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Thromboelastography

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https://www.readbyqxmd.com/read/29783879/effects-of-sodium-citrate-citric-acid-and-lactic-acid-on-human-blood-coagulation
#1
Vittorio Scaravilli, Luca Di Girolamo, Eleonora Scotti, Mattia Busana, Osvaldo Biancolilli, Patrizia Leonardi, Andrea Carlin, Caterina Lonati, Mauro Panigada, Antonio Pesenti, Alberto Zanella
INTRODUCTION: Citric acid infusion in extracorporeal blood may allow concurrent regional anticoagulation and enhancement of extracorporeal CO2 removal. Effects of citric acid on human blood thromboelastography and aggregometry have never been tested before. METHODS: In this in vitro study, citric acid, sodium citrate and lactic acid were added to venous blood from seven healthy donors, obtaining concentrations of 9 mEq/L, 12 mEq/L and 15 mEq/L. We measured gas analyses, ionized calcium (iCa++ ) concentration, activated clotting time (ACT), thromboelastography and multiplate aggregometry...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29768282/baseline-thromboelastogram-as-a-predictor-of-left-ventricular-assist-device-thrombosis
#2
Shannon L Piche, Scott D Nei, Erin Frazee, Sarah D Schettle, Barry A Boilson, Matthew F Plevak, Ross A Dierkhising, John M Stulak
Left ventricular assist device (LVAD) pump thrombosis occurs in up to 8.4% of patients within 3-months postimplantation. Thromboelastography (TEG) could be used to signal hypercoagulability at LVAD implantation to predict patients at high risk for thrombosis. We sought to evaluate whether TEG maximum amplitude (MA) hypercoagulability (MA ≥69 mm) at the time of LVAD implantation predicts pump thrombosis. A single center, retrospective, nested case-control study was conducted using patients from January 1, 2005, to March 31, 2015...
May 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29766129/is-thromboelastography-teg-based-resuscitation-better-than-empirical-1-1-transfusion
#3
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/29764673/comparison-between-thromboelastography-and-conventional-coagulation-test-should-we-abandon-conventional-coagulation-tests-in-polytrauma-patients
#4
Jaume Tur Martínez, Patrizio Petrone, Alexander Axelrad, Corrado P Marini
INTRODUCTION: TEG provides an in-vivo assessment of viscoelastic clot strength in whole blood compared with CCT, which may not reflect the influence of platelets. The aim of this study was to compare TEG vs. CCT in trauma patients stratified by mechanism of injury (MOI) and pre-existing coagulation status. METHODS: A retrospective, observational study of 230 polytrauma patients admitted to a University Hospital Level 1 Trauma Center, with TEG and CCT on admission stratified by MOI: multiple trauma (MT), isolated traumatic brain injury (TBI) or MT+TBI...
May 12, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29758989/the-double-hazard-of-bleeding-and-thrombosis-in-hemostasis-from-a-clinical-point-of-view-a-global-assessment-by-rotational-thromboelastometry-rotem
#5
Olga Meltem Akay
Hemostasis is a complex dynamic process involving bleeding and thrombosis as two end-points. Conventional coagulation tests which are measured in plasma examine only isolated portions of the coagulation cascade, thereby giving no information on important interactions essential to the clinical evaluation of hemostatic function. Thromboelastography (TEG), originally described in 1948 has improved over the decades and become a valuable tool of coagulation testing because of the limitations of standard coagulation tests...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29753821/thromboelastography-is-associated-with-surrogates-for-bleeding-after-pediatric-cardiac-surgery
#6
Sirisha Emani, Lynn A Sleeper, David Faraoni, Michelle Mulone, Fatoumata Diallo, James A DiNardo, Juan Ibla, Sitaram M Emani
BACKGROUND: Perioperative bleeding is a common complication in pediatric patients undergoing cardiac surgery. Although thromboelastography (TEG) has been utilized in patients undergoing adult cardiac surgery, limited data are available in pediatric patients. We hypothesize that TEG parameters may be associated with surrogate endpoints for postoperative bleeding in pediatric patients undergoing complex cardiac surgery. METHODS: In a retrospective study, TEG was obtained after protamine administration and upon intensive care unit (ICU) admission in pediatric patients (≤ 18yrs) undergoing cardiac surgery requiring cardiopulmonary bypass...
