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Thromboelastometry

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https://www.readbyqxmd.com/read/29324486/fibrinolysis-and-antifibrinolytic-treatment-in-the-trauma-patient
#1
Lewis S Gall, Ross A Davenport
PURPOSE OF REVIEW: The role of antifibrinolytics in trauma haemorrhage and early coagulopathy remains controversial with respect to patient selection, dosage, timing of treatment, and risk of thrombotic complications. This review presents our current understanding of the mechanisms of fibrinolysis in trauma, diagnostic evaluation, and the evidence base for treatment. RECENT FINDINGS: Excessive fibrinolysis following severe injury is a major component of acute traumatic coagulopathy and contributes to the high mortality from trauma haemorrhage...
January 10, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29306729/adding-to-the-complexity-of-fetal-and-neonatal-alloimmune-thrombocytopenia-reduced-fibrinogen-binding-in-the-presence-of-anti-hpa-1a-antibody-and-hypo-responsive-neonatal-platelets
#2
E Refsum, S Meinke, G Gryfelt, A Wikman, P Höglund
BACKGROUND: In fetal and neonatal alloimmune thrombocytopenia (FNAIT), maternal alloantibodies directed against paternally-derived platelet antigens are transported across the placenta to the fetus, where they may cause thrombocytopenia. The most serious complication of FNAIT is an intracranial hemorrhage (ICH), which may cause death or life-long disability of the child. Apart from alloantibody-mediated platelet destruction, the clinical outcome in FNAIT may be affected by properties of neonatal platelets and possible functional effects on platelets caused by maternal alloantibodies...
December 29, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29305999/high-fat-diet-induced-obesityexacerbateshematopoiesis-deficiency-and-cytopenia-caused-by-5-fluorouracil-via-ppar-%C3%AE
#3
Yanhong Li, Shuai Zhu, Yuanyuan Zhang, Ting Liu, Linchong Su, Qiuping Zhang, Yubin Luo
The present study aims to investigate the influence of high fat diet (HFD) on hematopoietic system recovery under stress condition caused by 5-Fluouracil (5-Fu) and evaluate the alleviating benefit of PPAR-γ inhibition on aggravation of 5-Fu-induced toxicity under HFD condition. Survival rate of HFD or normal diet (ND) mice was monitored after 5-Fu injection. HSC and the progenitor cells in bone marrow were detected at various time points after 5-Fu administration by flow cytometry. Genes expression involved in stem cell and platelet proliferation were tested by RT-PCR...
January 3, 2018: Experimental Hematology
https://www.readbyqxmd.com/read/29304529/passivating-injured-endothelium-with-kinexins-in-thrombolytic-therapy
#4
Yunn-Hwa Ma, Chao-Wei Huang, Chih-Jen Wen, Yi-Ching Lu, Shiaw-Pyng Wey, Tze-Chein Wun
Without conjunctive administration of an anticoagulant, endothelial injury-induced thrombosis is resistant to thrombolysis and prone to re-thrombosis. We hypothesized that co-delivery of recombinant tissue plasminogen activator (rtPA) with annexin V-containing anticoagulants that specifically target the injured endothelium may passivate the thrombogenic elements of the vascular injury site and enhance rtPA-induced thrombolysis. In this study, the effects of conjunctive administration of Kinexins (Kunitz inhibitor-annexin V fusion proteins) with rtPA on thrombolysis were determined in vitro and in vivo...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29304526/thromboelastometry-and-platelet-function-during-acclimatization-to-high-altitude
#5
Alistair S Rocke, Gordon G Paterson, Matthew T Barber, Alexander I R Jackson, Shona Main, Calum Stannett, Martin F Schnopp, J Kenneth Baillie, Elizabeth H Horne, Carl Moores, Paul Harrison, Alastair F Nimmo, A A Roger Thompson
