Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Jul 2009
Case ReportsPerioperative haemostatic management of Glanzmann thrombasthenia for abdominal surgery.
Glanzmann thrombasthenia is a rare congenital platelet disorder characterized by spontaneous mucocutaneous bleeding and severe bleeding complications during major surgery. This report centres on the perioperative haemostatic management of a patient with Glanzmann thrombasthenia undergoing elective major abdominal surgery. ⋯ No red blood cell transfusions were needed perioperatively. For haemostatic monitoring, routine laboratory tests were sufficient.
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Blood Coagul. Fibrinolysis · Jul 2009
Treatment of patients with dysfibrinogenemia and a history of abortions during pregnancy.
Dysfibrinogenemia is caused by a variety of structural abnormalities in the fibrinogen molecule, which results in a tendency for bleeding and thrombosis as well as obstetric complications. The obstetric complications of dysfibrinogenemia include first-trimester pregnancy loss, hemorrhage, placental abruption, and thrombosis. We conducted a retrospective study of four cases of dysfibrinogenemic patients from one family (fibrinogen Frankfurt III) with a history of recurrent pregnancy loss and who were treated with fibrinogen concentrates. ⋯ Fibrinogen was administered from the beginning of the pregnancy until delivery. In three out of four patients, abortions could be avoided by continuous administration of fibrinogen concentrates commencing as early as possible during the pregnancy in order to achieve fibrinogen plasma concentrations (Clauss) over 100 mg/dl. For the prophylaxis of thrombotic events, low-molecular heparin at a dosage of 40-60 IE/kg was administered postpartum for 14 days.
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Blood Coagul. Fibrinolysis · Jul 2009
Carbon monoxide releasing molecule-2 increases the velocity of thrombus growth and strength in human plasma.
Carbon monoxide derived from degradation of heme by heme oxygenase or carbon monoxide releasing molecules (CORMs) has been demonstrated to decrease thrombosis in vivo and to weakly inhibit platelet aggregation. We tested the hypothesis that carbon monoxide released from tricarbonyldichlororuthenium (II) dimer (CORM-2) would diminish the velocity of formation and strength of plasma thrombi as determined by thrombelastography. Normal plasma was exposed to 0 or 100 micromol/l CORM-2 or inactivated CORM-2 (iCORM-2), with coagulation initiated with tissue factor or celite (n = 8 per condition). ⋯ In FXIII deficient plasma CORM-2 significantly increased the velocity of clot formation (264%) and strength (240%). Carbon monoxide and iCORM-2 derived from CORM-2 markedly enhance the velocity of clot growth and strength. These findings serve as the rationale for further investigations to determine if CORMs could be utilized as hemostatic agents.