Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Jul 1995
Platelet function, coagulation tests, and cardiopulmonary bypass: lack of correlation between pre-operative and intra-operative whole blood lumiaggregometry and peri-operative blood loss in patients receiving autologous platelet-rich plasma.
Platelet function and blood coagulation were studied and correlated with the post-operative red blood cell (RBC) loss in 41 patients that underwent cardiopulmonary bypass surgery. Before and after surgery, whole blood platelet aggregation and secretion were tested with different agonists, and the platelet count, prothrombin time, and activated partial thromboplastin time measured simultaneously. Post-operatively, RBC loss in chest fluid was also calculated. ⋯ The clotting times were increased significantly after surgery, and after platelet-rich plasma infusion, the prothrombin time decreased significantly relative to the post-protamine value, the activated partial thromboplastin time being essentially unchanged. Postoperatively, the total volume of RBC collected after 36 h was 158 +/- 13 ml and there was no significant correlation with the above parameters. We conclude that pre-operative or intra-operative whole blood lumi-aggregometry is not a predictor of post-operative blood loss in patients receiving platelet-rich plasma intra-operatively.
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The 'derived' fibrinogen method is commonly used for the measurement of plasma fibrinogen. This method is not a direct quantitation of plasma fibrinogen, but an estimation of the fibrinogen concentration from the clotting curve of the prothrombin time on automated photo-optical coagulometers. An increasing number of laboratories are now routinely using this method to cope with increasing demands for fibrinogen testing. ⋯ The discrepancy between 'derived' and Clauss fibrinogen levels was greater in certain patient groups, e.g. patients receiving oral anticoagulants, than in normal controls. Some patients with documented hypodysfibrinogenaemia with low fibrinogen levels by Clauss assay gave normal 'derived' fibrinogen values. Although the 'derived' fibrinogen assay is rapid, economical and easily available to laboratories with suitable instruments, this study shows that it lacks standardization and is inaccurate compared with the Clauss assay.
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Blood Coagul. Fibrinolysis · Oct 1994
Clinical Trial Controlled Clinical TrialProtamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin). An experimental investigation in healthy volunteers.
The aim of the present study was to investigate whether tinzaparin sodium (a low-molecular-weight heparin (LMWH)) was fully and permanently neutralized in vivo in man by protamine sulphate (PS) after intravenous (i.v.) or subcutaneous (s.c.) injection. Fifty healthy adults equally divided in five age- and sex-matched groups were included. The groups received 50 IU unfractionated heparin (UH)/kg body weight (b.w.) i.v., 50 anti-factor Xa (anti-Xa) IU tinzaparin/kg b.w. i.v., 75 anti-Xa IU tinzaparin/kg b.w. s.c., 175 anti-Xa IU tinzaparin/kg b.w. s.c., or 1 ml of saline s.c. ⋯ A slight, but statistically significant, increase in anti-Xa and anti-IIa activities were seen following i.v. tinzaparin. In the s.c. groups 60-65% of the observed peak anti-Xa activity was neutralized, anti-IIa was almost completely reversed, and aPTT returned nearly to baseline values. A gradual return of the anti-Xa activity (65-75%), anti-IIa activity (55%) and aPTT activity (35-45%) was seen in the s.c. groups 3 h after reversal compared with the observed peak values.(ABSTRACT TRUNCATED AT 250 WORDS)
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Blood Coagul. Fibrinolysis · Oct 1994
Comparative StudyStudy of the balance between coagulation and fibrinolysis in disseminated intravascular coagulation using molecular markers.
Plasma levels of thrombin-antithrombin III complex (TAT), plasmin-alpha 2-plasmin inhibitor complex (PIC) and active plasminogen activator inhibitor (PAI) were assayed in 66 cases of disseminated intravascular coagulation (DIC). Significant elevation of both TAT and PIC was observed in all cases of DIC. Most elevated levels of TAT were seen in DIC with acute promyelocytic leukaemia (APL) and sepsis. ⋯ Active PAI was higher in patients with multiple organ failure (MOF) than in those without MOF while PIC was lower in patients with this complication. Thus, the balance of coagulation and fibrinolysis varied according to the underlying cause of DIC; APL had more dominant activation of fibrinolysis, while sepsis had greater activation of coagulation. It is suggested that the inhibition of secondary fibrinolytic activation plays an important role in the progression of MOF by the disturbance of the microcirculation.