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https://www.readbyqxmd.com/read/28729903/tranexamic-acid-and-trauma-induced-coagulopathy
#1
REVIEW
Takeshi Nishida, Takahiro Kinoshita, Kazuma Yamakawa
Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking the interaction of plasminogen with the lysine residues of fibrin. Historically, TXA is commonly used for reduction of blood loss in perioperative situations, while recently it has attracted attention for clinical use in the trauma field. In 2010, the Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage 2 (CRASH-2) trial demonstrated that intravenous administration of TXA improved mortality significantly in trauma patients with significant bleeding...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28723878/evolution-of-surgery-for-adolescent-idiopathic-scoliosis-over-20-years-have-outcomes-improved
#2
Baron S Lonner, Yuan Ren, Burt Yaszay, Patrick J Cahill, Suken A Shah, Randal R Betz, Amer F Samdani, Harry L Shufflebarger, Peter O Newton
STUDY DESIGN: Retrospective review of a prospective Adolescent Idiopathic Scoliosis (AIS) registry OBJECTIVE.: To study the evolution of the operative approach, outcomes and complication rates in AIS surgery over the past 20 years. METHODS: 1819 AIS patients (1995-2013) with 2-year F/U were studied. Operative approach, perioperative parameters, major complication rates, and SRS outcomes were assessed. Linear regression was used to assess the trend of changes over 5-year quartiles...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28692467/intravenous-tranexamic-acid-bolus-plus-infusion-is-not-more-effective-than-a-single-bolus-in-primary-hip-arthroplasty-a-randomized-controlled-trial
#3
Paul J Zufferey, Julien Lanoiselée, Céline Chapelle, Dmitry B Borisov, Jean-Yves Bien, Pierre Lambert, Rémi Philippot, Serge Molliex, Xavier Delavenne, Béatrice Deygas, Mathilde Donnat, Juanita Techer, Laurent Tordella, Jean-Noël Fort, Nicolas Barbe, Julie Gavory, Sylvie Passot, Laetitia Burnol, Stéphanie Seve
BACKGROUND: Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss. METHODS: This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty...
July 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28688660/impact-of-tranexamic-acid-on-coagulation-and-inflammation-in-murine-models-of-traumatic-brain-injury-and-hemorrhage
#4
Ryan M Boudreau, Mark Johnson, Rosalie Veile, Lou Ann Friend, Holly Goetzman, Timothy A Pritts, Charles C Caldwell, Amy T Makley, Michael D Goodman
BACKGROUND: Posttraumatic coagulopathy and inflammation can exacerbate secondary cerebral damage after traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown clinically to reduce mortality in hemorrhaging and head-injured trauma patients and has the potential to mitigate secondary brain injury with its reported antifibrinolytic and antiinflammatory properties. We hypothesized that TXA would improve posttraumatic coagulation and inflammation in a murine model of TBI alone and in a combined injury model of TBI and hemorrhage (TBI/H)...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28682954/acute-intracardiac-thrombosis-and-pulmonary-thromboembolism-after-cardiopulmonary-bypass-a-systematic-review-of-reported-cases
#5
Brittney Williams, Brody Wehman, Michael A Mazzeffi, Patrick Odonkor, Ryan L Harris, Zachary Kon, Kenichi A Tanaka
Intracardiac thrombosis (ICT) and pulmonary thromboembolism (PE) after cardiopulmonary bypass (CPB) are life-threatening events, but pathological mechanisms are not yet well defined. The aim of this review is to provide an update of case literature of a postbypass hypercoagulable state. Case commonalities among 48 ICT/PE events included congestive heart failure (50%), platelet transfusion (37.5%), CPB duration greater than 3 hours (37.5%), and aortic injury (27.1%). Preexisting thrombophilia was rarely reported, and 16...
July 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28678070/tranexamic-acid-does-not-influence-cardioprotection-by-ischemic-preconditioning-and-remote-ischemic-preconditioning
#6
Patrick van Caster, Sandra Eiling, Yvonne Boekholt, Friederike Behmenburg, Marianne Dorsch, André Heinen, Markus W Hollmann, Ragnar Huhn
Prior studies have suggested that the antifibrinolytic drug aprotinin increases the infarct size after ischemia and reperfusion (I/R) and attenuates the effect of ischemic preconditioning (IPC). Aprotinin was replaced by tranexamic acid (TXA) in clinical practice. Here, we investigated whether TXA influences I/R injury and/or cardioprotection initiated by IPC and/or remote ischemic preconditioning (RIPC). Anesthetized male Wistar rats were randomized to 6 groups. Control animals were not further treated. Administration of TXA was combined with and without IPC and RIPC...
