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PubMedDate not supplied

[Thrombocytic hemostasis in patients with severe craniocerebral trauma].

Platelet vascular hemostasis was assessed in 32 patients with slight craniocerebral injuries (SCCI) (Glasgow coma score 14-15) (group 1) on days 1, 3, 5, and 7 and in 84 patients (score 3-8) (group 2) in the same terms and on days 9, 14, and 21 after the injury. Under study were platelet count, spontaneous platelet aggregation and that induced by ADP, adrenalin, and ristomicin. Moderate disorders of platelet vascular hemostasis were revealed in all the patients; they were most of all expressed on day 5 and were mainly due to moderate disorders of the athrombogenicity of the vascular endothelium. The injury caused a manifest dysfunction of platelets connected with the developing disseminated intravascular blood coagulation and, specifically, with injury to the vascular endothelium. Spontaneous aggregation of platelets was the maximum on day 5 and coincided in time with an increase in Willebrand factor-dependent ristomicin-induced platelet aggregation (Willebrand factor is a marker of injury to the vascular endothelium). An increase of ristomicin-induced platelet aggregation was more often observed in the patients who died than in the survivors, and in those developing the respiratory distress syndrome (stages II-IV) and that combined with pneumonia.

Acute Disease↗
PubMed1997

Interpretation of the literature on endoscopic hemostasis.

This article discusses the essential features of a well-designed clinical therapeutic trial to aid the clinician in his or her interpretation of the large number of papers available on the subject of endoscopic hemostasis. A thorough understanding of the variations in the study methodology can then be used to select the highest quality studies of endoscopic hemostasis for use in their practice.

Clinical Protocols↗
PubMed1997

[Influence of hemosorption on hemostasis in patients with sepsis].

The changes in the system of hemostasis were studied in 36 patients with sepsis managed with sorptive detoxication. The starting status of the system of hemostasis in patients with favorable outcome of the disease can be considered as the 2d stage of the disseminated intravascular coagulation (DIC), and in patients with the unfavorable outcome--as the 3d (hypocoagulative) stage. The sorptive detoxication provides the treatment of the DIC syndrome in favorable outcome, as well as further progression of the process in unfavorable outcome of sepsis. Conservative treatment provides stabilization of the hemostatic system and gives opportunity to perform delayed hemosorption with a positive clinical result.

Adolescent↗
PubMed1997

A new method of hemostasis for cementless total knee arthroplasty.

Heavy bleeding often occurs following cementless total knee arthroplasty (TKA) and it is difficult to control. We devised a new method of hemostasis after cementless TKA. In brief, the implant was inserted after coating the exposed surface of the cancellous bone with fibrin glue. Before removal of the tourniquet after completion of the operation a cocktail of hemostatic agents (containing 25 mg of carbazochrome sodium sulfonate and 250 mg of tranexamic acid) in 50 ml of physiological saline was injected into the joint cavity via the drain tube and the drain was clamped for about 30 min after removal of the tourniquet. After removal of the clamp, standard negative pressure suction was performed. This method was used on 84 knees in 42 patients who underwent simultaneous bilateral cementless TKA and 64 knees in 64 patients who underwent unilateral TKA. The mean total amount of blood loss during and after the operation was 235 +/- 178 ml in the unilateral TKA patients and 402 +/- 208 ml in the bilateral TKA patients. No patient required blood transfusions postoperatively. This method was effective for achieving hemostasis after cementless TKA.

Adrenochrome↗
PubMedDate not supplied

[Lipids, hemostasis and diabetes].

Modifications of hemostasis and plasma lipids are an integral part of diabetes mellitus, and probably play a key role in the evolution of vascular complications. This review points to the important relationships between hemostasis and lipids and their modifications in diabetes, with a special attempt to link the abnormalities described with the pathogenic mechanisms of diabetes.

Animals↗
PubMed1997

[Antibodies to cardiolipin and hemostasis in rheumatic patients during development of rheumatic valvular disease].

The observational study included 79 rheumatic patients aged 14-49 years. The diagnosis of acute rheumatic fever (ARF) was made in 29 patients (13-first attack, 16-recurrence), 50 patients had rheumatic heart disease (RHD) without signs of activity, 40 healthy donors served control. Antibodies to cardiolipin (a-CL) in the blood were determined by enzyme immunoassay, hemostasis was assessed by the level of antithrombin III, platelet aggregation, readings of electrocoagulograms. ARF patients were examined throughout the year, RHD patients--only once. Compared to the controls, both ARF and RHD patients demonstrated higher occurrence of a-CL, enhanced platelet aggregation, low antithrombin III level, hypercoagulation on electrocoagulogram, a-CL in ARF patients were detectable from the first month of the attack. By month 7-12 their count decreased, hemostasis normalized. In the onset and progression of RHD in the presence of ARF a-CL occurred more frequently. A direct relationship was found between the time of a-CL detection in the blood and severity, duration of rheumatic carditis. The data obtained validate feasibility of using a-CL for diagnosis of rheumatic carditis severity and prognosis of RHD development.

