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Trauma blood clotting

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https://www.readbyqxmd.com/read/29078874/14-day-thawed-plasma-retains-clot-enhancing-properties-and-inhibits-tpa-induced-fibrinolysis
#1
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Raymond Shepherd-Singh, Angela Sauaia, Gregory R Stettler, Geoffrey R Nunns, Christopher C Silliman
BACKGROUND: Plasma-first resuscitation attenuates trauma-induced coagulopathy (TIC); however, the logistics of plasma-first resuscitation require thawed plasma (TP) be readily available due to the obligatory thawing time of fresh frozen plasma (FFP). The current standard is storage of TP for up to 5 days at 4°C, based on factor levels at outdate, for use in patients at risk for TIC, but there remains a 2.2% outdated wastage rate. However, the multitude of plasma proteins in attenuating TIC remains unknown...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29065860/assessment-of-haemostasis-in-patients-undergoing-emergent-neurosurgery-by-rotational-elastometry-and-standard-coagulation-tests-a-prospective-observational-study
#2
Christoph Ellenberger, Najia Garofano, Gleicy Barcelos, John Diaper, Gordana Pavlovic, Marc Licker
BACKGROUND: Rotational elastometry (ROTEM) has been shown useful to monitor coagulation in trauma patients and in major elective surgery. In this study, we aimed to evaluate the utility of ROTEM to identify hemostatic disturbances and to predict the need for transfusion, compared with standard coagulation tests (SCTs) in patients undergoing emergent neurosurgery. METHODS: Over a four-year period, adult patients who met criteria for emergent neurosurgery lasting more than 90 min were included in the study...
October 24, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#3
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29019885/two-incision-laparoscopic-appendectomy-for-a-severe-hemophilia-a-child-patient-with-coagulation-factor-vii-deficiency-case-report-and-review-of-literature
#4
Jin Peng He, Jie Xiong Feng
RATIONALE: The main complication of patients with severe hemophilia is recurrent bleeding events that usually affected musculoskeletal contractures. And replacement therapy methods were continuously improved to minimize adverse impacts brought by those complications. However, only several cases reported about the appendectomy for hemophilia A. We report a case of acute appendicitis treated by two-incision laparoscopy in a boy with hemophilia A and coagulation factor VII deficiency for the first time...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28940322/blood-pressure-in-trauma-resuscitation-pop-the-clot-vs-drain-the-brain
#5
EDITORIAL
M D Wiles
No abstract text is available yet for this article.
December 2017: Anaesthesia
https://www.readbyqxmd.com/read/28930957/clot-dynamics-and-mortality-the-ma-r-ratio
#6
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing thromboelastography (TEG) to identify those at risk of subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28893050/-quirky-bulb-on-the-lower-jaw-an-organizing-haematoma
#7
Raghavendra Mahadev Naik, Ramanjaneya Raju Pennemetsa, Sudhakara Reddy, Praveen Gadde, Sruthi Rayapureddy
Organizing Haematoma is a rare, non/neoplastic benign lesion with locally destructive behaviour that may mimic a malignancy. Usually symptoms do not occur, while the lesion remains localized. An Organized Haematoma is an encapsulated blood clot undergoing neovascularization and fibrosis. It has also been referred to as a hemophilic pseudotumour and/or a haematoma like tumour, which is rarely found in the head and neck region. Other reported cases have been related to trauma or an underlying haemangioma. However, most of the cases have no identifiable underlying pathology, trauma or systemic disease...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28844307/clinical-evidence-for-regenerative-endodontic-procedures-immediate-versus-delayed-induction
#8
Tatiana M Botero, Xianli Tang, Richard Gardner, Jan C C Hu, James R Boynton, G Rex Holland
Clinicians face many challenges when treating immature permanent teeth in young patients. Immediate blood clot induction can be a successful option as described by some case reports. No experimental studies or clinical trials have addressed this question. We have designed a clinical trial in which we hypothesized that there is no difference in success between immediate or delayed induction protocols. After confirmation of pulpal necrosis, patients were randomized. In the delayed group, 15 teeth were treated following the American Association of Endodontists guidelines, and calcium hydroxide was used as the intracanal medication...
