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Thromboelastography

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https://www.readbyqxmd.com/read/29340875/thromboelastography-based-anticoagulation-management-during-extracorporeal-membrane-oxygenation-a-safety-and-feasibility-pilot-study
#1
Mauro Panigada, Giacomo E Iapichino, Matteo Brioni, Giovanna Panarello, Alessandro Protti, Giacomo Grasselli, Giovanna Occhipinti, Cristina Novembrino, Dario Consonni, Antonio Arcadipane, Luciano Gattinoni, Antonio Pesenti
BACKGROUND: There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened by a high rate of hemostatic complications, possibly associated with inadequate monitoring of heparin anticoagulation. This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol...
January 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29335059/association-of-%C3%AE-2a-adrenergic-receptor-genetic-variants-with-platelet-reactivity-in-chinese-patients-on-dual-antiplatelet-therapy-undergoing-percutaneous-coronary-intervention
#2
Ying Song, Xiao Fang Tang, Yi Yao, Chen He, Jing Jing Xu, Huan Huan Wang, Zhan Gao, Mia Wang, Jin Qing Yuan
OBJECTIVE: The alpha 2A-adrenergic receptor gene (ADRA2A) polymorphism in individuals modifies the antiplatelet response to sympathetic stimulation. The aim of this study was to investigate the effect of ADRA2A variants on platelet reactivity in Chinese patients on dual antiplatelet therapy (DAPT) after undergoing percutaneous coronary intervention (PCI). METHODS: From March 2011 to March 2013, 1,024 patients were enrolled in this prospective, single-center, observational study in China...
December 2017: Biomedical and Environmental Sciences: BES
https://www.readbyqxmd.com/read/29334497/deep-vein-thrombosis-and-venous-thromboembolism-in-trauma
#3
Keith J Ruskin
PURPOSE OF REVIEW: Deep vein thrombosis (DVT) and pulmonary embolus are major causes of hospital-related morbidity and mortality, and are recognized as complications in patients with traumatic injury. Despite the significant morbidity and mortality associated with DVTs, prophylaxis and treatment are still not well understood and remain the subject of research and debate. RECENT FINDINGS: Elements of the patient's history and physical examination, along with thromboelastography, can be used to predict patients who are at greatest risk of DVT and venous thromboembolism (VTE)...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29331555/preoperative-thromboelastographic-profile-of-patients-with-congenital-heart-disease-association-of-hypercoagulability-and-decreased-heparin-response
#4
Zhe Amy Fang, Rachel Bernier, Sirisha Emani, Sitaram Emani, Gregory Matte, James A DiNardo, David Faraoni, Juan C Ibla
OBJECTIVE: To describe the demographic and thromboelastographic characteristics of patients with congenital heart disease presenting with decreased heparin response before cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single institution, tertiary, academic, university hospital. PARTICIPANTS: The study comprised 496 pediatric and adult patients undergoing cardiac surgery for congenital heart disease...
December 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29330077/blood-ethanol-levels-are-not-related-to-coagulation-changes-as-measured-by-thromboelastography-in-traumatic-brain-injury-patients
#5
Abigail J Rao, Amber Laurie Lin, Cole Hilliard, Rongwei Fu, Tori Lennox, Ronald R Barbosa, Susan E Rowell
No abstract text is available yet for this article.
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29324514/anticoagulant-bridge-comparison-in-mechanical-circulatory-support-patients
#6
Richard H Cosgrove, Robyn L Basken, Richard G Smith, Chiu-Hsieh Hsu, Toshinobu Kazui, Brandon K Martinez, Richard W Burt, Eric S Crawford, Scott D Lick, Zain Khalpey
Maintaining mechanical circulatory support (MCS) device patients in a specified therapeutic range for anticoagulation remains challenging. Subtherapeutic international normalized ratios (INRs) occur frequently while on warfarin therapy. An effective anticoagulant bridge strategy may improve the care of these patients. This retrospective review of MCS patients with subtherapeutic INRs compared an intravenous unfractionated heparin (UFH) strategy with a subcutaneous enoxaparin or fondaparinux strategy. Native thromboelastography (n-TEG) was used to evaluate anticoagulant effect with coagulation index (CI) as the primary outcome measure...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29313313/relationship-of-coagulopathy-and-platelet-dysfunction-to-transfusion-needs-after-traumatic-brain-injury
#7
Grace Martin, Dhavan Shah, Nora Elson, Ryan Boudreau, Dennis Hanseman, Timothy A Pritts, Amy T Makley, Brandon Foreman, Michael D Goodman
BACKGROUND: Coagulopathy and platelet dysfunction commonly develop after traumatic brain injury (TBI). Thromboelastography (TEG) and platelet function assays (PFAs) are often performed at the time of admission; however, their roles in assessing post-TBI coagulopathy have not been investigated. We hypothesized that compared to blunt TBI, penetrating TBI would (1) demonstrate greater coagulopathy by TEG, (2) be associated with abnormal PFA results, and (3) require more blood product transfusions...