Interaction between hypoxia and coagulation is important given the increased risk of thrombotic diseases in chronically hypoxic patients who reside at sea level and in residents at high altitude. Hypoxia alters the proteome of platelets favouring a prothrombotic phenotype, but studies of activation and consumption of specific coagulation factors in hypoxic humans have yielded conflicting results. We tested blood from 63 healthy lowland volunteers acclimatizing to high altitude (5,200 m) using thromboelastometry and assays of platelet function to examine the effects of hypoxia on haemostasis...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29299962/thromboelastometry-in-trauma-care-a-place-in-the-2018-belgian-health-care-system
#6
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/29286337/identification-of-two-novel-fibrinogen-b%C3%AE-chain-mutations-in-two-slovak-families-with-quantitative-fibrinogen-disorders
#7
Tomas Simurda, Jana Zolkova, Zuzana Snahnicanova, Dusan Loderer, Ingrid Skornova, Juraj Sokol, Jan Hudecek, Jan Stasko, Zora Lasabova, Peter Kubisz
Congenital fibrinogen disorders are caused by mutations in one of the three fibrinogen genes that affect the synthesis, assembly, intracellular processing, stability or secretion of fibrinogen. Functional studies of mutant Bβ-chains revealed the importance of individual residues as well as three-dimensional structures for fibrinogen assembly and secretion. This study describes two novel homozygous fibrinogen Bβ chain mutations in two Slovak families with afibrinogenemia and hypofibrinogenemia. Peripheral blood samples were collected from all subjects with the aim of identifying the causative mutation...
December 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29238008/association-between-platelet-count-and-postoperative-blood-loss-in-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-and-fresh-frozen-plasma-administration-guided-by-thromboelastometry
#8
Junko Ichikawa, Yoshiko Osada, Mitsuharu Kodaka, Keiko Nishiyama, Makiko Komori
BACKGROUND: Coagulopathy after cardiopulmonary bypass (CPB) is caused by multiple factors, including reduced coagulation factors and a low platelet count.Methods and Results:In this study, we undertook a post hoc analysis to identify factors associated with increased postoperative blood loss in 97 patients undergoing cardiac surgery with CPB, with fresh frozen plasma administered according to a ROTEM-guided algorithm. We identified 24 patients for the top quartile of postoperative blood loss, >528 mL and defined as having excessive blood loss...
December 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29223684/thromboelastometry-as-guidance-for-blood-management-in-patients-undergoing-cardiac-surgery
#9
C Sarrais Polo, A Alonso Morenza, J Rey Picazo, L Álvarez Mercadal, R Beltrao Sial, C Aguilar Lloret
OBJECTIVE: Thromboelastometry is a viscoelastometric method for haemostasis testing in a whole blood sample. The aim of this study was to assess the results of using thromboelastometry as guidance for blood management in cardiac surgery, postoperative adverse events and ICU stay. MATERIAL AND METHOD: Analytical and comparative non-randomised quasi-experimental prospective study with a retrospective control group. The inclusion criteria for the 80 patients were: patients undergoing cardiac surgery who had had prior cardiac surgery, endocarditis surgery or aortic arch surgery...
December 6, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29222338/blood-sample-transportation-by-pneumatic-transportation-systems-a-systematic-literature-review
#10
REVIEW
Mads Nybo, Merete E Lund, Kjell Titlestad, Christian U Maegaard
BACKGROUND: Pneumatic transportation systems (PTSs) are increasingly used for transportation of blood samples to the core laboratory. Many studies have investigated the impact of these systems on different types of analyses, but to elucidate whether PTSs in general are safe for transportation of blood samples, existing literature on the subject was systematically assessed. METHODS: A systematic literature review was conducted following the preferred reporting items for systematic reviews and metaanalyses (PRISMA) Statement guidelines to gather studies investigating the impact of PTS on analyses in blood samples...