Acute Disease↗
PubMed1998

[Alternation of protease inhibitors and hemostasis system in treatment of spontaneous pneumothorax].

3 groups of 37 patients were examined, in which for treatment of spontaneous pneumothorax drainage of pleural cavity and medicamentous pleurodesis with tetracycline hydrochloride and 4% solution of sodium bicarbonate were used. Interdependence of clinical criteria and level of protease inhibitors were evaluated, as well as the basic components of hemostasis. The best effectiveness of treatment in carrying out chemical pleurodesis was demonstrated, especially when 4% sodium bicarbonate solution was used. At the same time the application of this agent has evoked the most evident changes in values of hemostasis and protease inhibitors. The possibility of use of the above mentioned biochemical in dices together with clinical criteria for the evaluation of effectiveness of treatment of the unspecific spontaneous pneumothorax is stressed.

Adult↗
PubMed1979

[Hemodilution in vitro and parameters of hemostasis].

High molecular weight (approximately 60,000) dextran having been selected in a protocol of per-operative hemodilution, a prior study was undertaken in vitro in order to measure the variations in parameters of hemostasis. Factor of primary hemostasis, of plasma coagulation and fibrinolysis were thus evaluated in control blood samples, not diluted and diluted to 1/5 th by dextran or by a buffer solution. Statistical analysis was carried out using the t-test for pairs of variables. The following emerge from the results: 1 - an absence of difference with regard to the fibrinolytic activity of the plasma, but marked fragility of the fibrin clot in the presence of dextran; 2 - variations for plasma coagulation factors due to dilution; 3 - acceleration of the phase of polymerisation of fibrin monomeres and a decrease in platelet stickiness and aggregation due to dextran.

Blood Coagulation↗
PubMedDate not supplied

[Thrombocytic hemostasis in hemorrhages].

With the purpose of evaluating the thrombocytic hemostasis in hemorrhages, blood platelet function was studied as recommended by Born-O'Brien in patients in the early period following the surgical arrest of gastrointestinal hemorrhage. Enhanced functional activity of cells was revealed in 88.24% of cases, with marked hyperaggregation being recordable in 38.24% of cases and moderate one in the others when it revealed itself only with small concentrations of an inductor of aggregation being employed. In 11.76% of cases the blood platelets functional activity has gotten decreased. When comparing with an analysis of enzymic hemostasis and clinical picture of the condition a conclusion was drawn to the effect that enhanced functional activity of blood platelets is of compensatory and adaptive nature and that it maintains blood hemostatic potential in the pro- and anticoagulants dysbalance. Lowering of thrombocytic activity against that background can account for recurring nature of hemorrhage.

Adenosine Diphosphate↗
PubMed1998

Role of plasma and platelet von Willebrand factor in arterial thrombogenesis and hemostasis in the pig.

To evaluate the relative role of plasma and platelet von Willebrand factor (vWF) pools in hemostasis and arterial thrombogenesis, pigs with vW disease (vWD) were injected with vWF concentrate and/or grafted with bone marrow from a normal pig. Hemostasis was assessed by measurement of ear immersion bleeding time, factor VIII (FVIII) activity, and plasma and platelet vWF antigen levels. The thrombotic process was explored at 650 s(-1) and 1600 s(-1) in an ex vivo cylindrical perfusion chamber. Pigs with vWD exhibited a prolonged bleeding time (>30 minutes) compared with normal pigs (<5 minutes); in addition, they showed normal platelet adhesion and thrombus formation at 650 s(-1) but profoundly reduced platelet adhesion and thrombus formation at 1600 s(-1). Each experiment was performed before and 3 and 24 hours after injection of vWF concentrate. In our bleeding time study, only plasma vWF restoration induced a partial but delayed correction (24 hours postinjection), which was correlated with the highest measured level of FVIII activity. In the perfusion chamber model, restoration of plasma or platelet vWF pools resulted in similar partial correction of platelet adhesion and average thrombus size. In the perfused pigs, the maximum correction occurred 3 hours postinjection. Platelet deposition reached normal values after vWF concentrate was injected into a grafted pig. The present results suggest that when both plasma and platelet vWF levels are restored in vWD pigs, bleeding time and the thrombotic process are normalized according to different kinetics and with differing degrees of effectiveness.

