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TEG fibrinogen

Marco Ranucci, Ekaterina Baryshnikova, Valeria Pistuddi, Lorenzo Menicanti, Alessandro Frigiola
OBJECTIVES: Postoperative bleeding in cardiac surgery remains an important complication, leading to increased morbidity and mortality. Different interventions are possible to prevent/treat postoperative bleeding. The present study aims to investigate the effectiveness of these interventions in a real-world scenario. METHODS: This is a retrospective study based on 19 670 consecutive adult cardiac surgery patients operated from 2000 to 2015. During the study period, the following interventions have been applied and tested for effectiveness with a before versus after analysis: thromboelastography (TEG)-based diagnosis and treatment in actively bleeding patients; platelet function tests (PFTs); timing of surgery based on PFTs; fresh frozen plasma (FFP)-free strategy using prothrombin complex concentrate and fibrinogen concentrate...
October 17, 2016: Interactive Cardiovascular and Thoracic Surgery
Per Lehnert, Pär I Johansson, Sisse R Ostrowski, Christian H Møller, Lia E Bang, Peter Skov Olsen, Jørn Carlsen
Whole blood coagulation and markers of endothelial damage were studied in patients with acute pulmonary embolism (PE), and evaluated in relation to PE severity. Twenty-five patients were enrolled prospectively each having viscoelastical analysis of whole blood done using thrombelastography (TEG) and Multiplate aggregometry. Fourteen of these patients were investigated for endothelial damage by ELISA measurements of Syndecan-1 (endothelial glycocalyx degradation), soluble endothelial Selectin (endothelial cell activation), soluble Thrombomodulin (endothelial cell injury) and Histone Complexed DNA fragments (endothelial cytotoxic histones)...
October 11, 2016: Scandinavian Journal of Clinical and Laboratory Investigation
M Martinuzzo, L Barrera, D Altuna, F Tisi Baña, J Bieti, Q Amigo, M D'Adamo, M S López, J Oyhamburu, J C Otaso
BACKGROUND: Homozygous or double heterozygous factor XIII (FXIII) deficiency is characterized by soft tissue hematomas, intracranial and delayed spontaneous bleeding. Alterations of thromboelastography (TEG) parameters in these patients have been reported. The aim of the study was to show results of TEG, TEG Lysis (Lys 60) induced by subthreshold concentrations of streptokinase (SK), and to compare them to the clot solubility studies results in samples of a 1-year-old girl with homozygous or double heterozygous FXIII deficiency...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Samy Figueiredo, Audrey Tantot, Jacques Duranteau
Viscoelastic haemostatic assays (VHAs), mainly thromboelastography (TEG) and the rotational thromboelastometry (ROTEM), provide global information on clot formation and dissolution at patient bedside, allowing fast identification of coagulation disorders. In trauma patients, VHAs are able to predict massive transfusion and mortality. These devices might also be used for applying targeted administration of procoagulant factors (e.g. fibrinogen concentrate) as an alternative to or in addition to using predefined fixed ratios of red blood cells: platelets: fresh frozen plasma/cryoprecipitate...
September 8, 2016: Minerva Anestesiologica
Albe C Swanepoel, Amcois Visagie, Zelda de Lange, Odette Emmerson, Vance G Nielsen, Etheresia Pretorius
BACKGROUND: The effect of endogenous hormone concentrations, specifically 17β-estradiol and progesterone, on fibrin network formation has not been established. OBJECTIVES: It is essential to understand natural hormone mechanisms since these hormones are still present in circulation while hormonal contraceptives, which are associated with increased risk of venous thromboembolism, are used. METHODS: Due to the fact that these hormones are known to increase hypercoagulability and the prothrombotic state scanning electron microscopy (SEM), atomic force microscopy (AFM), thromboelastography (TEG) and turbidimetry were employed to investigate the morphology, surface roughness, viscoelastic properties and formation and lysis of fibrin...
October 2016: Thrombosis Research
Zhijun Qu, Geng Wang, Chengshi Xu, Dazhi Zhang, Xiangdong Qu, Haibin Zhou, Jun Ma
BACKGROUND: Preoperative platelet rich plasma (PRP) harvest has been used in cardiopulmonary surgery for more than 10 years. There is no previous study dealing with PRP in bilateral total hip replacement. This study was to investigate the effects of PRP on blood saving and blood coagulation function in patients with bilateral total hip replacement. PATIENTS AND METHODS: A prospective, randomized, clinical trial was conducted. Sixty patients were enrolled, including 30 patients undergoing PRP in the PRP group and 30 controls...