May 10, 2018: Annals of Thoracic Surgery
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
#7
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/29727528/a-prospective-evaluation-of-oral-yunnan-baiyao-therapy-on-thromboleastographic-parameters-in-apparently-healthy-dogs
#8
Colleen Tansey, Melissa L Wiebe, Gabrielle C Hybki, Jeffrey E Patlogar, Lisa A Murphy, Domenico Bianco, Reid K Nakamura
OBJECTIVE: To determine the effect of Yunnan Baiyao (YB) on hemostatic parameters measured by thromboelastography (TEG) in healthy dogs administered 1 capsule of YB orally twice daily for 1 week. DESIGN: Prospective study of client-owned dogs at a small animal specialty hospital. SETTING: Private referral center. ANIMALS: Eighteen client-owned adult dogs weighing at least 15 kg. INTERVENTIONS: Dogs had a baseline TEG performed and then each dog was administered 1 capsule of YB twice daily by mouth for 1 week and the TEG was reevaluated...
May 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29717984/effect-of-tranexamic-acid-on-intra-and-postoperative-haemorrhage-in-dogs-with-surgically-treated-hemoperitoneum
#9
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/29708302/congenital-dysfibrinogenaemia-assessed-by-whole-blood-thromboelastography
#10
A Wei, L Liao, L Xiang, J Yan, W Yang, G Nai, M Luo, D Deng, F Lin
INTRODUCTION: Congenital dysfibrinogenaemia (CD) is a rare hereditary blood disorder, and thromboelastography (TEG) can comprehensively assess the clotting function of patients. However, only few studies have focussed on the application of TEG in CD. We aim to investigate the clinical value of TEG in congenital CD. METHODS: We performed TEG and routine coagulation tests, including plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), functional fibrinogen (Fg) concentration (Clauss method) and Fg concentration (PT-derived method) tests, in 17 patients with CD (experimental group) and 28 healthy individuals (control group)...
April 30, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29704268/characteristics-of-hemostasis-during-experimental-ehrlichia-canis-infection
#11
Sarah Shropshire, Christine Olver, Michael Lappin
BACKGROUND: Ehrlichia canis infection in dogs can cause thrombocytopenia and clinical evidence of bleeding. It is unknown why some dogs show signs of bleeding whereas others do not despite clinically relevant thrombocytopenia. HYPOTHESIS/OBJECTIVES: Activated platelets, decreased fibrinolysis or both mitigate bleeding tendency. Assess standard hemostatic variables, platelet dynamics, and specialized coagulation testing in dogs experimentally infected with E. canis to evaluate this clinical discrepancy...
April 27, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29700007/abnormal-clotting-of-the-intrinsic-contact-pathway-in-alzheimer-disease-patients-is-related-to-cognitive-ability
#12
Georgette L Suidan, Pradeep K Singh, Sunita Patel-Hett, Zu-Lin Chen, Dmitri Volfson, Hitomi Yamamoto-Imoto, Erin H Norris, Robert D Bell, Sidney Strickland
Alzheimer disease (AD) is a neurodegenerative disorder characterized by extracellular β-amyloid (Aβ) deposition. Although peripheral inflammation and cerebrovascular pathology are reported in AD, there is a lack of plasma biomarkers in this field. Because the contact system is triggered in patient plasma, we hypothesized that the hemostasis profile could be a novel biomarker in AD. Here, we assessed the clotting profile in plasma from AD patients and age-matched controls. Utilizing clinically relevant assays, thromboelastography and activated partial thromboplastin time, we found impaired clot initiation and formation rate in AD patient plasma...
May 8, 2018: Blood Advances
https://www.readbyqxmd.com/read/29688784/thromboelastographic-evaluation-of-dogs-bitten-by-rattlesnakes-native-to-southern-california
#13
Beth A Lieblick, Philip J Bergman, Nathan W Peterson
OBJECTIVE To validate that dogs become hypocoagulable following rattlesnake envenomation and to determine whether thromboelastographic abnormalities are correlated with envenomation severity for dogs bitten by rattlesnakes native to southern California. ANIMALS 14 dogs with observed or suspected rattlesnake envenomation (envenomated dogs) and 10 healthy control dogs. PROCEDURES For each dog, a citrate-anticoagulated blood sample underwent kaolin-activated thromboelastography. For each envenomated dog, a snakebite severity score was assigned on the basis of clinical findings, and prothrombin time, activated partial thromboplastin time, and platelet count were determined when the attending clinician deemed it necessary and owner finances allowed...