January 8, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29299962/thromboelastometry-in-trauma-care-a-place-in-the-2018-belgian-health-care-system
#8
Martin Lucien Tonglet, Jean-Louis Poplavsky, Laurence Seidel, Jean Marc Minon, Vincenzo D'Orio, Alexandre Ghuysen
Introduction Evidence supporting the use of Thromboelastography (TEG®) and rotational thromboelastometric (ROTEM®) in the trauma setting remains limited. We present the results of a practical evaluation of the potential interest of ROTEM® in the diagnosis of acute coagulopathy and the need for emergent blood product transfusion in the general trauma population of a non-trauma Belgian emergency department. Methods Extracting a convenience cohort from the initial prospective TICCS study, we performed a retrospective analysis to test the following hypothesis: ROTEM® might be helpful to discriminate trauma patients with or without acute coagulopathy...
January 4, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29298240/increased-risk-of-fibrinolysis-shutdown-among-severely-injured-trauma-patients-receiving-tranexamic-acid
#9
Jonathan P Meizoso, Roman Dudaryk, Michelle B Mulder, Juliet J Ray, Charles A Karcutskie, Sarah A Eidelson, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: The association between tranexamic acid (TXA) and fibrinolysis shutdown is unknown. We hypothesize that TXA is associated with fibrinolysis shutdown in critically injured trauma patients. METHODS: 218 critically injured adults admitted to the intensive care unit (ICU) at an urban level 1 trauma center from 08/2011-01/2015 who had thromboelastography performed upon ICU admission were reviewed. Groups were stratified based on fibrinolysis shutdown, which was defined as LY30<0...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29297814/coagulation-assessment-underutilized-diagnostic-tools-in-zoo-and-aquatic-animal-medicine
#10
Trevor J Gerlach, Ashley Barratclough, Bobbi Conner
Veterinarians specializing in nondomestic species are faced with unique challenges regarding research and diagnostic capabilities given the wild and frequently dangerous nature of their patients. Standard diagnostic techniques used in small or large animal practice are not always possible due to anatomical constraints, size, tractability, or the inherent risk of anesthesia in highly valued, rare species. Diagnostic modalities that utilize simple, relatively noninvasive techniques show promise in evaluating nondomestic species and elucidating the pathophysiology behind poorly characterized disease processes in both wild and captive populations...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29289486/posterior-reversible-encephalopathy-syndrome-following-blood-transfusion-in-a-patient-with-factor-x-deficiency-is-it-an-unusual-systemic-manifestation-of-an-adverse-transfusion-reaction
#11
Anupam Verma, Hemlata, Priti Elhence, Shubha R Phadke, Zafar Neyaz
Adverse neurological transfusion reactions including posterior reversible encephalopathy syndrome (PRES) following blood transfusion are rare. Our case an 18-year-female with known Factor X deficiency with menorrhagia developed severe hypertension, followed by generalised tonic clonic convulsions apparently after blood component transfusion. She had earlier received 4 units of red blood cells (RBC) for anaemia and 10 units of fresh frozen plasma (FFP) for menorrhagia (with prolonged PT and APTT) within short span of time at another hospital...
December 6, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29276028/evaluation-for-effects-of-severe-acidosis-on-hemostasis-in-trauma-patients-using-thrombelastography-analyzer
#12
Xin Lv, Yong Mao, Zonghe Qin
OBJECTIVE: To investigate effects of metabolic acidosis on hemostasis function in trauma patients using thromboelastography analyzer. METHODS: 65 critically injured patients and 19 healthy volunteers were enrolled in the study. Three samples of whole blood were collected from each patient or healthy volunteer. These three samples were acidified with 50mmol/l phosphate-buffered saline (PBS) (pH5.8) or a neutral buffer (50mmol/l phosphate, pH7.4) and acidified blood sample with target pH of 6...
December 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29241232/thromboelastographic-assessment-of-the-impact-of-mexiletine-on-coagulation-abnormalities-induced-by-air-or-normal-saline-intravenous-injections-in-conscious-rats
#13
Joseph L Nates, Davide Cattano, Fernanda S Costa, Jacques E Chelly, Marie-Francoise Doursout
BACKGROUND: Thromboelastography (TEG) in venous air embolism (VAE) has been poorly studied. We induced coagulation abnormalities by VAE in a rat model, assessed by TEG with and without mexiletine, a lidocaine analogue local anesthetic. METHODS: Twenty-three Sprague Dawley rats instrumented under isoflurane anesthesia and allowed to recover five days prior to the experiments were randomized into three experimental groups: 1) VAE (n = 6); 2) VAE and mexiletine (n = 9); and 3) normal saline (NS) alone (control group, n = 8)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29237921/impact-of-proton-pump-inhibitors-on-the-pharmacodynamic-effect-and-clinical-outcomes-in-patients-receiving-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-a-propensity-score-analysis
#14
Pei Zhu, Zhan Gao, Xiao-Fang Tang, Jing-Jing Xu, Yin Zhang, Li-Jian Gao, Jue Chen, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, Jin-Qing Yuan
BACKGROUND: Prior studies have reported controversial conclusions regarding the risk of adverse cardiovascular events in patients using proton-pump inhibitors (PPIs) combined with clopidogrel therapy, causing much uncertainty in clinical practice. We sought to evaluate the safety of PPIs use among high-risk cardiovascular patients who underwent percutaneous coronary intervention (PCI) in a long-term follow-up study. METHODS: A total of 7868 consecutive patients who had undergone PCI and received dual antiplatelet therapy (DAPT) at a single center from January 2013 to December 2013 were enrolled...
