Thrombosis research
-
Thrombosis research · Dec 2018
Review Meta AnalysisAntithrombotic therapies in children on durable Ventricular Assist Devices: A literature review.
Ventricular Assist Devices (VADs) are increasingly utilised in children with end-stage heart failure, and experience high bleeding and clotting rates. In particular, pediatric VAD patients are more challenging than adults to anticoagulate due to developmental hemostasis, lack of suitable drug preparations, and difficult anticoagulation monitoring often due to poor vascular access; in addition to difficulties of VAD design in smaller children. This review aims to summarize the current evidence related to antithrombotic therapy in pediatric VAD patients. ⋯ The clinical use of antithrombotic therapies - including dosages, timing and monitoring - varies considerably. This review highlights the further research required to improve understanding of hemostasis in the pediatric VAD field.
-
Thrombosis research · Dec 2018
Comparative StudyComparative thrombosis risk of vascular access devices among critically ill medical patients.
Central venous catheters (CVC) and peripherally inserted central catheters (PICCs) are central vascular access devices (CVADs) that facilitate administration of medications among critically ill patients. Both are associated with risk of venous thromboembolism (VTE). The relative risk of VTE between these catheter types is not well defined. We report the rate of VTE in intensive care unit (ICU) medical patients receiving PICC, CVC, both, or neither. ⋯ Among critically ill medical patients, PICCs and CVCs were associated with increased risk of VTE. Placement of both conferred higher risk of VTE compared with either alone.
-
Thrombosis research · Dec 2018
Amniotic fluid as a potent activator of blood coagulation and platelet aggregation: Study with rotational thromboelastometry.
Pulmonary thromboembolism (PTE) is a leading cause of maternal death and frequently occurs during early puerperium. Amniotic fluid components are frequently observed in the maternal circulation in parturition; however, it currently remains unclear whether amniotic fluid contamination in maternal blood is related to the high incidence of PTE in early postpartum. ⋯ Amniotic fluid accelerated thrombin production and activated platelet aggregation without inducing hyperfibrinolysis in whole blood. The activated tissue factor pathway with amniotic fluid produced soft and fragile clots due to its influence on platelets, which may be associated with, at least partly, the high incidence of PTE in early puerperium, particularly after cesarean section.