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Trauma blood clotting

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https://www.readbyqxmd.com/read/28297730/point-of-care-coagulation-monitoring-in-trauma-patients
#1
Philipp Stein, Alexander Kaserer, Gabriela H Spahn, Donat R Spahn
Trauma remains one of the major causes of death and disability all over the world. Uncontrolled blood loss and trauma-induced coagulopathy represent preventable causes of trauma-related morbidity and mortality. Treatment may consist of allogeneic blood product transfusion at a fixed ratio or in an individualized goal-directed way based on point-of-care (POC) and routine laboratory measurements. Viscoelastic POC measurement of the developing clot in whole blood and POC platelet function testing allow rapid and tailored coagulation and transfusion treatment based on goal-directed, factor concentrate-based algorithms...
March 15, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28292321/prothrombin-time-is-predictive-of-low-plasma-prothrombin-concentration-and-clinical-outcome-in-patients-with-trauma-hemorrhage-analyses-of-prospective-observational-cohort-studies
#2
Clare A Balendran, Ann Lövgren, Kenny M Hansson, Karin Nelander, Marita Olsson, Karin J Johansson, Karim Brohi, Dietmar Fries, Anders Berggren
BACKGROUND: Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outcome is unknown. METHODS: We have utilized two trauma patient databases (database 1 n = 358 and database 2 n = 331) to investigate the relationship of plasma prothrombin concentration on clinical outcome and coagulation status. Database 1 has been used to assess the relationship of plasma prothrombin to administered packed red blood cells (PRBC), clinical outcome and coagulation biomarkers (Prothrombin Time (PT), ROTEM EXTEM Coagulation Time (CT) and Maximum Clot Firmness (MCF))...
March 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28257393/potential-role-of-platelet-leukocyte-aggregation-in-trauma-induced-coagulopathy-ex-vivo-findings
#3
Johannes Zipperle, Katrin Altenburger, Martin Ponschab, Christoph J Schlimp, Andreas Spittler, Soheyl Bahrami, Heinz Redl, Herbert Schöchl
BACKGROUND: Platelet dysfunction has been identified as an important contributor of trauma-induced coagulopathy (TIC) but the underlying mechanism still remains to be elucidated. Trauma-associated pro-inflammatory stimuli strongly activate leukocytes, which in turn bind activated platelets. Therefore, we investigated the role of platelet-leukocyte aggregation (PLA) as a potential feature of trauma-induced platelet dysfunction. METHODS: Whole blood from 10 healthy donors was exposed to selective and collective platelet and leukocyte agonists in order to simulate differential states of activation...
March 2, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28248123/-snowball-fight-an-unusual-cause-of-spleen-injury
#4
Jana Bušková, Monika Justýna Poláčková, Zdeněk Pavlovský
Our case describes an innocuous snowball fight arising into a life-threatening condition. Patient with progressive left-sided abdominal pain was brought by ambulance to the hospital. According to history he was not aware of any trauma, just a snowball fight with his wife 5 days ago. Clinical examination finding was: hint of peritoneal irritation, Kehr´s sign and left-subchondrium palpation pain. The spleen trauma suspicion was high. After clinical examination an ultrasound examination was performed, revealing inhomogeneous structure of the spleen surrounded by hypoechoic collection and free fluid in the pelvic area...
2017: Soudní Lékarství
https://www.readbyqxmd.com/read/28246141/vasopressor-use-following-traumatic-injury-protocol-for-a-systematic-review
#5
Mathieu Hylands, Augustin Toma, Nicolas Beaudoin, Anne-Julie Frenette, Frederick D'Aragon, Emilie Belley-Côté, Morten Hylander, François Lauzier, Reed Alexander Siemieniuk, Emmanuel Charbonney, Joey Kwong, Jon Henrik Laake, Gordon Guyatt, Per Olav Vandvik, Bram Rochwerg, Robert Green, Ian Ball, Damon Scales, Srinivas Murthy, Sandro Rizoli, Pierre Asfar, François Lamontagne
INTRODUCTION: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28236302/pathogen-inactivation-treatment-of-plasma-and-platelet-concentrates-and-their-predicted-functionality-in-massive-transfusion-protocols
#6
Ahmad F Arbaeen, Peter Schubert, Katherine Serrano, Cedric J Carter, Brankica Culibrk, Dana V Devine
BACKGROUND: Trauma transfusion packages for hemorrhage control consist of red blood cells, plasma, and platelets at a set ratio. Although pathogen reduction improves the transfusion safety of platelet and plasma units, there is an associated reduction in quality. This study aimed to investigate the impact of riboflavin/ultraviolet light-treated plasma or platelets in transfusion trauma packages composed of red blood cell, plasma, and platelet units in a ratio of 1:1:1 in vitro by modeling transfusion scenarios for trauma patients and assessing function by rotational thromboelastometry...
