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Thromboelastometry

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https://www.readbyqxmd.com/read/29768939/higher-preoperative-plasma-thrombin-potential-in-patients-undergoing-surgery-for-aortic-stenosis-compared-to-surgery-for-stable-coronary-artery-disease
#1
Axel Dimberg, Ulrica Alström, Elisabeth Ståhle, Christina Christersson
Aortic stenosis (AS) and coronary artery disease (CAD) influence the coagulation system, potentially affecting hemostasis during cardiac surgery. Our aim was to evaluate 2 preoperative global hemostasis assays, plasma thrombin potential and thromboelastometry, in patients with severe aortic valve stenosis compared to patients with CAD. A secondary aim was to test whether the assays were associated with postoperative bleeding. Calibrated automated thrombogram (CAT) in platelet-poor plasma and rotational thromboelastometry (ROTEM) in whole blood were analyzed in patients scheduled for elective surgery due to severe AS (n = 103) and stable CAD (n = 68)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29764497/activated-prothrombin-complex-concentrate-to-reverse-the-factor-xa-inhibitor-apixaban-effect-before-emergency-surgery-a-case-series
#2
Nina Haagenrud Schultz, Runar Lundblad, Pål Andre Holme
BACKGROUND: The lack of an antidote against factor Xa inhibitors in case of major bleeding or need for urgent surgery is a concern to clinicians. Guidelines on managing major bleeding in patients under anticoagulation with a factor Xa inhibitor suggest several hemostatic agents to reverse the effect, but there is no consensus regarding the choice of drug or appropriate dose. The ability of prothrombin complex concentrate, activated prothrombin complex concentrate, and recombinant factor VIIa to reverse the effect of factor Xa inhibitors has been evaluated in animal studies, in vitro studies, and healthy volunteers, but not yet in randomized clinical studies...
May 16, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29758989/the-double-hazard-of-bleeding-and-thrombosis-in-hemostasis-from-a-clinical-point-of-view-a-global-assessment-by-rotational-thromboelastometry-rotem
#3
Olga Meltem Akay
Hemostasis is a complex dynamic process involving bleeding and thrombosis as two end-points. Conventional coagulation tests which are measured in plasma examine only isolated portions of the coagulation cascade, thereby giving no information on important interactions essential to the clinical evaluation of hemostatic function. Thromboelastography (TEG), originally described in 1948 has improved over the decades and become a valuable tool of coagulation testing because of the limitations of standard coagulation tests...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29758126/abrogating-fibrinolysis-does-not-improve-bleeding-or-rfviia-rfviii-treatment-in-a-non-mucosal-venous-injury-model-in-haemophilic-rodents
#4
Rikke Stagaard, Matthew J Flick, Barbara Bojko, Krzysztof Goryński, Paulina Z Goryńska, Carsten D Ley, Lisbeth H Olsen, Tom Knudsen
BACKGROUND: Fibrinolysis may exacerbate bleeding in haemophilia A (HA). Accordingly, antifibrinolytics have been used to help maintain haemostatic control. While antifibrinolytic drugs have been proven effective in the treatment of mucosal bleeds in the oral cavity, their efficacy in non-mucosal tissues remain an open question of significant clinical interest. OBJECTIVE: To determine whether inhibiting fibrinolysis improves the outcome in non-mucosal haemophilic tail vein transection (TVT) bleeding models, and to determine whether a standard ex vivo clotting/fibrinolysis assay can be used as a predictive surrogate for in vivo efficacy...
May 14, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29757137/reversal-of-apixaban-induced-alterations-in-haemostasis-by-different-coagulation-factor-concentrates-in-patients-after-hip-or-knee-replacement-surgery
#5
Katrin Schmidt, Kerstin Krüger, Elisabeth Langer, Martin Schmutzler, Elke Johnen, Klaus D Wernecke, Christian Von Heymann, Mareike K Körber
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) with a specific inhibition of activated factor X (FXa). In case of bleeding or need of urgent surgery a direct antidote is not yet available. Off-label application of non-specific haemostatic agents, such as prothrombin complex concentrate (PCC) and recombinant FVIIa (rFVIIa), has been reported to reverse the effects of apixaban in in vitro and animal studies. The aim of this study is to measure the reversal potential of PCC and rFVIIa in patients with prophylactic apixaban concentrations...
