Thrombosis research
-
Thrombosis research · Jan 2015
Randomized Controlled TrialMild induced hypothermia: effects on sepsis-related coagulopathy--results from a randomized controlled trial.
Coagulopathy associates with poor outcome in sepsis. Mild induced hypothermia has been proposed as treatment in sepsis but it is not known whether this intervention worsens functional coagulopathy. ⋯ Interim analysis data from an ongoing randomized controlled trial; The Cooling And Surviving Septic shock (CASS) study. Patients suffering severe sepsis/septic shock are allocated to either mild induced hypothermia (cooling to 32-34°C for 24hours) or control (uncontrolled temperature).
-
Thrombosis research · Jan 2015
Review Meta AnalysisHow safe is acetaminophen use in patients treated with vitamin K antagonists? A systematic review and meta-analysis.
Acetaminophen is a commonly prescribed and over-the-count used drug, and is considered to be the preferred treatment choice for anticoagulated patients requiring analgesic drug therapy. However, observational data have suggested that this drug combination may increase the International Normalized Ratio (INR) values and bleeding events in patients taking Vitamin K antagonists (VKAs). Still, the clinical impact of this putative effect remains unknown. Therefore, we performed a systematic review of randomized controlled trials (RCTs) to estimate the impact of concomitant use of acetaminophen and VKA in the INR measurements ⋯ Acetaminophen is associated with a statistically significant and possible clinically relevant increase in the INR, with a dose dependent relationship. Patients treated concomitantly with VKA and acetaminophen should be monitored more regularly for possible VKA dosage adjustment.
-
Thrombosis research · Jan 2015
ReviewA systematic review of prothrombin complex concentrate dosing strategies to reverse vitamin K antagonist therapy.
Management of patients with a major bleed while on vitamin K antagonist (VKA) is a common clinical challenge. Prothrombin Complex Concentrates (PCC) provide a rapid reversal of VKA induced coagulopathy. However, a well-defined PCC dosing strategy, especially in emergency setting, is still lacking. ⋯ We found no evidence that one dosing strategy is superior. Future studies should be designed to investigate if body weight and INR are relevant for PCC dosing. In these, we need uniform outcome definitions.
-
Thrombosis research · Jan 2015
Multicenter StudyTinzaparin and VKA use in patients with cancer associated venous thromboembolism: a retrospective cohort study.
After 6months, little is known about the optimal anticoagulant strategy for an acute episode of VTE in cancer patients. ⋯ The risk of recurrent VTE was mainly related to early discontinuation of anticoagulation in patients considered at low risk of recurrence (after surgery). When the anticoagulation was stopped before the sixth month, the risk was eight fold higher. After 6month, the risks of recurrent VTE, major bleeding and death were similar in patients with either VKA or tinzaparin when patients were treated according to the guidelines.
-
Thrombosis research · Jan 2015
Observational StudyEx vivo thrombin generation patterns in septic patients with and without disseminated intravascular coagulation.
The thrombin generation test (TGT) describes the ability of the plasma to generate thrombin. Its usefulness in septic patients has yet to be assessed. ⋯ The thrombin Generation Test displayed particular patterns in septic patients and in septic DIC patients. The wide overlap between patients in TGT values prevents the usefulness of this test in clinical practice.