December 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29234191/thromboelastography-for-assessing-the-risk-of-bleeding-in-patients-with-cirrhosis-moving-closer
#15
Vaibhav Somani, Deepak Amarapurkar, Apurva Shah
Background and aims: Conventional coagulation tests (CCTs) in patients with cirrhosis only assess procoagulant factors and are poor predictors of bleeding risk. In spite of this knowledge, they are routinely used prior to invasive procedures, and attempts are made to correct these abnormalities before invasive procedures. These practices are not supported by the evidence and are harmful to the patients. Methods: This prospective study included 150 patients of cirrhosis undergoing invasive procedures...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29224955/reference-intervals-of-citrated-native-whole-blood-thromboelastography-in-premature-neonates
#16
Mario Motta, Brunetta Guaragni, Elena Pezzotti, Carmen Rodriguez-Perez, Gaetano Chirico
No abstract text is available yet for this article.
December 7, 2017: Early Human Development
https://www.readbyqxmd.com/read/29192952/thromboelastography-for-predicting-bleeding-in-patients-with-aortic-stenosis-treated-with-tavi
#17
Bartosz Rymuza, Karol Zbroński, Piotr Scisło, Kajetan Grodecki, Janusz Kochman, Krzysztof Jerzy Filipiak, Grzegorz Opolski, Zenon Huczek
BACKGROUND AND AIMS: Bleeding complications are frequent and independently impact mortality after TAVI. Thromboelastography (TEG) measures viscoelastic properties of clot formation and is currently best known for perioperative management to reduce blood transfusion in cardiac surgery. We sought to determine whether TEG may be predictive of bleeding in patients treated with TAVI. METHODS AND RESULTS: Overall, 54 consecutive patients with severe aortic stenosis treated with TAVI were prospectively included...
December 1, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29183575/diagnosis-of-canine-pulmonary-thromboembolism-by-computed-tomography-and-mathematical-modelling-using-haemostatic-and-inflammatory-variables
#18
C B Marschner, A T Kristensen, E A Rozanski, F J McEvoy, L Kühnel, O Taeymans, A de Laforcade, A F Sato, B Wiinberg
There is no evidence-based diagnostic approach for diagnosis of pulmonary thromboembolism (PTE) in dogs. Many dogs with diseases that predispose to thrombosis are hypercoagulable when assessed with thromboelastography (TEG), but no direct link has been established. The aims of this study were: (1) to investigate if diseased dogs with PTE, diagnosed by computed tomography pulmonary angiography (CTPA), had evidence of hypercoagulability by TEG; (2) to characterise haemostatic and inflammatory changes in dogs with PTE; (3) to construct models for prediction of PTE based on combinations of haemostatic and inflammatory variables; and (4) to evaluate the performance of D-dimer measurement for prediction of PTE...
November 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29183569/development-of-a-fibrinolysis-assay-for-canine-plasma
#19
U Jeffery, M B Brooks, D N LeVine
Unbalanced coagulation and fibrinolysis leads to hemorrhage or thrombosis. Thromboelastography has been used to characterize hypo- and hyper-fibrinolysis in dogs, however the technique requires specialized instrumentation and proprietary reagents that limit its availability. The aim of this study was to develop a simple microplate method for assessment of fibrinolysis in canine plasma. Plasma from healthy dogs was mixed in a microwell plate with tissue factor, calcium, phospholipid and tissue plasminogen activator...
November 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29181670/anticoagulant-effects-of-arginine-containing-peptides-of-the-glyproline-family-his-phe-arg-trp-pro-gly-pro-and-thr-lys-pro-arg-pro-gly-pro-revealed-by-thromboelastography
#20
E Ya Rogozinskaya, M G Lyapina
Thromboelastography revealed anticoagulant effects of 3 glyproline oligopeptides (in various concentrations): His-Phe-Arg-Trp-Pro-Gly-Pro, Thr-Lys-Pro-Arg-Pro-Gly-Pro (Selank), and Pro-Gly-Pro. The parameters R, K, MA, S, TMA, and J changed to hypocoagulation direction in comparison to the control. At this, Selank demonstrated the maximal anticoagulation potency.
November 27, 2017: Bulletin of Experimental Biology and Medicine
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