September 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28837538/human-neutrophil-elastase-mediates-fibrinolysis-shutdown-through-competitive-degradation-of-plasminogen-and-generation-of-angiostatin
#9
Christopher D Barrett, Hunter B Moore, Anirban Banerjee, Christopher C Silliman, Ernest E Moore, Michael B Yaffe
BACKGROUND: A subset of trauma patients undergo fibrinolysis shutdown rather than pathologic hyperfibrinolysis, contributing to organ failure. The molecular basis for fibrinolysis shutdown in trauma is incompletely understood. Elastase released from primed/activated human neutrophils (HNE) has historically been described as fibrin(ogen)olytic. However, HNE can also degrade plasminogen (PLG) to angiostatin (ANG), retaining the Kringle domains but not the proteolytic function, and could thereby compete for generation of active plasmin by tPA...
August 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28832765/is-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-with-a-stylet-necessary-for-lymph-node-screening-in-lung-cancer-patients
#10
Y Xu, J Lin, Y Jin, X Wu, H Zheng, J Feng
During endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), a needle is commonly used with a stylet, although recently the stylet has been omitted. This prospective study aimed to compare the quality of specimens obtained by EBUS-TBNA performed with and without a stylet. Between November 2013 and November 2014, 131 patients with lung cancer underwent EBUS-TBNA, with a total of 148 mediastinal or hilar lymph nodes sampled both with and without an inner-stylet, yielding 296 cytological specimens...
August 17, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28765353/hemostatic-management-of-trauma-induced-coagulopathy
#11
Janise B Phillips, Phillip L Mohorn, Rebecca E Bookstaver, Tanya O Ezekiel, Christopher M Watson
Trauma-induced coagulopathy is a primary factor in many trauma-related fatalities. Management hinges upon rapid diagnosis of coagulation abnormalities and immediate administration of appropriate hemostatic agents. Use of crystalloids and packed red blood cells has traditionally been the core of trauma resuscitation, but current massive transfusion protocols include combination therapy with fresh frozen plasma and predefined ratios of platelets to packed red blood cells, limiting crystalloid administration. Hemostatic agents such as tranexamic acid, prothrombin complex concentrate, fibrinogen concentrate, and, in cases of refractory bleeding, recombinant activated factor VIIa may also be warranted...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28745251/-using-thromboelastography-to-measure-coagulation-following-massive-blood-loss
#12
M C A Müller, G A E Ponjee
Thromboelastography is becoming increasingly important for diagnosing coagulation disorders in patients with massive blood loss. This whole-blood measurement provides information about the speed of clot formation, clot strength, and degree of fibrinolysis. The result can be used as a basis for making a faster and better choice of a suitable blood product for the patient with severe blood loss. This technique can be carried out simply and quickly as a rapid test ('point-of-care test') or in a central laboratory...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28731369/experimental-evaluation-of-tranexamic-acid-loaded-porous-starch-as-a-hemostatic-powder
#13
Chaoyun Xi, Liguo Zhu, Yuan Zhuang, Shufang Wang, Guixiang Sun, Yaqian Liu, Deqing Wang
We evaluated the effectiveness of a novel hemostatic powder called Tranexamic Acid-loaded Porous Starch (TAPS) developed recently on blood clotting activity and hemostasis. The effectiveness of TAPS was evaluated by comparing hemostatic properties with those of Quick-acting Styptic Powder (QSP) and Compound Microporous Polysaccharide Haemostatic powder (CMPHP). The blood clotting activities of human blood were analyzed by thromboela-stogram (TEG) assays in vitro. The hemostatic effectiveness in vivo was evaluated using a rat model with hepatic traumatic hemorrhage...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28697023/clot-dynamics-and-mortality-the-ma-r-ratio
#14
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing TEG to identify those at risk for subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632435/relative-effects-of-plasma-fibrinogen-concentrate-and-factor-xiii-on-rotem-coagulation-profiles-in-an-in-vitro-model-of-massive-transfusion-in-trauma
#15
David E Schmidt, Märit Halmin, Agneta Wikman, Anders Östlund, Anna Ågren
Massive traumatic haemorrhage is aggravated through the development of trauma-induced coagulopathy, which is managed by plasma transfusion and/or fibrinogen concentrate administration. It is yet unclear whether these treatments are equally potent in ensuring adequate haemostasis, and whether additional factor XIII (FXIII) administration provides further benefits. In this study, we compared ROTEM whole blood coagulation profiles after experimental massive transfusion with different transfusion regimens in an in vitro model of dilution- and transfusion-related coagulopathy...