December 8, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29220876/pharmacokinetics-clot-strength-and-safety-of-a-new-fibrinogen-concentrate-randomized-comparison-with-active-control-in-congenital-fibrinogen-deficiency
#11
C Ross, S Rangarajan, M Karimi, G H Toogeh, S Apte, T Lissitchkov, S Acharya, M J Manco-Johnson, A Srivastava, B Brand, B Schwartz, S Knaub, F Peyvandi
BACKGROUND: Human fibrinogen concentrate (HFC) corrects fibrinogen deficiency in congenital a-/hypofibrinogenaemia. OBJECTIVES: To assess pharmacokinetics (PK), effects on thromboelastometry maximum clot firmness (MCF), and safety of a new double virus-inactivated/eliminated, highly purified HFC vs. active control. PATIENTS/METHODS: In this multinational, randomized, phase II, open-label, crossover study in 22 congenital afibrinogenaemia patients ≥12 years, 70 mg kg-1 of new HFC (FIBRYGA, Octapharma AG) or control (Haemocomplettan® P/RiaSTAP™ , CSL Behring GmbH) were administered, followed by crossover to the other concentrate...
December 8, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29198748/microparticles-from-stored-red-blood-cells-promote-a-hypercoagulable-state-in-a-murine-model-of-transfusion
#12
Young Kim, Brent T Xia, Andrew D Jung, Alex L Chang, William A Abplanalp, Charles C Caldwell, Michael D Goodman, Timothy A Pritts
BACKGROUND: Red blood cell-derived microparticles are biologically active, submicron vesicles shed by erythrocytes during storage. Recent clinical studies have linked the duration of red blood cell storage with thromboembolic events in critically ill transfusion recipients. In the present study, we hypothesized that microparticles from aged packed red blood cell units promote a hypercoagulable state in a murine model of transfusion. METHODS: Microparticles were isolated from aged, murine packed red blood cell units via serial centrifugation...
November 29, 2017: Surgery
https://www.readbyqxmd.com/read/29194665/efficacy-and-safety-of-a-new-human-fibrinogen-concentrate-in-patients-with-congenital-fibrinogen-deficiency-an-interim-analysis-of-a-phase-iii-trial
#13
Toshko Lissitchkov, Bella Madan, Claudia Djambas Khayat, Nadezhda Zozulya, Cecil Ross, Mehran Karimi, Kaan Kavakli, Guillermo R De Angulo, Abdulkareem Almomen, Bruce A Schwartz, Cristina Solomon, Sigurd Knaub, Flora Peyvandi
BACKGROUND: Fibrinogen concentrate is the preferred choice for fibrinogen replacement in congenital fibrinogen deficiency. This study investigated hemostatic efficacy of a new plasma-derived, double virus-inactivated (using two dedicated virus inactivation/elimination steps) human fibrinogen concentrate for on-demand treatment of bleeding episodes (BEs) and surgical prophylaxis. STUDY DESIGN AND METHODS: In this planned interim analysis of a prospective, multinational Phase III study (NCT02267226), 13 patients with afibrinogenemia (≥12 years) received fibrinogen concentrate (FIBRYGA, Octapharma AG)...
November 30, 2017: Transfusion
https://www.readbyqxmd.com/read/29188763/prothrombotic-state-in-a-patient-with-acute-liver-failure-the-question-of-anticoagulation
#14
Ecaterina Scărlă Tescu, Dana Rodica Tomescu
A 35-year-old male with acute liver failure due to acute hepatitis B virus infection was admitted to the intensive care unit with significant hepatocellular injury, cholestasis, abnormal standard coagulation tests, normal rotational thromboelastometry indices, and without signs of bleeding. He underwent emergency liver transplantation without requiring blood product transfusions or procoagulant treatments. The postoperative course was complicated by deep vein thrombosis and impending hepatic artery thrombosis treated with unfractionated heparin, aspirin, and intravenous prostacyclin...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29157015/influence-of-selected-antithrombotic-treatment-on-thromboelastometric-results
#15
Mia Hammer Holck, Thomas Decker Christensen, Anne-Mette Hvas
Rotatory thromboelastometry (ROTEM(®)) is used for diagnosing and monitoring bleeding patients. Some of these patients receive antithrombotic treatment, thus having an increased risk of bleeding. Only sparse knowledge exists about whether the ROTEM(®) analysis is influenced by antithrombotic treatment. The objective of the present study was to examine if the ROTEM(®) results are affected in patients receiving antithrombotic treatment. This prospective observational study included patients receiving either vitamin K-antagonists (VKA), aspirin (ASA) or ASA combined with an adenosine diphosphate (ADP) receptor antagonist (ASA + ADP)...
