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At least 469 records · Page 26Linked to original sources
PubMed1996

The effect of dextran infusion on antithrombin III concentrations and on platelet function during minor surgery.

The effects of dextran on the antithrombin (AT) III activity and blood coagulation, evaluated with thromboelastography, were investigated in 26 patients (anaesthesia risk class I or II) scheduled for minor surgery under general anaesthesia. In the Dextran group the patients were infused first with dextran 7 ml/kg, then with Ringer's acetate. In the Ringer group, the patients received only Ringer's acetate. In the recovery room fluid therapy was continued with 5% dextrose in water until the first postoperative day. Blood loss and fluid replacement were comparable in the groups. Haematocrit (Hcr) decreased significantly in the Dextran group, and the platelet count decreased in both groups during surgery. The median baseline AT III values were similar in the study groups. In the recovery room, the median AT III value was lower in the Dextran than in the Ringer group, 78% and 92%, respectively (P < 0.05). By the following day, the AT III values had returned near the initial level. After surgery, the maximal amplitude of thromboelastogram was 48 mm in the Dextran group, and 58 mm in the Ringer group (P < 0.05). In conclusion, fluid replacement with dextran resulted in modest and short-lived alterations in blood coagulation.

Adult↗
PubMed1977

[Normal hemostatic indices in experimental animals].

On the basis of the studies conducted by the authors on 19 nonbred dogs and 25 rabbits of the strain Cincilla and Belgium giant the normal values of the basis indices of hemostasis were determined: thromboelastography (r+k and ma), amount of fibrinogen, number of thrombocytes, thromoboplastic time, time of recalcification. The obtained data are shown on a table. The obtained data could serve as orienting data in examining hemostasis in dogs and rabbits under various experimental conditions and models for investigating various human pathology.

Animals↗
PubMed1995

[Changes in hemostasis during orthotopic liver transplantation and massive transfusion: a case report].

UNLABELLED: Changes in hemostasis during orthotopic liver transplantation (OLT) and an intraoperative bleeding complication requiring massive transfusion are discussed. DESIGN: The monitoring of hemostasis included bed-sided thromboelastography, measurement of in vitro platelet function with the thrombostat and routine coagulation tests as well as retrospective analysis of coagulation factors. RESULTS: Changes in hemostasis during OLT were documented as reported previously until reperfusion of the donor organ. Due to an incongruence between the caval veins and massive surgical bleeding, the liver had to be clamped again for reconstruction and perfused with University-of-Wisconsin solution. The second reperfusion was technically uncomplicated. However, the coagulation profile deteriorated dramatically: especially a decrease in platelet function and hyperfibrinolysis led to massive oozing. Successful therapeutical intervention included substitution of packed red blood cells. fresh frozen plasma, platelets. concentrates of hemostatic factors, and aprotinin. The patient was discharged from hospital after 5 weeks with a good liver function and a normal coagulation profile. CONCLUSION: During OLT, clinically relevant changes in hemostasis can occur suddenly. Therefore. a close perioperative monitoring of primary and secondary coagulation is mandatory.

Blood Coagulation Tests↗
PubMed1996

[A hematologic coagulation monitoring system for bedside use].

Perioperative hemorrhage in patients undergoing surgery is a major cause of morbidity and mortality. DRIHEMATO SYSTEM COAG-1 can detect prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) easily. We combined this monitor with platelet count (PLT), activated clotting time (ACT) and thromboelastography (TEG) and devised a hematologic monitoring system for bedside use. This study of 10 adults undergoing cardiopulmonary bypass was conducted to determine the utility of this monitoring system. The specificity for lotting abnormality of this monitoring system included the following values; PT = 88%, FIB = 100% and TEG = 67%. This study suggests that this monitoring system may be useful in early diagnosis and treatment of postoperative coagulopathy.

Adult↗
PubMed1977

[Staphylococcal plasmacoagulase. III. Use of thrombelastography to study the properties of extracellular staphylocoagulase].

A method of thromboelastography was applied to the study of the influence of supernatents of the S. aureus and S. epidermidis culture fluid on the process of blood coagulation. S. aureus No. 209 P, No. 8325-1 strains and mutants of the No. 209 P strain, resistant to proflavin induced a distinct shortening of the reaction time. In using S. epidermidis (strains D5/240 and D-5/48) and also in control experiments (plasma and medium) no shortening of the reaction period was observed. The data obtained permitted to recommend the use of thromboelastographic method for the purpose of detection of coagulase-positive staphylococcus strains and for the assessment of relative staphylocoagulase activity.

Coagulase↗
PubMed1997

Prediction of bleeding diathesis in patients undergoing cardiopulmonary bypass during cardiac surgery: viscoelastic measures versus routine coagulation test.

BACKGROUND: Severe hemorrhagic tendency often complicates cardiopulmonary bypass (CPB) in cardiac surgery. In this study, we compared the effectiveness of thromboelastography (TEG), Sonoclot (SCT), and routine coagulation test (RCT) in the prediction of coagulation defects. METHODS: Forty-three patients undergoing cardiac surgery with CPB were included. Blood for RCT, TEG, and SCT profiles was sampled before systemic heparinization and after protamine administration. Clinically significant bleeding was defined as chest tube drainage in excess of 100 ml/h for 3 consecutive hours or 300 ml/h in 1 h. All coagulation parameters obtained before and after CPB were compared. The sensitivity, specificity, accuracy, false positive, and false negative rate were also calculated and compared. RESULTS: All coagulation tests were within normal range except higher partial thromboplastin time. Variables which were significantly different from those before CPB included platelet count, fibrinogen level, prothrombin time, and thrombin time in RCT, alpha angle and maximum amplitude in TEG, and R2 and peak time in SCT. In the TEG tracing, all variables had high sensitivity, specificity, and accuracy (average 85.4%, 83%, and 83.5% respectively) and low false positive and negative rate (12.5% and 5% respectively). Although SCT had high sensitivity (76.3%) and low false negative rate (6.5%), its specificity and accuracy were all under 50%. CONCLUSIONS: Our data demonstrated that the TEG monitoring is a useful tool for detecting post-CPB bleeding diathesis and can provide much predictive information. RCT and SCT are of limited value because of higher rate of unreliable results.