Animals↗
PubMed1998

[Effects of drug therapy on serum lipids and plasma hemostasis in aged patients with ischemic heart disease on different diets].

The effects of antianginal and hypolipidemic therapy on biochemical status and plasmatic hemostasis were studied in 57 aged patients with ischemic disease. The study group (n = 19) got the vegetarian diet (VA-IIIG) enriched with soya-based products. The control 38 patients were on conventional mixed diet including meat, fish and poultry (A-1). It is shown that the vegetarian diet promotes normalization of lipid serum spectrum and plasmatic hemostasis. Inclusion of atherogenic vegetarian diet in the treatment of aged patients considerably improves the effect of antianginal and hypolipidemic therapy.

Aged↗
PubMed1976

[Disorders of hemostasis during partial hepatectomies. Study of 20 cases].

Changes in blood coagulation have been studied during and after 20 elective hepatic lobectomies, most of them for tumors necessitating extensive resection (17 right lobectomies, 10 of which were extended to the medial segment of the left lobe). In addition, 9 unresectable tumors, as proved by exploratory laparotomy, were taken for controls. Before operation, hemostasis in essentially normal except a hyperfibrinogenemia and a slight increase of fibrinogen split products in half the cases. Factor VIII antigen levels are consistently increased. During mobilization of the liver an increased fibrinolytic activity and soluble complexes are frequently observed. Fibrinolysic activity spontaneously returns to normal at the end of the operation, except in cirrhotic patients. No bleeding disthesis is observed and haemorrhage appears to be related to technical problems. On the other hand, there is no clinical evidence of thromboembolism after operation. Therefore any specific therapy either pro or anti-coagulant, appears unjustified, apart from the eventual and transient administration of antifibrinolytic drugs in cirrhotic patients. In the post operative period, blood clotting factors synthetized by the liver (prothrombin complex and antithrombin III) slowly return to normal. Rapid correction of hypo-accelerinaemia reflects the onset of liver regeneration. A simplified method for surveying hemostasis during and after liver resection is proposed.

Adolescent↗
PubMed1990

Endoscopic hemostasis. An effective therapy for bleeding peptic ulcers.

We performed a meta-analysis of 25 randomized control trials that compared endoscopic hemostasis with standard therapy for bleeding peptic ulcer. For recurrent or continued bleeding, the mean rate in control patients was 0.39, and the pooled rate difference, or reduction due to therapy, was 0.27 +/- 0.15 (95% confidence interval) (69% relative reduction). For emergency surgery, the mean rate in control patients was 0.26, and the pooled rate difference was 0.16 +/- 0.05 (62% relative reduction). Most important, for overall mortality, the mean rate in control patients was 0.10, and the pooled rate difference was 0.03 +/- 0.02 (30% relative reduction). The effects were greatest in patients with spurting or visible blood vessels and equivocal when the ulcer showed only signs of recent bleeding. We conclude that endoscopic hemostasis is clearly effective but that data were insufficient for direct comparisons between modalities. Randomized control trials to compare the different modes of endoscopic therapy should continue.

Adult↗
PubMed1992

Initial experience with a new compression device for hemostasis after femoral arterial puncture.

We evaluated a new hemostasis device to maintain focused pressure over the femoral artery puncture site for 2-6 hours in 330 cases after diagnostic catheterization or coronary angioplasty. No patient developed later hematoma or vascular complications. The initial favorable experience suggests that this hemostasis device has advantageous features of stability and site visualization and is a suitable adjunct to current methods of maintaining puncture site pressure after brief manual compression following arterial catheterization.

Cardiac Catheterization↗
PubMed1993

Improved anticoagulation management after Palmaz Schatz coronary stent implantation by sealing the arterial puncture site with a vascular hemostasis device.

