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  • 11
    Online Resource
    Online Resource
    No hyperfibrinolysis following subarachnoid or intracerebral haemorrhage : a prospective cohort study
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Blood Coagulation & Fibrinolysis Vol. 30, No. 7 ( 2019-10), p. 341-349
    Details
    In: Blood Coagulation & Fibrinolysis, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 7 ( 2019-10), p. 341-349
    Type of Medium: Online Resource
    ISSN: 0957-5235
    URL: Article
    DOI: 10.1097/MBC.0000000000000845
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2035229-3
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  • 12
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    Viscoelastic Testing in the Clinical Management of Subarachnoid Hemorrhage and Intracerebral Hemorrhage
    Georg Thieme Verlag KG ; 2022
    In:  Seminars in Thrombosis and Hemostasis Vol. 48, No. 07 ( 2022-10), p. 828-841
    Details
    In: Seminars in Thrombosis and Hemostasis, Georg Thieme Verlag KG, Vol. 48, No. 07 ( 2022-10), p. 828-841
    Abstract: Subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) are both debilitating and life-threatening incidents calling for immediate action and treatment. This review focuses on the applicability of viscoelastic testing (rotational thromboelastometry or thromboelastography [TEG]) in the management of SAH and ICH. A systematic literature search was performed in PubMed and EMBASE. Studies including patients with SAH or ICH, in which viscoelastic testing was performed, were identified. In total, 24 studies were included for analysis, and further subdivided into studies on SAH patients investigated prior to stenting or coiling (n = 12), ICH patients (n = 8) and studies testing patients undergoing stenting or coiling, or ischemic stroke patients undergoing thrombolysis or thrombectomy and developing ICH as a complication (n = 5). SAH patients had increased clot firmness, and this was associated with a higher degree of early brain injury and higher Hunt-Hess score. SAH patients with delayed cerebral ischemia had higher clot firmness than patients not developing delayed cerebral ischemia. ICH patients showed accelerated clot formation and increased clot firmness in comparison to healthy controls. Patients with hematoma expansion had longer clot initiation and lower platelet aggregation than patients with no hematoma expansion. During stent procedures for SAH, adjustment of antiplatelet therapy according to TEG platelet mapping did not change prevalence of major bleeding, thromboembolic events, or functional outcome. Viscoelastic testing prior to thrombolysis showed conflicting results in predicting ICH as complication. In conclusion, viscoelastic testing suggests hypercoagulation following SAH and ICH. Further investigation of the predictive value of increased clot firmness in SAH seems relevant. In ICH, the prediction of hematoma expansion and ICH as a complication to thrombolysis might be clinically relevant.
    Type of Medium: Online Resource
    ISSN: 0094-6176 , 1098-9064
    URL: Article
    DOI: 10.1055/s-0042-1756191
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2072469-X
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  • 13
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    In vitro Effect of Dalteparin and Argatroban on Hemostasis in Critically Ill Sepsis Patients with New-Onset Thrombocytopenia
    Georg Thieme Verlag KG ; 2023
    In:  TH Open Vol. 07, No. 01 ( 2023-01), p. e42-e55
    Details
    In: TH Open, Georg Thieme Verlag KG, Vol. 07, No. 01 ( 2023-01), p. e42-e55
    Abstract: Thrombocytopenia is common among critically ill sepsis patients, while they also hold an increased risk for thromboembolic events. Thus, the choice of anticoagulant prophylaxis for this patient population is challenging. We investigated the in vitro effect of low-molecular-weight heparin (dalteparin) and direct thrombin inhibitor (argatroban) on the hemostasis in blood from sepsis patients with new-onset thrombocytopenia. Thrombocytopenia was defined as a platelet count drop of ≥30% and/or from 〉 100 × 109/L to 30 to 100 × 109/L within 24 hours prior to inclusion. We included five healthy individuals and ten patients. Analyses of thrombin generation (Calibrated Automated Thrombogram), thrombin-antithrombin (TAT) complex levels, prothrombin fragment 1+2 (F1+2), and rotational thromboelastometry (ROTEM) were performed. Based on dose–response relationships investigated in healthy blood, patient samples were spiked with prophylactic (0.25 IU/mL) and therapeutic (0.75 IU/mL) dalteparin and low (0.25 µg/mL) and high (0.50 µg/mL) argatroban concentrations, each with a sample without anticoagulant. In patients, the endogenous thrombin potential was markedly lower in therapeutic dalteparin samples than in samples without anticoagulant [median (range): 29 (0–388) vs. 795 (98–2121) nM × min]. In high argatroban concentration samples, thrombin lag time was longer than in samples without anticoagulant [median (range): 15.5 (10.5–20.2) versus 5.3 (2.8–7.3) min] . Dalteparin and argatroban both increased clotting time but did not affect maximum clot firmness in the ROTEM INTEM assay. Six patients had elevated TAT and eight patients had elevated F1 + 2. In conclusion, dalteparin mainly affected the amount of thrombin generated and argatroban delayed clot initiation in critically ill sepsis patients with new-onset thrombocytopenia. Neither anticoagulant affected clot strength.