February 24, 2017: Transfusion
https://www.readbyqxmd.com/read/28230635/valproic-acid-modulates-platelet-and-coagulation-function-ex-vivo
#7
Ted Bambakidis, Simone E Dekker, Ihab Halaweish, Baoling Liu, Vahagn C Nikolian, Patrick E Georgoff, Patryk Piascik, Yongqing Li, Martin Sillesen, Hasan B Alam
Trauma-induced coagulopathy is associated with adverse patient outcome. Animal models demonstrate that histone deacetylase inhibitors, such as valproic acid (VPA), improve survival following injury. While in-vivo data suggest that improved survival may in part be because of an attenuation of coagulopathy, it remains unknown whether this is a direct effect of the drug, or the establishment of an overall prosurvival phenotype. We thus conducted an ex-vivo experiment to determine if VPA has an effect on coagulation and platelet function...
February 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28129263/tissue-injury-suppresses-fibrinolysis-after-hemorrhagic-shock-in-nonhuman-primates-rhesus-macaque
#8
Antoni R Macko, Hunter B Moore, Andrew P Cap, M Adam Meledeo, Ernest E Moore, Forest R Sheppard
BACKGROUND: Hypoperfusion is associated with hyperfibrinolysis and early death from exsanguination, whereas tissue trauma is associated with hypofibrinolysis and delayed death from organ failure. We sought to elucidate the effects of injury patterns on fibrinolysis phenotypes using a nonhuman primate (NHP) model. METHODS: NHPs were randomized to three injury groups (n = 8/group): 60 minutes severe pressure-targeted controlled hemorrhagic shock (HS); HS + soft tissue injury (HS+); or HS + soft tissue injury + femur fracture (HS++)...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28122682/fibrinogen-level-on-admission-is-a-predictor-for-massive-transfusion-in-patients-with-severe-blunt-trauma-analyses-of-a-retrospective-multicentre-observational-study
#9
Yoshihiko Nakamura, Hiroyasu Ishikura, Shigeki Kushimoto, Fumiaki Kiyomi, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogura, Tetsuya Matsuoka, Toshifumi Uejima, Naoto Morimura, Mineji Hayakawa, Akiyoshi Hagiwara, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Daisuke Kudo, Kunihiko Maekawa, Takashi Kanemura, Takayuki Shibusawa, Yasushi Hagihara, Shintaro Furugori, Atsushi Shiraishi, Kiyoshi Murata, Gou Mayama, Arino Yaguchi, Shiei Kim, Osamu Takasu, Kazutaka Nishiyama
INTRODUCTION: In the early phase of trauma, fibrinogen (Fbg) plays an important role in clot formation. However, to the best of our knowledge, few studies have analysed methods of predicting the need for massive transfusion (MT) based on Fbg levels using multiple logistic regression. Therefore, the present study aimed to evaluate whether Fbg levels on admission can be used to predict the need for MT in patients with trauma. METHODS: We conducted a retrospective multicentre observational study...
January 16, 2017: Injury
https://www.readbyqxmd.com/read/28112988/platelet-bioreactor-accelerated-evolution-of-design-and-manufacture
#10
Jonathan N Thon, Brad J Dykstra, Lea M Beaulieu
Platelets, responsible for clot formation and blood vessel repair, are produced by megakaryocytes in the bone marrow. Platelets are critical for hemostasis and wound healing, and are often provided following surgery, chemotherapy, and major trauma. Despite their importance, platelets today are derived exclusively from human volunteer donors. They have a shelf life of just five days, making platelet shortages common during long weekends, civic holidays, bad weather, and during major emergencies when platelets are needed most...
January 23, 2017: Platelets
https://www.readbyqxmd.com/read/28093693/a-simple-post-mortem-room-angiography-method-for-the-investigation-of-traumatic-basal-subarachnoid-hemorrhage
#11
Christopher P Johnson, Mike Murphy, George A Johnson, Stephen M Wills, Jonathan E Medcalf
Identifying the site of vascular bleeding in fatal cases of traumatic basal subarachnoid hemorrhage (TBSAH) is important, but can be very difficult to achieve when there is extensive blood clot in the posterior cranial fossa. Post mortem angiography in these circumstances has been reported previously but with mixed results, and is rarely used in current practice within the United Kingdom. We have developed a simple and effective post mortem angiography method, using fluoroscopy and clear modern contrast medium, suitable for use in the autopsy room...
March 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28092093/regenerative-endodontics-a-true-paradigm-shift-or-a-bandwagon-about-to-be-derailed
#12
REVIEW
H Nazzal, M S Duggal
AIMS: Regenerative endodontic techniques (RETs) have been hailed as a paradigm shift for the management of traumatised non-vital immature permanent anterior teeth. In this article the aim was to critically appraise the literature with regards to the outcome of regenerative endodontics on root development. METHODS: Critical review of the literature where regenerative endodontic techniques have been used in the management of immature non-vital teeth with continuation of root development as the main outcome reported...
February 2017: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/28089408/the-various-assays-for-measuring-activity-states-of-factor-viia-in-plasma-and-therapeutic-products-diagnostic-value-and-analytical-usefulness-in-various-pathophysiological-states
#13
REVIEW
Jean Amiral, Claire Dunois, Cédric Amiral, Jerard Seghatchian
The key coagulation factor FVII, and its activated form FVIIa, present a major interest for their role at the initiation phase of blood coagulation, and because they can activate all blood coagulation cascade, through the extrinsic, but also the intrinsic pathway. Blood activation initiated through FVII is first presented, as it is understood nowadays. Measurement of FVII and FVIIa were of main interest for epidemiological studies, but FVIIa contribution to assay results was only deduced. The introduction of specific FVIIa assays, functional or immunoassays, allowed measuring directly FVIIa without any interference of non-activated FVII, or other coagulation factors or their activated forms...
