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Roos E Marck, Ivo van der Bijl, Herbert Korsten, Jos Lorinser, Dirk de Korte, Esther Middelkoop
Burn injury has severe impact on the physiologic homeostasis. Platelet counts show a distinct course post-burn injury, with a nadir at day 3 followed by a thrombocytotic period with at peak at day 15, with a gradual return to normal. So far, it is unknown how the functionality and activational status of platelets develop post burn. In this study, we investigated if the function, activation and growth factor content of platelets of burn patients are affected and how this evolves in time. Six burn patients with over 15% total burned surface area were followed during 1 month...
March 19, 2018: Platelets
Michael L Ekaney, Gabrielle Gonzalez Gray, Iain H McKillop, Susan L Evans
BACKGROUND: Limited availability and use of whole blood (WB) following trauma is driven by perceptions that hemostatic function is limited by platelet dysfunction within 5 days storage. We sought to define the hemostatic function of WB stored at 4°C for up to 25 days, elucidate changes in metabolic parameters and mitochondrial dysfunction in platelets in WB, and the effect of supplementation using resveratrol (Res) or cytochrome c (Cyt c). METHODS: WB was collected, aliquoted, and stored at 4°C without agitation...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Hui Y Lim, Cheryl Ng, Joseph Rigano, Mark Tacey, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
: Myeloproliferative neoplasms (MPN) are independent risks for thrombotic events. Routine laboratory tests are inadequate to evaluate the underlying procoagulant state. Global coagulation assays such as thromboelastography, thrombin and fibrin generation may provide better assessment of coagulation activation and thereby of thrombosis risk. Participants with MPN were recruited. Thromboelastography was performed on citrated whole blood while thrombin generation using calibrated automated thrombogram, fibrin generation using overall haemostatic potential assays and P-selectin were quantified on platelet-poor plasma...
March 13, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Gemlyn George, Wuttiporn Manatasahit, Manjula Balasubramanian, Victor Navarro
Background: Thromboelastography (TEG) has become the standard of care in liver-transplant surgery to identify real-time abnormalities in the coagulation cascade. To our knowledge, no studies have been performed to measure the intrasubject reproducibility of TEG parameters in cirrhotic patients. Objective: To perform a validation study to determine the reproducibility of TEG in cirrhosis. Methods: We recruited 30 patients with stable cirrhosis and tested 25 of them...
February 24, 2018: Laboratory Medicine
Ashley Barratclough, Ruth Francis Floyd, Roger L Reep, Ray L Ball, Bobbi J Conner
BACKGROUND: Thromboelastography (TEG) provides a comprehensive evaluation of blood clot formation. This test can be used to identify abnormalities in coagulation by assessing multiple aspects of the clotting cascade, including the speed of clot initiation and formation, clot strength, and ultimately fibrinolysis. Thromboembolic disease has been hypothesized to play a role in the pathophysiology of cold stress syndrome (CSS), an important cause of mortality in the threatened Florida manatee (Trichechus manatus latirostris)...
March 9, 2018: Veterinary Clinical Pathology
Hepeng Fu, Yuxiang Zhang
Platelets play a pivotal role in the thromboembolic, inflammatory, and immunomodulatory process. The alteration of platelet quality often affects the treatment and prognosis of critically ill patients, and has a significant correlation with mortality. With the further research on the function of the platelet, it is found that the abnormal platelet quality can present during the early stage of the illness of the critically ill patients. In order to evaluate the alterations of the platelet quality more accurately, the further studies of platelet parameters, including platelet counts (PLT), platelet hematocrit (PCT), platelet large cell ratio (PLCR), mean platelet volume (MPV), platelet distribution width (PDW), immature platelet fraction (IPF) and so on, are still be the focus of current researches in the field of critical illness...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Kathryn L Perrin, Anne K Krogh, Mads Kjelgaard-Hansen, Lauren Howard, Louise Bochsen, Wendy K Kiso, Dennis Schmitt, Annemarie T Kristensen, Mads F Bertelsen
Hemorrhagic disease associated with elephant endotheliotropic herpesvirus infection is the most-frequent cause of mortality in captive Asian elephants ( Elephas maximus). Survival relies on intensive monitoring of hemostatic status. Thromboelastography (TEG) utilizes whole blood samples containing all the blood components of hemostasis and is therefore a sensitive indicator of the clinical status in the patient. This study was performed to assess the practicability of TEG in Asian elephants in a zoo environment...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Anna Clebone
PURPOSE OF REVIEW: Trauma is the most common cause of pediatric mortality. Much of the research that led to life-saving interventions in adults, however, has not been replicated in the pediatric population. Children have important physiologic and anatomic differences from adults, which impact hemostasis and transfusion. Hemorrhage is a leading cause of death in trauma, and children have important differences in their coagulation profiles. Transfusion strategies, including the massive transfusion protocol and use of antifibrinolytics, are still controversial...
