Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Jan 2006
Elastic modulus-based thrombelastographic quantification of plasma clot fibrinolysis with progressive plasminogen activation.
Thrombelastographic detection of fibrinolysis has been critical in the identification and treatment of coagulopathy in many perioperative settings. However, the fibrinolytic assessments have been at best non-parametric, amplitude-based determinations (e.g. estimated % lysis, clot lysis time or clot lysis rate). Recognizing this limitation, a methodology was developed to measure the onset, speed and extent of clot disintegration by changes in elastic modulus derived from the amplitude. ⋯ While the estimated % lysis and clot lysis time were significantly affected by tPA (0-300 U/ml), elastic modulus-based analyses in a more activity-specific fashion demonstrated significantly decreased onset, increased rate and increased extent of fibrinolysis. Furthermore, aprotinin was found to inhibit the onset, rate and extent of fibrinolysis in an activity-dependent fashion, whereas activated factor XIII was noted to enhance the speed of onset of clot growth and delay the onset of fibrinolysis. In summary, our results serve as the rational basis to utilize this elastic modulus-based approach to quantify the extent of fibrinolysis in clinical and laboratory settings, as well as potentially guiding antifibrinolytic therapy.
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Blood Coagul. Fibrinolysis · Nov 2005
Phlegmasia cerulea dolens as a complication of deep vein thrombosis in a man with primary antiphospholipid syndrome.
We report here the occurrence of phlegmasia cerulea dolens of both lower extremities as a complication of massive deep vein thrombosis in a 37-year-old man with primary antiphospholipid syndrome. The patient had no history of thromboembolic events or any comorbidities. ⋯ In the literature, there is a single case of phlegmasia cerulea dolens as a complication of deep vein thrombosis in an obese woman with a history of thrombosis. We show that phlegmasia may occur in a previously healthy man with positive lupus anticoagulant.
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Blood Coagul. Fibrinolysis · Nov 2005
Randomized Controlled TrialControl of bleeding in children with Dengue hemorrhagic fever using recombinant activated factor VII: a randomized, double-blind, placebo-controlled study.
We evaluated the efficacy and safety of recombinant activated factor VII (rFVIIa) in children aged < 18 years old with grade II or grade III Dengue hemorrhagic fever (DHF) who required blood component therapy for controlling bleeding episodes. ⋯ rFVIIa appears to be a useful adjunctive treatment to blood component transfusion for controlling active bleeding in children with DHF especially when platelet concentrate is not readily available.
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Blood Coagul. Fibrinolysis · Nov 2005
An evaluation of the procoagulant action of recombinant activated factor VII in cord whole blood versus adult whole blood using thromboelastography.
Recombinant activated factor VII (rFVIIa) has been reported to be effective in adult patients in various clinical situations and might be beneficial in neonates with bleeding tendency. In the present study we compared the procoagulant action of increasing amounts of rFVIIa in both cord whole blood and adult whole blood with respect to changes in the values of the clotting time, clot formation time, and maximum clot firmness by means of thromboelastography. Thromboelastography allows evaluation of the effects of rFVIIa on haemostasis in whole blood. ⋯ Cord whole blood was significantly more sensitive to rFVIIa addition than adult whole blood, an effect probably attributable to the low anticoagulant capacity of the neonatal plasma. Maximum clot firmness values were significantly lower in cord whole blood than in adult whole blood, an effect mainly attributable to the hypofunctional state of neonatal platelets. Since cord whole blood exerted a significantly higher sensitivity to addition of rFVIIa, we speculate that lower doses of rFVIIa might be required to treat neonates with bleeding tendency compared with the adult rFVIIa administration strategy.
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Blood Coagul. Fibrinolysis · Sep 2005
Case ReportsShort-course use of recombinant factor VIIa in a haemophilia patient with inhibitor undergoing cataract surgeries.
A 36 year-old patient with severe haemophilia A and high-titre inhibitor underwent cataract surgery under topical anaesthesia. Recombinant factor VIIa was used only three times, once before and twice following surgery. ⋯ Both procedures were uneventful. Neither bleeding complications nor any other side effects occurred.