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Coagulopathy

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https://www.readbyqxmd.com/read/28094485/management-of-coagulopathy-in-the-severely-burned-patient-a-place-for-antifibrinolytic-therapy
#1
Ruedger Kopp, Christian Bruells
No abstract text is available yet for this article.
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28091838/fluid-levels-in-the-bleeding-brain-a-marker-for-coagulopathy-and-hematoma-expansion
#2
EDITORIAL
Mougnyan Cox, Solomon Bisangwa, Franziska Herpich, Angela Crudele, Carissa Pineda
No abstract text is available yet for this article.
January 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28081351/the-effect-of-methylprednisolone-treatment-on-fibrinolysis-thecoagulation-system-and-blood-loss-in-cardiac-surgery
#3
Leila Ebrahimi, Maryam Kheirandish, Mahnoosh Foroughi
BACKGROUND/AIM: The purpose of this study was to examine steroid pretreatment in order to decrease postoperative coagulopathy disorders and bleeding. MATERIALS AND METHODS: In this randomized double-blinded study, the efficacy of low versus high doses of methylprednisolone on the coagulation system and postoperative bleeding was compared in patients who were undergoing cardiac surgery with cardiopulmonary bypass (CPB). The platelet response to agonists, D-dimer concentration, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) antigens, and platelet receptors CD42b, CD62P, and CD41a were evaluated...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28079789/the-impact-of-irrigating-fluid-absorption-on-blood-coagulation-in-patients-undergoing-transurethral-resection-of-the-prostate-a-prospective-observational-study-using-rotational-thromboelastometry
#4
Hyun-Jung Shin, Hyo-Seok Na, Young-Tae Jeon, Hee-Pyoung Park, Sun-Woo Nam, Jung-Won Hwang
Although endoscopic transurethral resection of the prostate (TURP) is a well-established procedure as a treatment for benign prostatic hyperplasia, its complications remain a concern. Among these, coagulopathy may be caused by the absorption of irrigating fluid. This study aimed to evaluate such phenomenon using a rotational thromboelastometry (ROTEM).A total of 20 patients undergoing TURP participated in this study. A mixture of 2.7% sorbitol-0.54% mannitol solution and 1% ethanol was used as an irrigating fluid, and fluid absorption was measured via the ethanol concentration in expired breath...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079258/combined-effect-of-therapeutic-strategies-for-bleeding-injury-on-early-survival-transfusion-needs-and-correction-of-coagulopathy
#5
K Balvers, S van Dieren, K Baksaas-Aasen, C Gaarder, K Brohi, S Eaglestone, S Stanworth, P I Johansson, S R Ostrowski, J Stensballe, M Maegele, J C Goslings, N P Juffermans
BACKGROUND: The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on trauma-induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, tranexamic acid and products containing fibrinogen on the outcome of injured patients with bleeding. METHODS: A prospective multicentre observational study was performed in six level 1 trauma centres. Injured patients who received at least 4 units of red blood cells (RBCs) were analysed and divided into groups receiving a low (less than 1 : 1) or high (1 or more : 1) ratio of plasma or platelets to RBCs, and in receipt or not of tranexamic acid or fibrinogen products (fibrinogen concentrates or cryoprecipitate)...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28078348/the-fifth-epidermal-growth-factor-like-region-of-thrombomodulin-alleviates-lps-induced-sepsis-through-interacting-with-g-protein-coupled-receptor-15
#6
Bin Pan, Xiangmin Wang, Shinsuke Kojima, Chie Nishioka, Akihito Yokoyama, Goichi Honda, Kailin Xu, Takayuki Ikezoe
Thrombomodulin (TM) exerts cytoprotection via the fifth region of epidermal growth factor (EGF)-like domain of TM (TME5) by interacting with G-protein coupled receptor 15 (GPR15) expressed on cell surface of vascular endothelial cells. TM is also implied to mediate anti-inflammatory functions by unknown mechanism. By applying a lipopolysaccharide (LPS)-induced murine sepsis model, we assessed the role of TME5 in septic inflammation and coagulation. We found that TME5 treatment protected mice in association with ameliorating inflammation and coagulopathy in LPS-induced sepsis...
January 12, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28070656/peri-procedural-use-of-anticoagulants-in-radiology-an-evidence-based-review
#7
REVIEW
Thomas D Atwell, Paul W Wennberg, Brendan P McMenomy, Naveen S Murthy, Jeremy R Anderson, J Scott Kriegshauser, J Mark McKinney
Peri-procedural anticoagulant management hinges on the balance of hemorrhagic and thrombotic complications. The radiologist is tasked with accurately assessing the hemorrhagic risk for patients undergoing procedures, taking into account procedural bleeding rates, underlying coagulopathy based on lab tests, and use of anticoagulants. The purpose of this article is to provide a contemporary review of commonly used anticoagulants and, incorporating published evidence, review their management related to image-guided procedures...