May 11, 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29756268/does-rotational-thromboelastometry-accurately-predict-coagulation-status-in-patients-with-lupus-anticoagulant
#6
L Hensch, V Kostousov, K Bruzdoski, M Losos, M Pereira, M de Guzman, S Hui, J Teruya
INTRODUCTION: Rotational thromboelastometry (ROTEM) is increasingly used as a tool for monitoring coagulation status. However, ROTEM is susceptible to misinterpretation due to particular coagulation abnormalities. Here, we report the effects of lupus anticoagulant (LA) on ROTEM. METHODS: A prospective observational analysis was performed on 16 children with prior studies indicating the presence of LA or antiphospholipid antibodies. ROTEM analysis was performed, and samples were further analyzed by adding phospholipids (PL) to repeat ROTEM analysis if clotting time (CT) abnormalities were discovered with comparison to ROTEM using an equal volume of isotonic saline...
May 13, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29743045/haematological-and-fibrinolytic-status-of-nigerian-women-with-post-partum-haemorrhage
#7
Ian Roberts, Haleema Shakur, Bukola Fawole, Modupe Kuti, Oladapo Olayemi, Adenike Bello, Olayinka Ogunbode, Taiwo Kotila, Chris O Aimakhu, Tolulase Olutogun, Beverley J Hunt, Sumaya Huque
BACKGROUND: Early treatment with tranexamic acid reduces deaths due to bleeding after post-partum haemorrhage. We report the prevalence of haematological, coagulation and fibrinolytic abnormalities in Nigerian women with postpartum haemorrhage. METHODS: We performed a secondary analysis of the WOMAN trial to assess laboratory data and rotational thromboelastometry (ROTEM) parameters in 167 women with postpartum haemorrhage treated at University College Hospital, Ibadan, Nigeria...
May 9, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29736870/can-we-predict-thrombotic-tendency-in-rheumatoid-arthritis-a-thromboelastographic-analysis-with-rotem
#8
Sümeyye Merve Türk, Döndü Üsküdar Cansu, Hava Üsküdar Teke, Timuçin Kaşifoğlu, O Meltem Akay, Muzaffer Bilgin, Cengiz Korkmaz
The higher incidence of arterial and venous events is well established in patients with rheumatoid arthritis (RA). Our aim here was to investigate whether there is a prothrombotic state in RA patients by using rotational thromboelastometry (ROTEM) method and to demonstrate whether the disease variables play a role in this process. A total of 85 patients who met the 2010 RA classification criteria were consecutively included in the study. The patients with RA who have been using antiaggregant, anticoagulant, or nonsteroidal anti-inflammatory drugs (NSAIDs) and had a history of arterial or venous thromboembolism were excluded from the study...
May 7, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29716485/the-effects-of-haemodilution-with-succinylated-gelatin-solution-on-coagulation-in-vitro-as-assessed-by-thromboelastometry-and-impedance-multiple-electrode-aggregometry
#9
Pca Kam, S Varanasi, K X Yang
We investigated the in vitro viscoelastic changes of progressive haemodilution with succinylated gelatin (SG) solution compared with normal saline (NS) using rotational thromboelastometry (ROTEM®). Whole blood (WB) samples obtained from 20 healthy volunteers were diluted in vitro with SG solution or NS by 10%, 20% and 40%. Fibrinogen concentration and ROTEM (EXTEM, FIBTEM) variables including coagulation time (CT), clot formation time (CFT), α-angle, and maximum clot firmness (MCF) were measured in the undiluted sample and at each degree of haemodilution...
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29703920/prevalent-metabolic-derangement-and-severe-thrombocytopenia-in-abo-incompatible-liver-recipients-with-pre-transplant-plasma-exchange
#10
Hye-Mee Kwon, In-Gu Jun, JungBok Lee, Young-Jin Moon, Kyeo-Woon Jung, Hye-Won Jeong, Yong-Seok Park, Jun-Gol Song, Gyu-Sam Hwang
Desensitisation with therapeutic plasma exchange (TPE) is essential for ABO-incompatible (ABO-I) liver transplants (LTs). However, excessive citrate load and coagulation disturbances after TPE have been poorly studied, in particular in cirrhotic patients with hypocapnic alkalosis, metabolic compensation and electrolyte imbalances. We retrospectively evaluated 1123 consecutive LT recipients (923 ABO-compatible [ABO-C], 200 ABO-I) from November 2008 to May 2015. TPE was generally performed a day before LT and blood sampling was performed before anaesthesia induction...