August 24, 2016: International Journal of Surgery
Michael Fabbro, Jacob T Gutsche, Todd A Miano, John G Augoustides, Prakash A Patel
BACKGROUND: The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest is factor I (fibrinogen). Hypofibrinogenemia is typically tested for using time-consuming standard laboratory assays. The thrombelastography (TEG)-based functional fibrinogen level (FLEV) provides an assessment of whole blood clot under platelet inhibition to report calculated fibrinogen levels in significantly less time...
September 2016: Anesthesia and Analgesia
Petra M Meier, David Zurakowski, Susan M Goobie, Mark R Proctor, John G Meara, Vanessa J Young, Gary F Rogers, James A DiNardo
BACKGROUND: Operative treatment of craniosynostosis is associated with substantial blood loss, often requiring transfusion of packed red blood cells (PRBC) and coagulation products. AIMS: The aim of this prospective study was to analyze thromboelastographic (TEG) parameters and platelet fibrinogen product to determine predictors of substantial blood loss, and the need for PRBC transfusion and coagulation products. METHODS: With IRB approval, we enrolled 120 children undergoing craniosynostosis repair with a standardized anesthetic, fluid management, and TEG measurements at predefined times...
October 2016: Paediatric Anaesthesia
Lesley De Pietri, Francesca Ragusa, Annalisa Deleuterio, Bruno Begliomini, Valentina Serra
UNLABELLED: Patients undergoing orthotopic liver transplantation are at high risk of bleeding complications. Several Authors have shown that thromboelastography (TEG)-based coagulation management and the administration of fibrinogen concentrate reduce the need for blood transfusion. METHODS: We conducted a single-center, retrospective cohort observational study (Modena Polyclinic, Italy) on 386 consecutive patients undergoing liver transplantation. We assessed the impact on resource consumption and patient survival after the introduction of a new TEG-based transfusion algorithm, requiring also the introduction of the fibrinogen functional thromboelastography test and a maximum amplitude of functional fibrinogen thromboelastography transfusion cutoff (7 mm) to direct in administering fibrinogen (2012-2014, n = 118) compared with a purely TEG-based algorithm previously used (2005-2011, n = 268)...
January 2016: Transplantation Direct
Anne Godier, Kiran Parmar, Karuna Manandhar, Beverley J Hunt
AIMS: Acute traumatic coagulopathy is characterised by fibrinolysis and low fibrinogen. It is unclear how much fibrinogenolysis contributes to reduce fibrinogen levels. The study aim was to: investigate in vitro the effects of tissue-plasminogen activator (t-PA) and tranexamic acid (TXA) on coagulation and fibrinolysis. METHODS: Whole blood was spiked with varying t-PA concentrations. Clauss fibrinogen levels and thrombelastography (TEG, Haemonetics) were performed, including functional fibrinogen level (FLEV)...
July 21, 2016: Journal of Clinical Pathology
Sulman Rafiq, Pär I Johansson, Klaus F Kofoed, Peter S Olsen, Daniel A Steinbrüchel
BACKGROUND: We sought to assess predictability of excessive bleeding using thrombelastography (TEG), multiplate impedance aggregometry, and conventional coagulation tests including fibrinogen in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: A total of 170 patients were enrolled in this prospective observational study. TEG, Multiplate aggregometry, and coagulation tests were sampled on the day before surgery. Excessive bleeding was defined as >1000 mL over 18 hours...
September 2016: Journal of Cardiac Surgery
Jacob Steinmetz, Anne Marie Sørensen, Hanne Hee Henriksen, Theis Lange, Claus Falck Larsen, Pär I Johansson, Jakob Stensballe
BACKGROUND: Haemorrhage remains a leading cause of morbidity and mortality in trauma patients. Fibrinogen is an essential endogenous component of haemostasis and the plasma level is associated with bleeding, transfusion and outcome. Fibrinogen concentrate is widely used to correct acquired hypofibrinogenaemia, recommended by several international guidelines for the treatment of trauma patients, but evidence is lacking regarding the treatment safety and efficacy. We aim to assess the efficacy and safety of an immediate pre-emptive first-line treatment with fibrinogen concentrate in patients with trauma haemorrhage in need of haemostatic resuscitation...