May 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29683829/harmful-or-physiologic-diagnosing-fibrinolysis-shutdown-in-a-trauma-cohort-with-rotational-thromboelastometry
#14
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/29683037/pharmacological-differentiation-of-thrombomodulin-alfa-and-activated-protein-c-on-coagulation-and-fibrinolysis-in-vitro
#15
Kosuke Tanaka, Shunsuke Tawara, Kazuhisa Tsuruta, Debra Hoppensteadt, Jawed Fareed
Although thrombomodulin alfa (TM alfa), recombinant human soluble thrombomodulin, exerts antithrombogenic effects through activated protein C (APC), clinical trials suggested that TM alfa has a lower bleeding risk than does recombinant human APC. To address the mechanism explaining this difference, effects of TM alfa and APC on thrombogenic, coagulation, and fibrinolytic processes were compared in vitro. TM alfa and APC inhibited generation of thrombogenic markers, thrombin, and prothrombin fragment F1+2 and prolonged coagulation parameters, activated clotting time (ACT), and activated partial thromboplastin time (APTT)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29682837/massive-transfusion-changing-practice-in-a-single-norwegian-centre-2002-2015
#16
H Doughty, T O Apelseth, J Sivertsen, K Annaniasen, T Hervig
OBJECTIVES: To describe the change in massive transfusion (MT) practice in a single Norwegian centre throughout the period 2002-2015. BACKGROUND: MT support for traumatic haemorrhage has changed since the mid-2000s. However, life-threatening haemorrhage may occur in other clinical specialties. In 2007, Haukeland University Hospital (HUS) introduced a universal MT programme including education, Acute Transfusion Packages (ATPs) and thromboelastography. METHODS/MATERIALS: A retrospective review was performed of all MT episodes defined as ≥10 red cell concentrates (RCC) in 24 h...
April 23, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29662861/global-hemostatic-assay-of-different-target-procoagulant-activities-of-factor-viii-and-factor-ix
#17
Ki-Young Yoo, Soo-Young Jung, Sung-Ho Hwang, Su-Min Lee, Jong-Ho Park, Hyun-Ja Nam
Background: Korean National Health Insurance reimburses factor VIII (FVIII) and factor IX (FIX) clotting factor concentrate (CFC) infusions to discrepant activity levels, allowing elevation of FVIII activity to 60 IU/dL and FIX to 40 IU/dL. We aimed to assess hemostatic response to these target levels using global hemostatic assays. Methods: We enrolled 34 normal healthy men, 34 patients with hemophilia A, and 36 with hemophilia B, with residual factor activity of 3 IU/dL or less and without inhibitors...
March 2018: Blood Research
https://www.readbyqxmd.com/read/29662809/validation-of-nafamostat-mesilate-as-an-anticoagulant-in-extracorporeal-membrane-oxygenation-a-large-animal-experiment
#18
Sung Joon Han, Woosik Han, Hee-Jung Song, Cuk-Seong Kim, Seong-Mok Jeong, Min Woong Kang
Background: Unfractionated heparin is commonly used for anticoagulation in extracorporeal membrane oxygenation (ECMO). Several studies have shown that nafamostat mesilate (NM) has comparable clinical outcomes to unfractionated heparin. This study compared anticoagulation with NM and heparin in a large-animal model. Methods: Beagle dogs (n=8; weight, 6.5-9 kg) were placed on venovenous ECMO. Blood samples were taken every hour and the following parameters were compared: hemoglobin level, activated partial thromboplastin time (aPTT), thromboelastography (TEG) data, platelet function, and inflammatory cytokine levels...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29661415/reversal-of-dabigatran-by-intraosseous-or-intravenous-idarucizumab-in-a-porcine-polytrauma-model
#19
N Akman, T Braunschweig, M Honickel, K Schütt, H Schöchl, C Stoppe, R Rossaint, O Grottke
BACKGROUND: Idarucizumab is licensed to reverse dabigatran in life-threatening haemorrhage. Establishment of venous access can be challenging, and the intraosseous (IO) route is a potentially life-saving alternative. In this study, we compared the efficacy and safety of IO or intravenous (i.v.) idarucizumab for dabigatran reversal in a porcine polytrauma model. METHODS: Male pigs (n=21) received oral dabigatran etexilate (30 mg kg-1 bid) for 3 days. On the 4th day, animals received dabigatran infusion and were randomised 1:1:1 to receive IO saline (control), i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29653390/fondaparinux-versus-nadroparin-for-thromboprophylaxis-following-minimally-invasive-esophagectomy-a-randomized-controlled-trial
#20
Jieqiong Song, Lizhen Xuan, Wei Wu, Yaxing Shen, Lijie Tan, Ming Zhong
BACKGROUND: The methodology of thromboprophylaxis post minimally invasive esophagectomy (MIE) is unclear. Thus, we compared the efficacy and safety of fondaparinux and nadroparin on the prophylaxis of venous thromboembolism (VTE) after MIE. MATERIALS AND METHODS: We conducted a randomized, double-blind, treatment-controlled study. Consecutive patients undergoing MIE randomly received a single dose of either nadroparin 2850 AxaIU (Group H) or fondaparinux 2.5 mg (Group F) daily...
April 4, 2018: Thrombosis Research
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