Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Apr 2009
Multicenter Study Comparative StudyMulticentric comparison of single portion reagents and liquid reagents for thromboelastometry.
Thromboelastometry ROTEM (Pentapharm, Munich, Germany) is a viscoelastic method of whole blood clotting assessment with applications in perioperative hemostasis and hematology. The different tests available for the investigation of distinct coagulation aspects are performed with combinations of liquid reagents. The use of liquid reagents for the ROTEM measurement requires several pipetting steps, which complicates their application in clinical routine even though pipetting is performed semiautomatically. ⋯ In the second part of the study, the stability of SPR at 37 degrees C was also assessed on 23 blood samples in one center. Very good correlation was found between SPR and liquid reagents for all clotting parameters (correlation coefficient between 0.85-0.99). The SPR reagents showed excellent stability against thermic stress and the measurements were easier to perform than with the conventional liquid reagents system.
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Blood Coagul. Fibrinolysis · Apr 2009
The efficacy of Ankaferd Blood Stopper in antithrombotic drug-induced primary and secondary hemostatic abnormalities of a rat-bleeding model.
Ankaferd comprises a standardized mixture of plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum and Urtica dioica. Ankaferd Blood Stopper (ABS) as a medicinal product has been approved in the management of external hemorrhage and dental surgery bleedings in Turkey. This study aimed to evaluate the in-vivo hemostatic effect of ABS in rats pretreated with acetylsalicylic acid or enoxaparin. ⋯ In acetylsalicylic acid-treated animals, topical ABS reduced both the duration and also the amount of bleeding volume by 68.4 and 54.6%, respectively. It was also effective in shortening the duration of bleeding (30.6%) and decreasing the amount of bleeding (32.8%) in enoxaparin-treated animals. ABS, a traditional folkloric medicinal plant extract, has in-vivo hemostatic actions, which may provide a therapeutic potential for the management of patients with deficient hemostasis in the clinical medicine.
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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 · Jan 2009
Endotoxinemia-induced changes in coagulation as measured by rotation thrombelastometry technique and conventional laboratory tests: results of a pilot study on pigs.
Modified rotation thrombelastometry (ROTEM) is widely used in near-patient assessment of hemostasis, but data on functional consequences initiated by acute endotoxinemia are rare. To test the hypothesis that the ROTEM technique allows detection of endotoxinemia-induced changes in hemostasis, we conducted a pilot study on pigs. Fifteen healthy pigs were anesthetized and instrumented for invasive hemodynamic monitoring. ⋯ Simultaneously, a significant decrease in platelet count (P = 0.001), fibrinogen (P = 0.001), antithrombin and protein C (P = 0.001) was registered, whereas results of standard coagulation tests and D-dimers showed no significant changes although thrombin-antithrombin complex increased (P = 0.001). Wilcoxon Z score analysis showed that changes in ROTEM variables were comparable to changes in antithrombin, protein C, platelet count, white blood cells and fibrinogen concentrations. The ROTEM assays were able to reflect endotoxinemia-dependent changes in the hemostatic system in pigs early by showing not only activation but also signs of consumption, whereas results of routine coagulation tests remained unchanged.