Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Mar 2009
Review Meta AnalysisAre batroxobin agents effective for perioperative hemorrhage in thoracic surgery? A systematic review of randomized controlled trials.
The objective of the present study was to evaluate the effect of batroxobin agents on perioperative hemorrhage in thoracic surgery. We systematically searched Cochrane Library, Pubmed, EMBASE and the China Biological Medicine CD-ROM Databases up to August 2007. Reference lists of all included studies and of reviews related to the topic of the present systematic review were manually searched. ⋯ Mean differences at different time points after operation ranged from -15 ml (95% CI, -31.77 to 1.77) to -150.60 ml (95% CI, -179.26 to -121.94). Although most of the differences between the batroxobin agents group and the no treatment group were statistically significant, clinical value was limited. There is not enough evidence supporting any benefit of batroxobin agents for hemorrhage during thoracic surgery.
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Blood Coagul. Fibrinolysis · Mar 2009
ReviewVon Willebrand factor/factor VIII concentrates in the treatment of von Willebrand disease.
Therapy for von Willebrand disease (VWD) aims to restore the hemostatic function conferred by von Willebrand factor (VWF), which facilitates platelet adhesion and aggregation, and serves to increase potentially low coagulation factor VIII (FVIII) in plasma. In patients unresponsive to desmopressin (DDAVP), the preferred treatment is with plasma-derived VWF-containing FVIII concentrates. Only a few of the available VWF/FVIII concentrates have been licensed for use in VWD based on prospective studies. ⋯ Several clinical studies have demonstrated the efficacy of concentrates dosed according to VWF:RCo. Dosing is generally consistent across VWD subtypes, although patients with severe phenotypes or undergoing major procedures may require more infusions or longer treatment duration. Other considerations for the use of VWF-containing concentrates include laboratory monitoring of efficacy and safety issues such as thrombosis risk and thromboprophylaxis.
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Blood Coagul. Fibrinolysis · Jul 2008
ReviewConsensus opinion for the selection and use of therapeutic products for the treatment of haemophilia in Spain.
The period between isolation of HIV in the early 1980s and the development of effective viral inactivation procedures able to eradicate the virus from the blood supply was long and unfortunately many recipients of blood-derived products became infected; this translated into a devastating impact on their quality of life, quality of care as well as on their life expectancy. Some years later, hepatitis C virus infection was identified as another known blood-borne disease complicating the treatment of haemophilia. ⋯ The aim of the present publication was to review some of the crucial aspects related to the choice of haemostatic concentrates for the treatment of haemophilia and other inherited bleeding disorders, to analyse the current situation in the United States, Canada and European Union countries and to report the most relevant aspects of the Spanish consensus opinion of haemophilia-treating doctors for the use of therapeutic products for haemophilia recently issued. Essentially, it suggests that a gradual switch to recombinant concentrates may be a beneficial decision for patients with haemophilia and for the National Health Service.
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Recombinant activated factor VII, a bypassing hemostatic agent originally developed for the treatment of hemorrhages in hemophilic patients with inhibitors, is increasingly being employed on a compassionate use basis for the treatment of uncontrolled massive bleeding from various causes. In this review, we present the current knowledge on the use of this agent in patients with severe coagulopathy due to end-stage liver disease. ⋯ Given the paucity of the published data and the lack of randomized trials, there is not enough evidence to support the extensive use of recombinant activated factor VII in any of the clinical indications analyzed. In conclusion, further large randomized, controlled clinical trials are needed to better define the role of recombinant activated factor VII in the treatment of bleeding complications of liver disorders.
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Blood Coagul. Fibrinolysis · Oct 2007
Review Case ReportsLow-dose tenecteplase during cardiopulmonary resuscitation due to massive pulmonary embolism: a case report and review of previously reported cases.
The case of a 29 year-old man who suffered a cardiac arrest due to a massive pulmonary embolism while he was undergoing surgical repair of a complex tibial plateau fracture is presented. After 70 min of unsuccessful cardiopulmonary resuscitation a bolus of 20 mg tenecteplase was given, with a return of spontaneous circulation 2 min after administration of the drug. ⋯ To our knowledge this is the first report to show that the use of a low dose of tenecteplase might be useful to achieve the return of spontaneous circulation in the resuscitation of patients with cardiac arrest secondary to massive pulmonary embolism. Previously reported cases are reviewed.