Blood Coagulation Tests↗
PubMedDate not supplied

Coagulation and hemorheology.

The application of principles of hemorheology on a process of blood coagulation was suggested by H.H. Hartert - inventor of the thromboelastograph which he introduced in 1947. These principles of applying of a mechanical force and detecting the response of coagulating blood enable to determine a functional evidence of the physiological process producing a hemostatic clot. The thromboelastography, as well as other rheological techniques used for this determination, are introduced evaluating the process in terms of the rate of coagulation, clot elasticity, deformability and permeability. Recent applications of the techniques to the diagnosis of disorders of hemostasis and the study of drug effects on coagulation are presented as well.

Blood Coagulation↗
PubMed1997

Thromboelastographic study of thrombosis in the implantable central venous access device.

BACKGROUND: In the present study thromboelastography (TEG) was to study whether or not hypercoagulopathy might contribute to the thrombosis of implantable central venous access device (Port-A-Cath, Pharmacia) in cancer patients. METHODS: All 76 oncological patients who were enrolled in this study had their R time, alpha angle and MA value measured before Port-A-Cath implantation, of whom 11 patients received re-implantation because of thrombotic device. We compared the measurements of these 11 patients (thrombotic group) with that of 65 patients (control group) who received Port-A-Cath implantation for the first time. According to TEG values the hemostatic status in these patients was classified as hypercoagulable, normal or hypocoagulable for comparison. All patients in the control group were followed up for 3 months for occurrence of thrombosis. RESULTS: It was found that no patient in the thrombotic group was associated with hypercoagulopathy. Five patients (7.5%) in the control group was found in hypercoagulable status at the time of catheter insertion but none of them developed clinical thrombosis during three months of observation. There was no significant difference between the two groups for R time, alpha angle but a higher MA value was found in the control group (p < 0.05). Furthermore, the hypercoagulability (7.5% for the control vs. none for the thrombotic group), hypocoagulability (1.5% vs. 9.1%) and normocoagulability (91.0% vs. 90.9%) were not statistically different between the two groups (Fisher exact test, P = 0.229). CONCLUSIONS: We conclude that hypercoagulopathy in cancer patients has little, if any, contribution in thrombosis of the implantable central venous access device.

Adult↗
PubMed1998

Effects of recombinant human soluble thrombomodulin (rhs-TM) on clot-induced coagulation in human plasma.

Recent studies have suggested that clot-bound thrombin plays an important role in thrombus growth. In this study, we examined the effects of recombinant human soluble thrombomodulin (rhsTM) on clot-induced coagulation. rhsTM enhanced the activation of protein C by clots, and attenuated clot-induced thrombin generation and fibrinopeptide A (FPA) production in a dose-dependent manner. The inhibitory effect of rhsTM was abolished by anti-protein C antibody. The inhibitory effect of rhsTM on clot-induced thrombin generation continued for over 60 min after the addition of the clot, while an active site-directed thrombin inhibitor, argatroban, produced a more transient inhibition. rhsTM also inhibited the regrowth of the clot in (125)I-fibrinogen-supplemented plasma. We also examined the effect of rhsTM by thromboelastography, rhsTM reduced the growth of the clot but had little effect on the time to begin clotting, while heparin and Fragmin (low molecular weight heparin) had effects opposite to those of rhsTM. These findings suggest that rhs-TM attenuates the growth of the clot by activating protein C and inhibiting further thrombin generation in the clot.

Antithrombins↗
PubMed1998

The effect of coagulation protection with combination of epsilon aminocaproic acid and plasma saver in open-heart surgery.

BACKGROUND: Bleeding remains a major complication and a major determinant in the prognosis of open-heart surgery. Coagulopathy related to cardiopulmonary bypass (CPB) seems to be the culprit. Since homologous blood transfusion in many occasions is not only responsible for mobidity and mortality but also increases medical costs. Therefore, the application of autologous blood transfusion including components such as PRBC, FFP and platelets concentrate is inevitable and comes in its stead. To reduce the use of homologous plasma and platelets transfusion in open-heart surgery, we designed a study to utilize the combination of autologous platelet rich plasma (PRP) and epsilon aminocaproic acid (EACA) to evaluate its effects on blood loss and blood component transfusion in open-heart patients. METHODS: Sixty patients who received elective cardiac surgery were randomly divided into 3 groups: 1. Control group; 2. EACA group (150 mg/kg, i.v. before CPB); 3. PRP-EACA group (PRP 10 ml/kg harvested with a plasma saver followed by i.v. EACA 150 mg/kg). Anesthesia was uniform in all patients. Coagulation profile was evaluated by thromboelastography (TEG) during the operation. Blood loss during operation and the amount of drainage from the chest tubes in the postoperative period were recorded and compared between groups. RESULTS: Patients who were given EACA injection before CPB saw less blood loss perioperatively and received less transfusion of blood components. TEG analysis showed that patients who received EACA injection had a better coagulation profile and the platelet function was also better after CPB. However, no additive effect can be attained from combination of autologous PRP transfusion and EACA injection. CONCLUSIONS: With Pre-CPB EACA as protection, reduction of both blood loss and blood transfusion could be realized in open-heart surgery.

Adult↗