Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Jul 2015
Autotransfusion of a restricted volume of shed mediastinal blood does not affect the haemostatic capacity in patients following cardiac surgery.
The aim was to investigate the haemostatic capacity after autotransfusion of shed mediastinal blood in patients following cardiac surgery. Fifteen cardiac surgery patients with a chest tube drainage ≥ 300 mL blood within the first 6 hours postoperatively were included. The haemostatic capacity was evaluated using whole blood thromboelastometry (ROTEM(®)), impedance aggregometry (Multiplate(®)) and conventional coagulation tests. Measurements were carried out in (1) mediastinal blood, and in blood samples obtained, (2) before autotransfusion, and (3) after autotransfusion of mediastinal blood. In shed mediastinal blood, ROTEM(®) analyses showed reduced clot firmness in the EXTEM (p < 0.001), INTEM (p < 0.001), and FIBTEM assay (p = 0.002). Platelet function and conventional coagulation parameters were significantly impaired (p < 0.001). However, ROTEM(®), platelet function and conventional coagulation tests remained unchanged after autotransfusion. ⋯ Shed mediastinal blood has a substantially reduced haemostatic capacity, but autotransfusion of an average of 350 mL did not affect the overall haemostatic capacity.
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Scand. J. Clin. Lab. Invest. · May 2015
Comparative StudyComparison of fibrin-based clot elasticity parameters measured by free oscillation rheometry (ReoRox ®) versus thromboelastometry (ROTEM ®).
Whole blood viscoelastic tests such as the fibrin-based thromboelastometry (ROTEM(®)) test FIBTEM are increasingly used in the perioperative setting to quickly identify deficits in fibrin quality, and to guide hemostatic therapy. The recently developed FibScreen2 test of the ReoRox(®) method, based on free oscillation rheometry, also provides an evaluation of fibrin clot quality. To date, little information is available on the performance of this test in hemodiluted blood, by comparison to FIBTEM. ⋯ ReoRox(®) Fibscreen2 test has a high coefficient of variation, and its application in various hemodilution conditions showed limited comparability with the ROTEM(®) FIBTEM test.
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Scand. J. Clin. Lab. Invest. · May 2015
The relationship between on-clopidogrel platelet reactivity, genotype, and post-percutaneous coronary intervention outcomes in Chinese patients.
High on-clopidogrel platelet reactivity reflects a poor response to clopidogrel and is associated with ischemic events, which has been attributed to several factors such as demographic, clinical characteristics and a polymorphism of CYP2C19. Some new platelet assays monitoring on-clopidogrel platelet reactivity are currently available in China, but their relevance to the CYP2C19 genotype and post-percutaneous coronary intervention outcomes remain to be elucidated. ⋯ CYP2C19 loss-of function genotypes with the *2 and/or *3 allele are highly prevalent in the Chinese population and are associated with higher residual platelet reactivity. High on-treatment platelet reactivity defined by MPA ADP or MA ADP predicts an increased risk of MACE for ACS patients undergoing PCI.