January 9, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28068786/topical-and-low-dose-intravenous-tranexamic-acid-in-cyanotic-cardiac-surgery
#8
Jigar Patel, Mrugesh Prajapati, Hardik Patel, Hemang Gandhi, Shilpa Deodhar, Himani Pandya
Background Coagulopathy is a major problem in surgery for cyanotic congenital heart disease. Tranexamic acid has been used both topically and systemically and plays a vital role in pediatric cardiac surgery by reducing blood loss and blood product requirement. We aimed to determine the anti-fibrinolytic effectiveness of low-dose systemic or topical tranexamic acid or a combination of both. Methods Seventy-five patients were divided in 3 groups of 25. Group A patients were given tranexamic acid 20 mg kg(-1) intravenously after sternotomy and 20 mg kg(-1) after heparin reversal...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#9
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28064268/percutaneous-transhepatic-angioplasty-for-portal-vein-cavernous-transformation-after-choledochal-cyst-surgery
#10
Wenjun Shen, Jianjun Luo, Shan Zheng, Xianmin Xiao
BACKGROUND: Cavernous transformation of the portal vein rarely occurs after a choledochal cyst surgery. CASE CHARACTERISTICS: A 7-year-old boy with a history of a choledochal cyst surgery was admitted with recurrent oral and nasal bleeding over next two years. After excluding coagulopathies and hematopathies, we treated him with percutaneous transhepatic angioplasty. OUTCOME: The flow of the portal vein recovered immediately after balloon dilation...
December 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/28063764/plasma-transfusion-in-patients-with-cirrhosis-in-china-a-retrospective-multicenter-cohort-study
#11
REVIEW
Yao Lu, Guixiang Sun, Xiangfu Liu, Zhiguo Liu, Jianguo Tan, Yiwen Hao, Guiqiu Shan, Qun Luo, Deqing Wang, Yanchao Xing, Xianqing Zhang, Jiwu Gong, Simon J Stanworth, Jun Wang, Aiqing Wen
Patients with cirrhosis used to be associated with frequent use of blood components because of their complex disorder of hemostasis and bleeding complications. Recent findings have indicated that patients with cirrhosis have a state of "rebalanced" or even procoagulant hemostasis and have questioned the prophylactic use of plasma. To evaluate the current status of plasma use in patients with cirrhosis, we conducted a retrospective survey in 11 tertiary-care hospitals in China from September 1 to October 31, 2013...
December 2, 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28062681/dialyzer-based-cell-salvage-system-a-superior-alternative-to-conventional-cell-salvage-in-off-pump-coronary-artery-bypass-grafting
#12
Amber Malhotra, Pankaj Garg, Arvind Kumar Bishnoi, Pranav Sharma, Vivek Wadhawa, Komal Shah, Sanjay Patel, Umesh Kumar Ahirwar, Dayesh Rodricks, Himani Pandya
OBJECTIVES: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters. METHODS: Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) (n = 75), (2) conventional cell salvage (CCS) (n = 73) and (3) without cell salvage (WCS) (n = 74)...
January 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28062209/thromboelastogram-does-not-detect-pre-injury-anticoagulation-in-acute-trauma-patients
#13
Jawad T Ali, Mitchell J Daley, Nina Vadiei, Zachary Enright, Joseph Nguyen, Sadia Ali, Jayson D Aydelotte, Pedro G Teixeira, Thomas B Coopwood, Carlos Vr Brown
PURPOSE: Thromboelastography (TEG) has been recommended to characterize post-traumatic coagulopathy, yet no study has evaluated the impact of pre-injury anticoagulation (AC) on TEG variables. We hypothesized patients on pre-injury AC have a greater incidence of coagulopathy on TEG compared to those without AC. METHODS: This retrospective chart review evaluated all trauma patients admitted to an urban, level one trauma center from February 2011 to September 2014 who received a TEG within the first 24h...
December 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28060110/antithrombin-iii-as-the-indicator-of-l-asparaginase-activity-in-children-treated-for-acute-lymphoblastic-leukemia
#14
Małgorzata Czogała, Walentyna Balwierz, Krystyna Sztefko, Iwona Rogatko
L-asparaginase (ASP) is widely used in the treatment of acute lymphoblastic leukemia (ALL) in children. Monitoring its activity is necessary because of the risk of drug inactivation as the result of an immune reaction. Besides allergic reactions, another frequent side effect of ASP treatment is coagulopathy, especially deficiency of antithrombin III (ATIII). The aim of this study was to analyze the relationship between ASP and ATIII activities and the possibility of ATIII activity use in an indirect ASP activity assessment...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28058475/strategies-for-intravenous-fluid-resuscitation-in-trauma-patients
#15
Robert Wise, Michael Faurie, Manu L N G Malbrain, Eric Hodgson
Intravenous fluid management of trauma patients is fraught with complex decisions that are often complicated by coagulopathy and blood loss. This review discusses the fluid management in trauma patients from the perspective of the developing world. In addition, the article describes an approach to specific circumstances in trauma fluid decision-making and provides recommendations for the resource-limited environment.