July 1, 2017: Anesthesia and Analgesia
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
#7
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...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28648705/an-aprotinin-containing-fibrin-sealant-does-not-reduce-blood-loss-in-total-hip-arthroplasty
#8
Sean M Kearns, Hannah N Kuhar, Daniel D Bohl, Brett R Levine
BACKGROUND: Fibrin sealants are topical agents used to reduce perioperative blood loss; however, their efficacy in total hip arthroplasty (THA) remains uncertain. The purpose of this study was to determine if a fibrin sealant containing aprotinin as an antifibrinolytic agent, TISSEEL (Baxter, Deerfield, IL), reduces postoperative blood loss and transfusion during THA when compared with intravenous (IV) tranexamic acid (TXA) and control groups. METHODS: Three retrospective uniform cohorts of primary THA procedures were identified, from a prospectively maintained database: 1 group who received TISSEEL, 1 group who received 1 g IV TXA, and 1 group who received neither (control)...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28640323/lys-42-43-44-and-arg-12-of-thrombin-activable-fibrinolysis-inhibitor-comprise-a-thrombomodulin-exosite-essential-for-its-antifibrinolytic-potential
#9
Chengliang Wu, Alan R Stafford, James C Fredenburgh, Jeffrey I Weitz, Ann Gils, Paul J Declerck, Paul Y Kim
The thrombin-thrombomodulin (TM) complex activates thrombin-activable fibrinolysis inhibitor (TAFI) more efficiently than thrombin alone. The exosite on TAFI required for its TM-dependent activation by thrombin has not been identified. Based on previous work by us and others, we generated TAFI variants with one or more of residues Lys 42, Lys 43, Lys 44 and Arg 12 within the activation peptide mutated to alanine. Mutation of one, two, or three Lys residues or the Arg residue alone decreased the catalytic efficiency of TAFI activation by thrombin-TM by 2...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28632940/characterization-of-the-i4399m-variant-of-apolipoprotein-a-implications-for-altered-prothrombotic-properties-of-lipoprotein-a
#10
Corey A Scipione, Jackson T McAiney, Daniel J Simard, Zainab A Bazzi, Matthew Gemin, Rocco Romagnuolo, Fraser L Macrae, Robert A Ariëns, Robert A Hegele, Janeen Auld, James W Gauld, Michael B Boffa, Marlys L Koschinsky
BACKGROUND: Lipoprotein(a) (Lp(a)) is a causal risk factor for a variety of cardiovascular diseases. Apolipoprotein(a) (apo(a)), the distinguishing component of Lp(a), is homologous to plasminogen, suggesting that Lp(a) can interfere with the normal fibrinolytic functions of plasminogen. This has implications for the persistence of fibrin clots in the vasculature and hence to atherothrombotic diseases. A single nucleotide polymorphism (rs3798220) in the gene encoding apo(a) has been reported that results in an Ile to Met substitution in the protease-like domain (I4399M variant)...
June 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28611888/efficacy-and-safety-of-tranexamic-acid-in-prehospital-traumatic-hemorrhagic-shock-outcomes-of-the-cal-pat-study
#11
Michael M Neeki, Fanglong Dong, Jake Toy, Reza Vaezazizi, Joe Powell, Nina Jabourian, Alex Jabourian, David Wong, Richard Vara, Kathryn Seiler, Troy W Pennington, Joe Powell, Chris Yoshida-McMath, Shanna Kissel, Katharine Schulz-Costello, Jamish Mistry, Matthew S Surrusco, Karen R O'Bosky, Daved Van Stralen, Daniel Ludi, Karl Sporer, Peter Benson, Eugene Kwong, Richard Pitts, John T Culhane, Rodney Borger
INTRODUCTION: The California Prehospital Antifibrinolytic Therapy (Cal-PAT) study seeks to assess the safety and impact on patient mortality of tranexamic acid (TXA) administration in cases of trauma-induced hemorrhagic shock. The current study further aimed to assess the feasibility of prehospital TXA administration by paramedics within the framework of North American emergency medicine standards and protocols. METHODS: This is an ongoing multi-centered, prospective, observational cohort study with a retrospective chart-review comparison...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28605821/abnormal-uterine-bleeding
#12
Cristina Laguna Benetti-Pinto, Ana Carolina Japur de Sá Rosa-E-Silva, Daniela Angerame Yela, José Maria Soares Júnior
Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evidence on the treatment of women with abnormal uterine bleeding, both acute and chronic...
July 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28601210/tranexamic-acid-use-in-prehospital-uncontrolled-hemorrhage
#13
REVIEW
Benjamin R Huebner, Warren C Dorlac, Chris Cribari
The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-blinded, placebo-controlled study incorporating >20,000 patients, numerous limitations and weaknesses have been described. As a result, additional studies have followed, delineating the potential risks and benefits of TXA administration...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28591091/antifibrinolytic-agents-in-acquired-bleeding-disorders
#14
Mark Walsh
No abstract text is available yet for this article.