February 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28005133/formulation-of-generalised-mass-transfer-correlations-for-blood-oxygenator-design
#14
Kenny Wei Quan Low, Raoul van Loon, Sam Rolland, Johann Sienz
This paper numerically investigates non-Newtonian blood flow with oxygen and carbon dioxide transport across and along an array of uniformly square and staggered arranged fibres at various porosity (e) levels, focussing on a low Reynolds number regime (Re < 10). The objective is to establish suitable mass transfer correlations, expressed in the form of Sherwood number (Sh = f (e,Re,Sc)), that identifies the link from local mass transfer investigations to full-device analyses. The development of a concentration field is initially investigated and expressions are established covering the range from a typical deoxygenated condition up to a full oxygenated condition...
December 22, 2016: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/27998147/chitosan-coated-diatom-silica-as-hemostatic-agent-for-hemorrhage-control
#15
Chao Feng, Jing Li, Guang Sheng Wu, Yu Zhi Mu, Ming Kong, Chang Qing Jiang, Xiao Jie Cheng, Ya Liu, Xi Guang Chen
Uncontrolled hemorrhage leads to high death risk both in military and civilian trauma. Current hemostatic agents still have various limitations and side effects. In this study, natural diatom silica obtained from diatomite and diatom culture was purified and developed for hemorrhage control. To improve the biocompatibility and hemostatic performance of diatom silica, a series of chitosan-coated diatom (CS-diatom) was developed. The composition of CS-diatom prepared was optimized by in vitro hemocompatibility and blood coagulation evaluation for that prepared with 0...
December 21, 2016: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/27941590/traumatic-hemothorax-blood-contains-elevated-levels-of-microparticles-that-are-prothrombotic-but-inhibit-platelet-aggregation
#16
Thomas A Mitchell, Maryanne C Herzig, Chriselda G Fedyk, Marc A Salhanick, Aaron T Henderson, Bijaya K Parida, Nicolas J Prat, Daniel L Dent, Martin G Schwacha, Andrew P Cap
OBJECTIVES: Autotransfusion of shed blood from traumatic hemothorax is an attractive option for resuscitation of trauma patients in austere environments. However, previous analyses revealed that shed hemothorax (HX) blood is defibrinated, thrombocytopenic, and contains elevated levels of D-dimer. Mixing studies with normal pooled plasma demonstrated hypercoagulability, evoking concern for potentiation of acute traumatic coagulopathy. We hypothesized that induction of coagulopathic changes by shed HX blood may be due to increases in cellular microparticles (MP) and that these may also affect recipient platelet function...
December 9, 2016: Shock
https://www.readbyqxmd.com/read/27940454/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#17
J W Simmons, M F Powell
Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27935296/graphene-montmorillonite-composite-sponge-for-safe-and-effective-hemostasis
#18
Guofeng Li, Kecheng Quan, Yuping Liang, Tianyi Li, Qipeng Yuan, Lei Tao, Qian Xie, Xing Wang
Montmorillonite (MMT) is considered to be the most effective hemostat among natural phyllosilicates. However, there is a barrier against using MMT for the commercial hemostatics because the invaded MMT powders might cause thrombosis in vessel. Until now, it is still a challenge to manage the release of MMT and eliminate its side effect. Herein, we present a graphene-MMT composite sponge (GMCS), synthesized under a hydrothermal reaction, fixing MMT powders into the cross-linked graphene sheets. We demonstrate that only a few embedded MMT can evoke remarkable platelet stimulation at the sponge interface, while maintaining fast plasma absorbency of the innate sponge...
December 28, 2016: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/27890816/pathophysiology-of-hemophilic-arthropathy-and-potential-targets-for-therapy
#19
REVIEW
Astrid E Pulles, Simon C Mastbergen, Roger E G Schutgens, Floris P J G Lafeber, Lize F D van Vulpen
Hemophilia is a congenital clotting factor deficiency characterized by spontaneous and trauma-related bleeding. Spontaneous bleeding shows a predilection for joints, and repeated hemarthroses lead to a disabling condition called hemophilic arthropathy. Treatment of this condition consists of preventing joint bleeding on the one hand and orthopedic surgery as a last resort on the other. Up till now, there is no disease modifying therapy available to fill the gap between these extremes. This review provides an overview of the pathogenesis of hemophilic arthropathy in order to identify potential targets for therapy...
January 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27882250/apical-revascularization-after-delayed-tooth-replantation-an-unusual-case
#20
Marília Pacífico Lucisano, Paulo Nelson-Filho, Lea Assed Bezerra Silva, Raquel Assed Bezerra Silva, Fabricio Kitazono de Carvalho, Alexandra Mussolino de Queiroz
The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11) had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed...
2016: Case Reports in Dentistry
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