November 20, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29151081/association-between-standard-laboratory-and-functional-tests-of-coagulation-in-dilutional-coagulopathy-an-in-vitro-study
#16
L J Krzych, P F Czempik
Standard laboratory tests (SLTs) of coagulation are in common use in clinical practice. We aimed to determine the association between SLTs and functional tests of coagulation in blood samples diluted with balanced crystalloid and colloid solutions in an ex vivo setting. The study group comprised 32 healthy young male volunteers. Whole blood samples were diluted at a 4:1 ratio with balanced crystalloid (Plasmalyte®) and two balanced colloids, 6% hydroxyethyl starch 130/0.4 (Volulyte®) and succinylated gelatin (Geloplasma®)...
August 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#17
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte® ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg-1 . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29149971/fibrinolysis-in-living-donor-liver-transplantation-recipients-evaluated-using-thromboelastometry-impact-on-mortality
#18
T Shimauchi, K Yamaura, M Higashi, K Abe, T Yoshizumi, S Hoka
BACKGROUND: Inadequate hemostasis during living donor liver transplantation (LDLT) is mainly due to coagulopathy but may also include fibrinolysis. The purpose of this study was to determine the incidence of fibrinolysis and assess its relevance to mortality in LDLT. METHODS: The incidence and prognosis of fibrinolysis were retrospectively studied in 76 patients who underwent LDLT between April 2010 and February 2013. Fibrinolysis was evaluated and defined by maximum lysis (ML) >15% within a 60-minute run time using thromboelastometry (ROTEM)...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29145467/adenosine-lidocaine-and-mg2-alm-fluid-therapy-attenuates-systemic-inflammation-platelet-dysfunction-and-coagulopathy-after-non-compressible-truncal-hemorrhage
#19
Hayley Letson, Geoffrey Dobson
BACKGROUND: Systemic inflammation and coagulopathy are major drivers of injury progression following hemorrhagic trauma. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg2+ (ALM) bolus and 0.9% NaCl/ALM 'drip' on inflammation and coagulation in a rat model of hemorrhagic shock. METHODS: Sprague-Dawley rats (429±4 g) were randomly assigned to: 1) shams, 2) no-treatment, 3) saline-controls, 4) ALM-therapy, and 5) Hextend®. Hemorrhage was induced in anesthetized-ventilated animals by liver resection (60% left lateral lobe and 50% medial lobe)...
2017: PloS One
https://www.readbyqxmd.com/read/29140832/platelet-function-changes-in-a-time-dependent-manner-following-traumatic-brain-injury-in-a-murine-model
#20
Grace E Martin, Brent Xia, Young Kim, Mark D Johnson, Rosalie Veile, Lou Ann Friend, Amy T Makley, Charles C Caldwell, Michael D Goodman
Traumatic brain injury (TBI) results in systemic changes in coagulation and inflammation that contribute to post-traumatic morbidity and mortality. The potential interaction of platelets and pro-inflammatory cytokines in the modulation of coagulation, microthrombosis, and venous thromboembolic events after moderate TBI (TBI) has not been determined. Using a murine model, we hypothesized 1) that the degree of platelet-induced coagulation varies depending on the platelet aggregation agonist 2) platelet-induced coagulation changes in a time-dependent manner following TBI, and 3) changes in platelet-induced coagulation are mirrored by changes in the levels of circulating pro-inflammatory cytokines...
November 14, 2017: Shock
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