Treatment with a total dose of 40mg/kg of tranexamic acid intravenously resulted in successful elimination of hyperfibrinolysis in the following, serially measured ROTEM tracings...
April 2018: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29557885/the-s100a10-pathway-mediates-an-occult-hyperfibrinolytic-subtype-in-trauma-patients
#13
Lewis S Gall, Paul Vulliamy, Scarlett Gillespie, Timothy F Jones, Rochelle S J Pierre, Sabine E Breukers, Christine Gaarder, Nicole P Juffermans, Marc Maegele, Jakob Stensballe, Pär I Johansson, Ross A Davenport, Karim Brohi
OBJECTIVE: To determine the characteristics of trauma patients with low levels of fibrinolysis as detected by viscoelastic hemostatic assay (VHA) and explore the underlying mechanisms of this subtype. BACKGROUND: Hyperfibrinolysis is a central component of acute traumatic coagulopathy but a group of patients present with low levels of VHA-detected fibrinolysis. There is concern that these patients may be at risk of thrombosis if empirically administered an antifibrinolytic agent...
March 19, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29554044/systemic-hyperfibrinolysis-after-trauma-a-pilot-study-of-targeted-proteomic-analysis-of-superposed-mechanisms-in-patient-plasma
#14
Anirban Banerjee, Christopher C Silliman, Ernest E Moore, Monika Dzieciatskowa, Marguerite Kelher, Angela Sauaia, Kenneth Jones, Michael P Chapman, Eduardo Gonzalez, Hunter B Moore, Angelo D'Alessandro, Erik Peltz, Benjamin E Huebner, Peter Einerson, James Chandler, Arsen Ghasabayan, Kirk Hansen
BACKGROUND: Viscoelastic measurements of hemostasis indicate that 20% of seriously injured patients exhibit systemic hyperfibrinolysis, with increased early mortality. These patients have normal clot formation with rapid clot lysis. Targeted proteomics was applied to quantify plasma proteins from hyperfibrinolytic (HF) patients to elucidate potential pathophysiology. METHODS: Blood samples were collected in the field or at Emergency Department arrival and thrombelastography (TEG) was used to characterize in vitro clot formation under native and tissue plasminogen activator (tPA)-stimulated conditions...
March 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29462172/hemostatic-findings-of-pleural-fluid-in-dogs-and-the-association-between-pleural-effusions-and-primary-hyperfibrino-geno-lysis-a-cohort-study-of-99-dogs
#15
Andrea Zoia, Michele Drigo, Christine J Piek, Paolo Simioni, Marco Caldin
The primary objective of this study was to determine if activation of coagulation and fibrinolysis occurs in canine pleural effusions. Thirty-three dogs with pleural effusions of different origin were studied. Pleural effusion fibrinogen concentrations were significantly lower, while pleural fibrin-fibrinogen degradation products (FDPs) and D-dimer concentrations were significantly higher than those in plasma (P < 0.001 for all comparisons). These results show that, in canine pleural fluids, there is evidence of coagulation activation and fibrinolysis...
2018: PloS One
https://www.readbyqxmd.com/read/29443859/over-resuscitation-with-plasma-is-associated-with-sustained-fibrinolysis-shutdown-and-death-in-pediatric-traumatic-brain-injury
#16
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29411358/optimisation-of-the-dosage-of-tranexamic-acid-in-trauma-patients-with-population-pharmacokinetic-analysis
#17
S Grassin-Delyle, O M Theusinger, R Albrecht, S Mueller, D R Spahn, S Urien, P Stein
Tranexamic acid is used both pre-hospital and in-hospital as an antifibrinolytic drug to treat or prevent hyperfibrinolysis in trauma patients; dosing, however, remains empirical. We aimed to measure plasma levels of tranexamic acid in patients receiving pre-hospital anti-hyperfibrinolytic therapy and to build a population pharmacokinetic model to propose an optimised dosing regimen. Seventy-three trauma patients were enrolled and each received tranexamic acid 1 g intravenously pre-hospital. A blood sample was drawn after arrival in the emergency department, and we measured the plasma tranexamic acid concentration using liquid chromatography-mass spectrometry, and modelled the data using non-linear mixed effect modelling...
February 7, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29369078/thromboelastographic-study-of-the-snakebite-related-coagulopathy-in-djibouti
#18
Sébastien Larréché, François-Xavier Jean, Alain Benois, Aurélie Mayet, Aurore Bousquet, Serge Vedy, Patrick Clapson, Céline Dehan, Christophe Rapp, Eric Kaiser, Audrey Mérens, Georges Mion, Christophe Martinaud
: Hemostasis disorders are one of the major clinical conditions of snakebites and are because of mechanisms which may disrupt vessels, platelets, clotting factors and fibrinolysis. Thromboelastography (TEG) could help to understand these effects in the clinical practice. A retrospective study reports a series of patients presenting a snakebite-related coagulopathy, treated with antivenom and monitored with conventional tests and TEG in a French military treatment facility (Republic of Djibouti, East Africa) between August 2011 and September 2013...
March 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29363269/measuring-fibrinolysis-from-research-to-routine-diagnostic-assays
#19
REVIEW
C Longstaff
Development and standardization of fibrinolysis methods have progressed more slowly than coagulation testing and routine high-throughput screening tests for fibrinolysis are still lacking. In laboratory research, a variety of approaches are available and are applied to understand the regulation of fibrinolysis and its contribution to the hemostatic balance. Fibrinolysis in normal blood is slow to develop. For practical purposes plasminogen activators can be added to clotting plasma, or euglobulin prepared to reduce endogenous inhibitors, but results are complicated by these manipulations...
April 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29324486/fibrinolysis-and-antifibrinolytic-treatment-in-the-trauma-patient
#20
Lewis S Gall, Ross A Davenport
PURPOSE OF REVIEW: The role of antifibrinolytics in trauma haemorrhage and early coagulopathy remains controversial with respect to patient selection, dosage, timing of treatment, and risk of thrombotic complications. This review presents our current understanding of the mechanisms of fibrinolysis in trauma, diagnostic evaluation, and the evidence base for treatment. RECENT FINDINGS: Excessive fibrinolysis following severe injury is a major component of acute traumatic coagulopathy and contributes to the high mortality from trauma haemorrhage...
April 2018: Current Opinion in Anaesthesiology
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