April 27, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29701562/letter-to-the-editor-rotational-thromboelastometry-guided-transfusion-protocol
#11
Thomas J Buell, Davis G Taylor, Ching-Jen Chen, Bhiken I Naik
No abstract text is available yet for this article.
April 27, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29699477/effects-of-bacterial-translocation-on-hemodynamic-and-coagulation-parameters-during-living-donor-liver-transplant
#12
Heba A Moharem, Fawzia Aboul Fetouh, Hamed M Darwish, Doaa Ghaith, Mohamed Elayashy, Amr Hussein, Riham Elsayed, Mohammad M Khalil, Amr Abdelaal, Mahmoud ElMeteini, Ahmed Mukhtar
BACKGROUND: Bacterial translocation (BT) has been proposed as a trigger for stimulation of the immune system with consequent hemodynamic alteration in patients with liver cirrhosis. However, no information is available regarding its hemodynamic and coagulation consequences during liver transplantation. METHODS: We screened 30 consecutive adult patients undergoing living-donor liver transplant for the presence of BT. Bacterial DNA, Anti factor Xa (aFXa), thromboelastometry, tumor necrosis factor-α TNF-α, and interleukin-17 (IL-17) values were measured in sera before induction of anesthesia...
April 25, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29687444/thrombin-generation-potential-and-clot-forming-capacity-of-thawed-fresh-frozen-plasma-plasma-frozen-within-24-h-and-solvent-detergent-treated-plasma-octaplaslg-%C3%A2-during-5-day-storage-at-1-6%C3%A2-c
#13
A Heger, A Neisser-Svae, L Trawnicek, D Triulzi
To enable rapid availability of plasma in emergency situations, the shelf-life of thawed fresh-frozen plasma (FFP) has been extended from 24 h to 5 days. The aim of this study was to evaluate the thrombin generation (TG) potential and clot-forming ability during 5 days of refrigerated storage of thawed FFP, plasma frozen within 24 h and solvent/detergent-treated plasma octaplasLG® . During storage for 5 days, TG capacity decreased significantly over time, and rotational thromboelastometry showed significantly prolonged clotting times...
April 23, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29683829/harmful-or-physiologic-diagnosing-fibrinolysis-shutdown-in-a-trauma-cohort-with-rotational-thromboelastometry
#14
J Carolina Gomez-Builes, Sergio A Acuna, Bartolomeu Nascimento, Fabiana Madotto, Sandro B Rizoli
BACKGROUND: Despite its central role in early trauma coagulopathy, abnormal fibrinolysis continues to be poorly understood. Excessive fibrinolysis is a known contributor to mortality. Recent studies with thromboelastography (TEG) suggest decreased fibrinolysis (or shutdown) may be just as harmful. Considering the broad use of 2 different viscoelastic assays, which are not interchangeable, we proposed for the first time to define and characterize fibrinolysis shutdown using rotational thromboelastometry (ROTEM)...