April 2018: Current Opinion in Anaesthesiology
Lee P Ferguson, Phuoc Duong, Kim F Pearce, Paul Murphy, Tina T Biss
The optimal method for monitoring antiplatelet therapy in children supported with ventricular assist devices (VADs) is unknown. We conducted a retrospective study to compare Thromboelastography Platelet Mapping (TEG/PM) with multiple electrode platelet aggregometry (MEA) on a Multiplate analyzer (Roche Diagnostics, Mannheim, Germany). We analyzed data from 66 paired blood samples from 9 patients <16 years of age on VAD where platelet function was simultaneously measured with TEG/PM and MEA. Antiplatelet dose-response relationships and intraindividual variability during steady state therapy were determined...
February 27, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Daniel Mandell, Raymond Planinsic, Fernando Melean, Christopher Hughes, Amit D Tevar, Abhinav Humar, Benjamin J Cassidy, Richard Simmons, Andre Dewolf, Tetsuro Sakai
Tissue plasminogen activator (tPA) has been reported to treat intraoperative pulmonary thromboembolism (PTE) during liver transplantation (LT). However, tPA administration is often delayed due to fear of uncontrolled bleeding and storage in a refrigerator outside of operating rooms. Various dosages of tPA were used. We hypothesize that a policy of tPA storage and low dosage use improves patient outcomes. At a transplantation center, a multidisciplinary committee has implemented a tPA policy since April 2014, which includes the following: (1) timely administering of low-dose tPA (0...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Andrew G Burton, Julie Burges, Angela Borchers, Kate Hopper
OBJECTIVE: Minimal data are available assessing the effect of acidemia on coagulation in dogs. The objective of this study was to assess the effect of in vitro acidification of canine blood on coagulation as measured via thromboelastography (TEG) and traditional tests of coagulation. We hypothesized that worsening acidemia would lead to progressive impairment on coagulation. DESIGN: Prospective study. SETTING: University teaching hospital...
February 27, 2018: Journal of Veterinary Emergency and Critical Care
Daniel Katz, Joshua Hamburger, Dorian Batt, Jeffrey Zahn, Yaakov Beilin
Agreement between estimated fibrinogen concentration via thromboelastography and traditional assays is not established in the parturient. We therefore recruited 56 parturients and performed Clauss and functional fibrinogen level (FLEV) tests. Mean difference of measurements was 36.8 mg/dL (95% CI, 21.8-51.9) with a standard deviation of 52.8 mg/dL. Calculated limits of agreement were 140.2 mg/dL (95% CI, 166.3-114.6) and -66.6 mg/dL (95% CI, -40.8 to -92.5), within the maximum allowable difference of 165 mg/dL...