May 2017: Clinical Advances in Hematology & Oncology: H&O
https://www.readbyqxmd.com/read/28584521/tranexamic-acid-encapsulating-thermosensitive-liposomes-for-site-specific-pharmaco-laser-therapy-of-port-wine-stains
#15
M Ingmar van Raath, Ruud Weijer, Gia Hung Nguyen, Bernard Choi, Anton I de Kroon, Michal Heger
Site-specific pharmaco-laser therapy (SSPLT) is a developmental stage treatment modality designed to non-invasively remove superficial vascular pathologies such as port wine stains (PWS) by combining conventional laser therapy with the prior administration of a prothrombotic and/or antifibrinolytic pharmaceutical-containing drug delivery system. For the antifibrinolytic SSPLT component, six different PEGylated thermosensitive liposomal formulations encapsulating tranexamic acid (TA), a potent antifibrinolytic lysine analogue, were characterized for drug:lipid ratio, encapsulation efficiency, size, endovesicular TA concentration (CTA), phase transition temperature (Tm), and assayed for heat-induced TA release...
August 2016: Journal of Biomedical Nanotechnology
https://www.readbyqxmd.com/read/28572282/cm352-reduces-brain-damage-and-improves-functional-recovery-in-a-rat-model-of-intracerebral-hemorrhage
#16
José A Rodríguez, Tomás Sobrino, Esteban López-Arias, Ana Ugarte, Juan A Sánchez-Arias, Alba Vieites-Prado, Irene de Miguel, Julen Oyarzabal, José A Páramo, Francisco Campos, Josune Orbe, José Castillo
BACKGROUND: Intracerebral hemorrhage (ICH) is an acute neurological disorder with high mortality and no effective treatment. In addition to the initial bleeding event, rebleeding and hematoma expansion are associated with poor outcome in these patients. We studied the effectiveness of the new antifibrinolytic agent CM352, a short-half-life matrix metalloproteinase inhibitor, for achieving early hemostasis and improving functional recovery in a rat model of collagenase-induced ICH. METHODS AND RESULTS: ICH was induced by striatal injection of collagenase, and 1 hour later, rats received an intravenous injection of saline (n=6) or CM352 (1 mg/kg, n=6)...
June 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28552944/intraoperative-tranexamic-acid-is-associated-with-postoperative-stroke-in-patients-undergoing-cardiac-surgery
#17
Zhen-Feng Zhou, Feng-Jiang Zhang, Yang-Fan Huo, Yun-Xian Yu, Li-Na Yu, Kai Sun, Li-Hong Sun, Xiu-Fang Xing, Min Yan
BACKGROUND: Stroke is a devastating and potentially preventable complication of cardiac surgery. Tranexamic acid (TXA) is a commonly antifibrinolytic agent in cardiac surgeries with cardiopulmonary bypass (CPB), however, there is concern that it might increase incidence of stroke after cardiac surgery. In this retrospective study, we investigated whether TXA usage could increase postoperative stroke in cardiac surgery. METHODS: A retrospective study was conducted from January 1, 2010, to December 31, 2015, in 2,016 patients undergoing cardiac surgery, 664 patients received intravenous TXA infusion and 1,352 patients did not receive any antifibrinolytic agent...
2017: PloS One
https://www.readbyqxmd.com/read/28546128/predictive-factors-of-intraoperative-cell-salvage-during-pediatric-scoliosis-surgery-cell-saver-during-scoliosis-surgery-in-children
#18
Daphné Michelet, Florence Julien-Marsollier, Julie Hilly, Thierno Diallo, Christophe Vidal, Souhayl Dahmani
INTRODUCTION: blood saving strategy during spinal surgery in children often includes recombinant erythropoietin (rEPO) and antifibrinolytic therapapy (AFT). The aim of this study was to investigate the efficacy of intraoperative blood salvage in decreasing homologous blood transfusion. MATERIAL AND METHODS: using the prospective data from patients operated during a one year period for scoliosis correction, we calculate the predictable hematocrit at day postoperative 1 without the use of blood salvage and compare it to the target hematocrit transfusion according to patient's status...
May 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28544698/the-use-of-antifibrinolytics-in-pediatric-patients-with-hypoproliferative-thrombocytopenia
#19
Meghan Delaney, Dana C Matthews, Terry B Gernsheimer
Despite the use of evidence-based platelet transfusion therapy during periods of hypoproliferative thrombocytopenia, a large proportion of pediatric hematology/oncology patients continue to suffer from clinically significant bleeding. Antifibrinolytic (AF) drugs have been shown in certain surgical and trauma settings to decrease bleeding, blood transfusion, and improve survival. We conducted a retrospective assessment of the safety of using AF drugs in pediatric patients with hypoproliferative thrombocytopenia at our center as well as the impact on bleeding occurrence and severity...
May 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28523092/management-of-a-life-threatening-bleeding-following-extraction-of-deciduous-second-molar-related-to-a-capillary-haemangioma
#20
REVIEW
Amr Amin Ghanem, Yasser Nabil El Hadidi
Various forms of vascular lesion affect the head and neck region. The head and neck vascular lesions are classified into neoplasms and malformations. Neoplasm presents either as hemangioma or lymphangioma; neoplasm usually presents in young age compared with vascular malformation. A 9-year-old female patient presented to the outpatient clinic referred from the department of pedodontics after extraction of a right mandibular second deciduous molar. Extraction was done by dental GP in outpatient clinic. Massive bleeding followed the extraction...
June 2017: Craniomaxillofacial Trauma & Reconstruction
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