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29661415/reversal-of-dabigatran-by-intraosseous-or-intravenous-idarucizumab-in-a-porcine-polytrauma-model
#15
N Akman, T Braunschweig, M Honickel, K Schütt, H Schöchl, C Stoppe, R Rossaint, O Grottke
BACKGROUND: Idarucizumab is licensed to reverse dabigatran in life-threatening haemorrhage. Establishment of venous access can be challenging, and the intraosseous (IO) route is a potentially life-saving alternative. In this study, we compared the efficacy and safety of IO or intravenous (i.v.) idarucizumab for dabigatran reversal in a porcine polytrauma model. METHODS: Male pigs (n=21) received oral dabigatran etexilate (30 mg kg-1 bid) for 3 days. On the 4th day, animals received dabigatran infusion and were randomised 1:1:1 to receive IO saline (control), i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29658985/using-rotational-thromboelastometry-clot-firmness-at-5-minutes-rotem-%C3%A2-extem-a5-to-predict-massive-transfusion-and-in-hospital-mortality-in-trauma-a-retrospective-analysis-of-1146-patients
#16
J M Kelly, S Rizoli, P Veigas, S Hollands, A Min
Viscoelastic assays such as TEG® and ROTEM® are increasingly used to guide transfusion of blood products. The EXTEM assay maximum clot firmness (MCF) is a ROTEM measure available after 25-29 min used to guide early decisions. EXTEM A10, the clot firmness at 10 min, is an accepted early surrogate, but investigators differ on whether A5, the clot firmness at 5 min, is acceptable. We re-examined this in a retrospective observational analysis of 1146 trauma patients in one centre who had ROTEM data recorded. A5 and A10 both correlated well with maximum clot firmness, with Pearson coefficients of r = 0...
April 16, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29652280/relationship-between-maximum-clot-firmness-in-rotem-%C3%A2-and-postoperative-bleeding-after-coronary-artery-bypass-graft-surgery-in-patients-using-clopidogrel
#17
Rasoul Azarfarin, Fereidoon Noohi, Majid Kiavar, Ziae Totonchi, Avaz Heidarpour, Amir Hendiani, Zahra Sadat Koleini, Saeid Rahimi
Background: The aim of the present study was to investigate the relationship between maximum clot firmness (MCF) in rotational thromboelastometry (ROTEM® ) and postoperative bleeding in patients on clopidogrel after emergency coronary artery bypass graft surgery (CABG). Methods: This observational study recruited 60 patients posted for emergency CABG following unsuccessful primary percutaneous coronary intervention (PCI) while on 600 mg of clopidogrel. The study population was divided into 2 groups on the basis of their MCF in the extrinsically activated thromboelastometric (EXTEM) component of the (preoperative) ROTEM® test: patients with MCF <50 mm (n = 16) and those with MCF ≥50 mm (n = 44)...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628664/7-5-nacl-resuscitation-leads-to-abnormal-clot-fibrinolysis-after-severe-hemorrhagic-shock-and-its-correction-with-7-5-nacl-adenosine-lidocaine-and-mg-2
#18
Hayley Louise Letson, Geoffrey Phillip Dobson
Background: Hyperfibrinolysis is a common complication of hemorrhagic shock. Our aim was to examine the effect of small-volume 7.5% NaCl adenosine, lidocaine, and Mg2+ (ALM) on fibrinolysis in the rat model of hemorrhagic shock. Methods: Rats were anesthetized and randomly assigned to one of four groups: (1) baseline, (2) shock, (3) 7.5% NaCl controls, and (4) 7.5% NaCl ALM. Animals were bled for 20 min (42% blood loss) and left in shock for 60 min before resuscitation with 0...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29618158/erratum-to-thromboelastometry-and-platelet-function-during-acclimatisation-to-high-altitude
#19
Alistair S Rocke, Gordon G Paterson, Matthew T Barber, Alexander I R Jackson, Shona E Main, Calum Stannett, Martin F Schnopp, Martin J MacInnis, J Kenneth Baillie, Elizabeth H Horn, Carl Moores, Paul Harrison, Alastair F Nimmo, A A Roger Thompson
No abstract text is available yet for this article.
April 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29615381/hyperfibrinolysis-diagnosed-with-rotational-thromboelastometry-and-treated-with-tranexamic-acid-in-a-dog-with-acute-traumatic-coagulopathy
#20
B Muri, P Schmierer, A Schwarz, N Sigrist
A 4-year old male Australian Cattle Dog involved in a road traffic accident was presented with severe polytrauma to the Small Animal Clinic, University of Zurich. He was presented in hemorrhagic shock, with an initial lactate of 10.3mmol/l and ongoing bleeding from multiple injury sites. Acute traumatic coagulopathy diagnosed with ROTEM within one hour after accident showed marked hypocoagulation and hyperfibrinolysis. Treatment with a total dose of 40mg/kg of tranexamic acid intravenously resulted in successful elimination of hyperfibrinolysis in the following, serially measured ROTEM tracings...
April 2018: Schweizer Archiv Für Tierheilkunde
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