October 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28601310/hemoglobin-based-oxygen-carriers-promote-systemic-hyperfibrinolysis-that-is-both-dependent-and-independent-of-plasmin
#16
Alexander P Morton, Ernest E Moore, Hunter B Moore, Eduardo Gonzalez, Michael P Chapman, Erik Peltz, Anirban Banerjee, Christopher Silliman
BACKGROUND: Hyperfibrinolysis plays an integral role in the genesis of trauma-induced coagulopathy. Recent data demonstrate that red blood cell lysis promotes fibrinolysis; however, the mechanism is unclear. Hemoglobin-based oxygen carriers (HBOCs) have been developed for resuscitation and have been associated with coagulopathy. We hypothesize that replacement of whole blood (WB) using an HBOC results in a coagulopathy because of the presence of free hemoglobin. MATERIALS AND METHODS: WB was sampled from healthy donors (n = 6)...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28583756/thrombelastography-indicates-limitations-of-animal-models-of-trauma-induced-coagulopathy
#17
Gregory R Stettler, Ernest E Moore, Hunter B Moore, Peter J Lawson, Miguel Fragoso, Geoffrey R Nunns, Christopher C Silliman, Anirban Banerjee
BACKGROUND: Thrombelastography (TEG) has been used to characterize the coagulation changes associated with injury and shock. Animal models developed to investigate trauma-induced coagulopathy (TIC) have failed to produce excessive bleeding. We hypothesize that a native TEG will demonstrate marked differences in humans compared with these experimental models, which explains the difficulties in reproducing a clinically relevant coagulopathy in animal models. METHODS: Whole blood was collected from 138 healthy human volunteers, 25 swine and 66 Sprague-Dawley rats before experimentation...
September 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28582290/atypical-growing-pattern-of-superficial-temporal-artery-pseudoaneurysm
#18
Jeonghyun Ha, Yong Hyun Kim, Bo La Yun, Kyu Sang Lee, Chang-Sik Pak, Jae Hoon Jeong
Superficial temporal artery pseudoaneurysm is rare and usually caused by trauma. Pseudoaneurysms have been reported to occur most frequently from 2 to 6 weeks after trauma and they range from 1 to 3 cm in diameter. The authors present a case of a patient with an atypical delayed rapid growing pseudoaneurysm, who had undergone neurosurgery after head trauma 20 years ago.A 72-year-old woman underwent craniotomy and extradural hemorrhage removal through a left temporoparietal incision caused by head trauma after a traffic accident 20 years prior...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28558815/pathophysiology-of-chronic-subdural-haematoma-inflammation-angiogenesis-and-implications-for-pharmacotherapy
#19
REVIEW
Ellie Edlmann, Susan Giorgi-Coll, Peter C Whitfield, Keri L H Carpenter, Peter J Hutchinson
Chronic subdural haematoma (CSDH) is an encapsulated collection of blood and fluid on the surface of the brain. Historically considered a result of head trauma, recent evidence suggests there are more complex processes involved. Trauma may be absent or very minor and does not explain the progressive, chronic course of the condition. This review focuses on several key processes involved in CSDH development: angiogenesis, fibrinolysis and inflammation. The characteristic membrane surrounding the CSDH has been identified as a source of fluid exudation and haemorrhage...
May 30, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28545548/circulating-microparticle-levels-are-reduced-in-patients-with-ards
#20
Ciara M Shaver, Justin Woods, Jennifer K Clune, Brandon S Grove, Nancy E Wickersham, J Brennan McNeil, Gregory Shemancik, Lorraine B Ware, Julie A Bastarache
BACKGROUND: It is unclear how to identify which patients at risk for acute respiratory distress syndrome (ARDS) will develop this condition during critical illness. Elevated microparticle (MP) concentrations in the airspace during ARDS are associated with activation of coagulation and in vitro studies have demonstrated that MPs contribute to acute lung injury, but the significance of MPs in the circulation during ARDS has not been well studied. The goal of the present study was to test the hypothesis that elevated levels of circulating MPs could prospectively identify critically ill patients who will develop ARDS and that elevated circulating MPs are associated with poor clinical outcomes...
May 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
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