Thrombosis research
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Thrombosis research · Apr 1997
Relationship between changes in F1+2 and TAT levels and blood coagulation early after prosthetic valve replacement.
Prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin III complex (TAT), D-dimer and other coagulation-related factors were measured over time in 48 patients who underwent prosthetic valve replacement and subsequent anticoagulant therapy, in order to evaluate the dynamics of thrombin generation. Before surgery, levels of both F1 + 2 and TAT were high, indicating enhanced thrombin generation. On the 7th day after initiation of postoperative administration of warfarin, F1 + 2 was significantly lower than preoperatively, while TAT tended to be increased. ⋯ Our findings suggest that both F1 + 2 and TAT levels are useful for evaluation of enhanced coagulability. D-dimer is also considered to be useful as a parameter of fibrinolysis. F1 + 2 is less affected by surgical invasion than TAT, and therefore appeared to reflect coagulability more accurately.
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Thrombosis research · Feb 1997
Randomized Controlled Trial Clinical TrialThe effect of tranexamic acid on local and plasma fibrinolysis during total knee arthroplasty.
The aim of the present study was to investigate aspects of coagulation and fibrinolysis during knee arthroplasties in order to find out. 1. whether an increased fibrinolysis is correlated to an increased blood loss 2. whether there is a difference in markers for coagulation and fibrinolysis in peripheral venous blood compared to those in blood from the wounds 3. whether the administration of tranexamic acid modifies the fibrinolytic response. Twenty-four patients were included. Twelve patients were given tranexamic acid intravenously at the end of the operation. ⋯ We found no direct correlation between the degree of fibrinolysis and blood loss. The administration of tranexamic acid reduced fibrinolysis in the wounds but not in peripheral venous blood. The postoperative blood loss was reduced by half.
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Thrombosis research · Apr 1996
Pulmonary vascular injury induced by hemorrhagic shock is mediated by P-selectin in rats.
To investigate whether the P-selectin-mediated leukocyte adhesion to the endothelial cells is involved in pulmonary vascular injury after hemorrhagic shock, we examined the effect of an anti-P-selectin monoclonal antibody (MAb PB1.3) on the pulmonary accumulation of leukocytes and the subsequent pulmonary vascular injury observed after hemorrhagic shock in rats. Two hours after hemorrhagic shock, pulmonary accumulation of leukocytes, as evaluated by measuring myeloperoxidase activity, began to increase and peaked after 6 hours. ⋯ MAb PNB1.6, an anti-P-selectin monoclonal antibody incapable of inhibiting P-selectin-mediated leukocyte adhesion, did not prevent either of these effects. These observations strongly suggest that the pulmonary sequestration of leukocytes and the subsequent pulmonary vascular injury after hemorrhagic shock are mediated by P-selectin.
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Thrombosis research · Mar 1996
Clinical TrialFlush heparin during cardiac catheterisation prevents long-term coagulation activation in children without APC-resistance-preliminary results.
This study was designed to prospectively evaluate haemostatic activation in 75 children undergoing cardiac catheterisation with intermittent flush heparin (10 IU/ml saline) and to relate these data to clinical findings and inherited risk factors for thrombophilia. In addition to flush heparin in infants < 6 months of age in whom additional arterial catheterisation was performed (n = 5) or patients with thrombophilia, heparin (300-400 IU/kg/d) was administered for a further 24 h. APTT was prolonged and anti Xa activity was significantly increased at the end of catheterisation and returned to normal 24 hours later. ⋯ No further thrombotic events occurred. This study indicates that low-dose flush heparin during catheterisation may prevent long-term haemostatic activation in children without thrombophilia. Whether further heparin after cardiac catheterisation in children with APCR prevents vascular insults requires a more intensive study.
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Thrombosis research · Sep 1995
Clinical Trial Controlled Clinical TrialThe effects of gynaecological surgery on coagulation activation, fibrinolysis and fibrinolytic inhibitor in patients with and without ketorolac infusion.
The effects of gynaecological surgery on the fibrinolytic and inhibitor mechanisms were followed up for 24 h post-operatively in patients receiving a single dose of ketorolac infusion (n = 18) as compared with those not receiving ketorolac infusion (n = 11). A pre-operative state of lower mean t-PA activity and higher PAI-1 levels with increased platelet activation than that reported in normal subjects were observed in both groups of patients. Increased t-PA activity upon anaesthetic induction together with a decreased level at 24 h post-operation was seen in both groups. ⋯ Ketorolac infusion elicited a significant response in PAI-1 activity within 24 h post-operation and this was not seen in the non-ketorolac group in spite of the rising trend by 24 h post-operation which did not achieve statistical significance. There were no statistical significant differences in blood loss and duration of surgery between the two groups of patients. Overall, both groups of patients showed similar haemostatic changes post-operatively for 24 h, a longer duration of post-operative study would have revealed any subtle changes in the molecular markers of thrombosis which was not the objective of this study.