February 23, 2018: Anesthesia and Analgesia
Susan E Smith, Kelli A Rumbaugh
PURPOSE: Persistent elevation of prothrombin time (PT) and International Normalized Ratio (INR) values in a patient receiving daptomycin is reported. SUMMARY: A morbidly obese 51-year-old man was hospitalized for evaluation for surgical intervention for gallstone pancreatitis and biliary obstruction. Previously prescribed warfarin therapy was withheld due to suspected coagulopathy and an elevated INR (5.1), and warfarin reversal was initiated. After undergoing partial cholecystectomy on hospital day 6, the patient developed sepsis and was treated with i...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
Wei-Nan Zeng, Jun-Li Liu, Fu-You Wang, Cheng Chen, Qiang Zhou, Liu Yang
BACKGROUND: The reductions of perioperative blood loss and inflammatory response are important in total knee arthroplasty. Tranexamic acid reduced blood loss and the inflammatory response in several studies. However, the effect of epinephrine administration plus tranexamic acid has not been intensively investigated, to our knowledge. In this study, we evaluated whether the combined administration of low-dose epinephrine plus tranexamic acid reduced perioperative blood loss or inflammatory response further compared with tranexamic acid alone...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
Laura Kearney, Derek Whelan, Brian D O'Donnell, Anthony J P Clover
Context: Delivery of slow-release local anesthesia has considerable potential for postoperative analgesia. Fibrin gel has shown huge potential for drug delivery, but has not been fully investigated for the delivery of local anesthetics nor has whether incorporation of anesthetic drugs into fibrin alters its mechanical properties. Aims: This study aimed to evaluate the effects of bupivacaine inclusion on the mechanical and kinetic properties of fibrin as measured by thromboelastography (TEG)...
January 2018: Journal of Natural Science, Biology, and Medicine
Ronit Beck-Fruchter, Israel Gavish, Shira Baram, Yoel Geslevich, Amir Weiss
OBJECTIVE: Thromboelastography (TEG) is a viscoelastic test of hemostasis which allows measurement of the processes of clot initiation, propagation, stabilization, and dissolution in real time. In this study we aimed to evaluate the alterations in coagulation as measured by TEG during In Vitro Fertilization (IVF) stimulation cycles and to investigate whether final oocyte maturation with recombinant hCG (rhCG) versus GnRH agonist results in a different coagulation state. STUDY DESIGN: This is a prospective observational study which included fifty-three normogonadotrophic women...
February 10, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Etheresia Pretorius, Martin J Page, Lisa Hendricks, Nondumiso B Nkosi, Sven R Benson, Douglas B Kell
In recent work, we discovered that the presence of highly substoichiometric amounts (10 -8 molar ratio) of lipopolysaccharide (LPS) from Gram-negative bacteria caused fibrinogen clotting to lead to the formation of an amyloid form of fibrin. We here show that the broadly equivalent lipoteichoic acids (LTAs) from two species of Gram-positive bacteria have similarly (if not more) potent effects. Using thioflavin T fluorescence to detect amyloid as before, the addition of low concentrations of free ferric ion is found to have similar effects...
February 2018: Journal of the Royal Society, Interface
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
Yvonne M C Henskens, Anouk J W Gulpen, René van Oerle, Rick Wetzels, Paul Verhezen, Henri Spronk, Simon Schalla, Harry J Crijns, Hugo Ten Cate, Arina Ten Cate-Hoek
Background: Traditional coagulation tests are included in emergency guidelines for management of patients on direct oral anticoagulants (DOACs) who experience acute bleeding or require surgery. We determined the ability of traditional coagulation tests and fast whole blood thromboelastography (ROTEM®) to screen for anticoagulation activity of dabigatran and rivaroxaban as low as 30 ng/mL. Methods: One hundred eighty-four citrated blood samples (75 dabigatran, 109 rivaroxaban) were collected from patients with non-valvular atrial fibrillation (NVAF), to perform screening tests from different manufacturers, (diluted, D) PT, aPTT, TT and ROTEM®...
2018: Thrombosis Journal
Yi-Da Tang, Wenyao Wang, Min Yang, Kuo Zhang, Jing Chen, Shubin Qiao, Hongbing Yan, Yongjian Wu, Xiaohong Huang, Bo Xu, Runlin Gao, Yuejin Yang
Background -Patients undergoing percutaneous coronary intervention (PCI) react differently to antiplatelet drugs. Those with low responsiveness to clopidogrel have a higher risk of cardiac ischemic events. The goal of this study is to conduct a head-to-head comparison of the safety and effectiveness of intensified antiplatelet therapies (either double-dose clopidogrel [DOUBLE] or adjunctive cilostazol [TRIPLE]) and conventional strategy (STANDARD) in post-PCI patients. Methods -In this single-center, randomized, controlled trial, we used thromboelastography (TEG), a platelet function test, to select 1078 PCI patients at high thrombotic risk and compared the intensified antiplatelet therapies with standard antiplatelet therapy...
February 2, 2018: Circulation
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