Sealing the arterial puncture site with a vascular hemostasis device has the potential to maintain optimal anticoagulation after stent implantation. The level of heparinization during the first 3 days after successful stent implantation was retrospectively compared between 2 groups of medically treated patients with (group A; n = 18) and without (group B; n = 17) a Vasoseal after sheath removal. The number of APTTs sampled in group A and B was 233 and 168, respectively. Respective mean values of APTT (seconds) in group A and B were 180 +/- 79 and 172 +/- 91 at day 1 (p = NS), 132 +/- 43 and 125 +/- 61 at day 2 (p = NS) and 123 +/- 36 and 116 +/- 48 at day 3 (p = NS). More APTTs were suboptimal (< 80 secs) in group B (34/168; 20%) compared to group A (17/233; 7%) [p < 0.001]. More patients in group B compared to group A had 1 or more (14/17; 82% vs. 8/18; 44%; p = 0.04), 2 or more (10/17; 59% versus 3/18; 17%; p = 0.02) and 3 or more (8/17; 47% vs. 2/18; 11%; p = 0.03) suboptimal APTTs. Bleeding complications were seen in 4 patients without and in 3 patients with a Vasoseal. Thus application of a vascular hemostasis device results in a less variable anticoagulation after coronary stenting, but it does not abolish entry site-related bleeding complications.

Collagen↗
PubMed1995

A single center randomized trial assessing use of a vascular hemostasis device vs. conventional manual compression following PTCA: what are the potential resource savings?

We undertook a randomized controlled trial comparing VasoSeal, a collagen vascular hemostasis device (VHD), with manual compression to assess its role and potential cost savings in the PTCA population. Of 460 patients, 359 were excluded due to clinical instability (30%), groin problems (18%), suboptimal PTCA result (15%), and other reasons (37%). The remaining 101 patients were randomized to either VHD (51) or manual compression (50). Hemostasis time, time to ambulation, duration of hospital stay, and nursing time and intensity were significantly reduced in the VHD group. There were no major groin complications in either treatment arm but there was a trend toward more minor groin complications in the VHD patients. The application of VasoSeal reduced resource use in this randomized study and may translate into significant cost reductions in the general coronary angioplasty population.

Adult↗
PubMed1991

Endoscopic hemostasis of bleeding peptic ulcers: 1:10000 adrenalin injection vs. 1:10000 adrenalin +1% aethoxysclerol injection vs. heater probe.

To evaluate the efficacy of three endoscopic methods which utilize different mechanisms of hemostasis to control bleeding peptic ulcers, we performed a prospective randomized study in 83 patients. Thirty-two patients were treated with 1:10000 adrenalin (Group I), 29 patients with 1:10000 adrenalin +1% aethoxysclerol (Group II), and 22 patients with the heater probe (Group III). Gastric ulcers were the source of bleeding in 14, 15 and 12 patients while duodenal ulcers were the source in 16, 13 and 10 patients in Groups I, II and III, respectively. Two stomal ulcers were noted in Group I and 1 in Group II. Two spurters were treated in Group I and 4 in Group II, while 22, 13 and 10 oozers were treated in Groups I, II and III, respectively. Definitive hemostasis was achieved in 94%, 100% and 95% in Groups I, II and III, respectively while the rebleeding rate was 6.25%, 6.9% and 9% respectively. 1:10000 adrenalin injection alone or when combined with subsequent instillation of a sclerosing agent and heater probe application have comparable efficacy in the endoscopic control of bleeding peptic ulcers.

Duodenal Ulcer↗
PubMed2003

Two cases of hemosuccus pancreaticus in which hemostasis was achieved by transcatheter arterial embolization.

Hemosuccus pancreaticus is a rare complication of chronic pancreatitis. We report two cases of hemosuccus pancreaticus in which hemostasis was achieved by transcatheter arterial embolization (TAE). The first patient was a 47-year-old man with alcoholic chronic pancreatitis. He presented with upper abdominal pain and hematemesis. Upper GI endoscopy failed to detect the source of bleeding, but computed tomography (CT) showed a hypervascular area about 3 cm in diameter in a pseudocyst at the pancreatic tail. Angiography revealed a pseudoaneurysm in the caudal pancreatic artery. Hematemesis was considered to be due to rupture of the pseudoaneurysm. TAE of the splenic artery was performed selectively, and this successfully stopped the bleeding. The second patient was a 52-year-old man with alcoholic chronic pancreatitis. He presented with hematemesis. Upper GI endoscopy detected bleeding from the papilla of Vater. CT showed hemorrhage in a pseudocyst at the pancreatic body. Angiography revealed angiogenesis around the pseudocyst. Hematemesis was considered to result from rupture of the pseudoaneurysm. TAE of the dorsal pancreatic artery and posterior superior pancreaticoduodenal artery was performed and hemostasis was achieved. We conclude that TAE is a minimally invasive and highly effective treatment for hemosuccus pancreaticus.

Ampulla of Vater↗