January 5, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28058104/severe-lower-limb-ischemia-by-massive-arterial-thrombosis-revealing-an-acute-myeloid-leukemia-needing-for-leg-amputation-clinical-and-emotional-aspects-related-to-the-communication-with-the-patient-and-his-family
#16
Paolo D'Angelo, Calogero Taormina, Clara Mosa, Floriana Di Marco, Fabrizio Valentino, Angela Trizzino, Paola Guadagna, Francesco Talarico
Large vessel thrombosis is a very rare clinical presentation of acute leukemia, generally associated with coagulopathy, usually characteristic of acute promyelocytic leukemia. A 13- year-old boy with a previously undiagnosed acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower limb due to occlusion of the right external iliac artery, treated with emergency double surgical thromboembolectomy and chemotherapy. The thrombotic complication resulted in leg amputation. Now the boy is well in complete remission, with a good social integration and quality of life, 30 months after completing treatment...
November 17, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/28054156/parental-refusal-of-vitamin-k-and-neonatal-preventive-services-a-need-for-surveillance
#17
Lauren H Marcewicz, Joshua Clayton, Matthew Maenner, Erika Odom, Ekwutosi Okoroh, Deborah Christensen, Alyson Goodman, Michael D Warren, Julie Traylor, Angela Miller, Timothy Jones, John Dunn, William Schaffner, Althea Grant
Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants...
January 4, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28053193/promyelocytic-extracellular-chromatin-exacerbates-coagulation-and-fibrinolysis-in-acute-promyelocytic-leukemia
#18
Muhua Cao, Tao Li, Zhangxiu He, Lixiu Wang, Xiaoyan Yang, Yan Kou, Lili Zou, Xue Dong, Valerie A Novakovic, Yayan Bi, Junjie Kou, Bo Yu, Shaohong Fang, Jinghua Wang, Jin Zhou, Jialan Shi
Despite routine treatment of unselected acute promyelocytic leukemia (APL) with all-trans-retinoic acid (ATRA), early death due to hemorrhage remains unacceptably common and the mechanism underlying this complication remains elusive. We have recently demonstrated that APL cells undergo a novel cell death program, termed ETosis, which involves release of extracellular chromatin. However, the role of promyelocytic extracellular chromatin in APL-associated coagulation remains unclear. Our objectives were to identify the novel role of ATRA-promoted extracellular chromatin in inducing a hypercoagulable and hyperfibrinolytic state in APL and to evaluate its interaction with fibrin and endothelial cells (ECs)...
January 4, 2017: Blood
https://www.readbyqxmd.com/read/28053156/targeted-clinical-control-of-trauma-patient-coagulation-through-a-thrombin-dynamics-model
#19
Amor A Menezes, Ryan F Vilardi, Adam P Arkin, Mitchell J Cohen
We present a methodology for personalizing the clinical treatment of severely injured patients with acute traumatic coagulopathy (ATC), an endogenous biological response of impaired coagulation that occurs early after trauma and shock and that is associated with increased bleeding, morbidity, and mortality. Despite biological characterization of ATC, it is not easily or rapidly diagnosed, not always captured by slow laboratory testing, and not accurately represented by coagulation models. This lack of knowledge, combined with the inherent time pressures of trauma treatment, forces surgeons to treat ATC patients according to empirical resuscitation protocols...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28052716/tripartite-stratification-of-the-glasgow-coma-scale-in-children-with-severe-traumatic-brain-injury-and-mortality-an-analysis-from-a-multicenter-comparative-effectiveness-study
#20
Sarah Murphy, Neal J Thomas, Shira Gertz, John Beca, James F Luther, Michael J Bell, Steven R Wisniewski, Adam Hartman, Robert Tasker
The Glasgow Coma Scale (GCS) score has not been validated in children < 5y and the clinical circumstances at the time of assignment can limit its applicability. This study describes the distribution of GCS scores in the population, the relationship between injury characteristics with the GCS score and the association between the tripartite stratification of the GCS on mortality in children with severe traumatic brain injury (TBI). The first 200 children from a multicenter, comparative effectiveness study in severe TBI (inclusion criteria [age 0 - 18 y, GCS ≤ 8 at the time of ICP monitoring] were analyzed...
January 4, 2017: Journal of Neurotrauma
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