2016: Trials
Abigail J Rao, Amber Laurie, Cole Hilliard, Rochelle Fu, Tori Lennox, Ronald Barbosa, Martin Schreiber, Susan Rowell
INTRODUCTION: Progression of traumatic intracranial hemorrhage (TICH) is associated with increased morbidity and mortality. Half of patients with TICH progression have normal traditional coagulation laboratory studies. We hypothesized that thromboelastography (TEG), which directly measures clot formation and strength, would predict progression of TICH, the need for neurosurgical procedure, and mortality in patients with TICH. METHODS: A prospective observational study in patients with TICH at a level 1 trauma center was undertaken...
August 2016: Neurosurgery
Florian Prüller, Harald Mangge
No abstract text is available yet for this article.
September 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Chen Liu, Zhao Guan, Qinzhu Xu, Lei Zhao, Ying Song, Hui Wang
Fractures are common among aged people, and rapid assessment of the coagulation status is important. The thromboelastography (TEG) test can give a series of coagulation parameters and has been widely used in clinics. In this research, we looked at fracture patients over 60 and compared their TEG results with those of healthy controls. Since there is a paucity of studies comparing TEG assessments with conventional coagulation tests, we aim to clarify the relationship between TEG values and the values given by conventional coagulation tests...
June 2016: Medicine (Baltimore)
Z Gratwick, A Viljoen, P C Page, A Goddard, G T Fosgate, C H Lyle
REASONS FOR PERFORMING STUDY: Adverse effects on renal health and haemostasis have been documented in human patients administered hydroxyethyl starches (HESs). Gelatins could provide useful substitutes should similar adverse effects be identified in horses. OBJECTIVES: To compare the effects of a 4% modified fluid gelatin (MFG) with a 6% (130/0.4) HES on haemodilution, colloid osmotic pressure (COP), haemostasis and renal parameters in healthy ponies. STUDY DESIGN: Randomised crossover experiment...
June 3, 2016: Equine Veterinary Journal
Sandro Rizoli, Arimie Min, Adic Perez Sanchez, Pang Shek, Richard Grodecki, Precilla Veigas, Henry T Peng
BACKGROUND: There is growing interest in viscoelastic hemostatic assays rotational thromboelastometry (ROTEM) and thromboelastography (TEG) for trauma. Despite shared features, it is unknown whether their results are interchangeable and whether one is clinically superior in predicting mortality, blood transfusion, and diagnosing early trauma coagulopathy. METHODS: We conducted a prospective observational study comparing equivalent ROTEM and TEG parameters. Severely injured patients expected to receive massive transfusion were included...
May 2016: Military Medicine
M Alexander, R Wolfe, D Ball, R Manser, M McManus, B Riedel, B Solomon, D Westerman, K Burbury
INTRODUCTION: Cancer associated thromboembolism (TE) is common however the risk is heterogeneous and dynamic. AIM: To assess the TE risk profile of patients with Non-Small Cell Lung Cancer (NSCLC), though treatment phases, and generate a risk-stratified decision algorithm for appropriate thromboprophylaxis. MATERIALS AND METHODS: Single centre, prospective observational study, profiling NSCLC patients using clinical-, tumour- and treatment-related risk factors, in conjunction with an extensive thrombogenic biomarker panel, during treatment (surgery, chemotherapy, targeted therapy and/ or radiotherapy) and disease phases...
April 2016: Thrombosis Research
Herbert Schöchl, Oliver Grottke, Marc Maegele
No abstract text is available yet for this article.
September 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Ondřej Zuščich, Roman Hájek, Pavel Ševčík, Vladimír Lonský, Jana Zapletalová
INTRODUCTION: This work is focused on mapping issues of hemostasis in patients during continuous renal replacement therapy, or the possible impact of the use of anticoagulants. METHODS: The study included 30 consecutive patients requiring continuous renal replacement therapy following cardiac surgery in the period of 2009 to 2012. Patients were placed into 2 branches according to the selected method of anticoagulation (regional citrate anticoagulation-RCA, unfractionated heparin UFH)...
May 16, 2016: International Journal of Artificial Organs
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