    Type of Medium: Online Resource
    ISSN: 2512-9465
    URL: Article
    DOI: 10.1055/a-2000-6576
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2893939-6
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  • 14
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    Hemostasis and Neuroscience—Hemostasis and Fibrinolysis Involved in Brain Pathology and Brain Disorders
    Georg Thieme Verlag KG ; 2022
    In:  Seminars in Thrombosis and Hemostasis Vol. 48, No. 03 ( 2022-04), p. 274-276
    Details
    In: Seminars in Thrombosis and Hemostasis, Georg Thieme Verlag KG, Vol. 48, No. 03 ( 2022-04), p. 274-276
    Type of Medium: Online Resource
    ISSN: 0094-6176 , 1098-9064
    URL: Article
    DOI: 10.1055/s-0042-1742737
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2072469-X
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  • 15
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    Effect of Desmopressin on Platelet Dysfunction During Antiplatelet Therapy: A Systematic Review
    Springer Science and Business Media LLC ; 2021
    In:  Neurocritical Care Vol. 34, No. 3 ( 2021-06), p. 1026-1046
    Details
    In: Neurocritical Care, Springer Science and Business Media LLC, Vol. 34, No. 3 ( 2021-06), p. 1026-1046
    Type of Medium: Online Resource
    ISSN: 1541-6933 , 1556-0961
    URL: Article
    DOI: 10.1007/s12028-020-01055-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2176033-0
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  • 16
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    Local and systemic coagulation marker response to musculocutaneous flap ischemia–reperfusion injury and remote ischemic conditioning: An experimental study in a porcine model
    Wiley ; 2018
    In:  Microsurgery Vol. 38, No. 6 ( 2018-09), p. 690-697
    Details
    In: Microsurgery, Wiley, Vol. 38, No. 6 ( 2018-09), p. 690-697
    Abstract: Remote ischemic conditioning (RIC) administered by non‐lethal periods of extremity ischemia and reperfusion attenuates ischemia–reperfusion injury. We aimed to investigate the local and systemic coagulation marker response to flap ischemia–reperfusion injury, and the effects of RIC on coagulation markers following flap ischemia–reperfusion injury. Methods A musculocutaneous latissimus dorsi flap was subjected to 4 h of ischemia followed by 7 h of reperfusion in 16 female Danish Landrace pigs (39 kg). Systemic venous blood samples were collected 1 h before flap reperfusion. Flap and systemic venous blood samples were collected at reperfusion and hourly during reperfusion. We measured thrombin generation, fibrinogen, von Willebrand factor, antithrombin, thrombin‐antithrombin complex, activated partial thromboplastin time (aPTT), and prothrombin time (PT). RIC was performed 1 h before flap reperfusion in the intervention group by three 10‐min periods of hind limb ischemia and reperfusion ( n  =   8). RIC was not performed in the control group ( n  =   8). Results Local and systemic coagulation marker changes were comparable following flap ischemia–reperfusion injury. Flap ischemia–reperfusion injury reduced thrombin generation lag time from 2.0 ± 0.3 to 1.6 ± 0.3 min ( P  〈   .001), time‐to‐peak thrombin from 3.5 ± 0.3 to 3.0 ± 0.5 min ( P  =   .001), peak thrombin from 79.6 ± 8.1 to 74.5 ± 7.1 nM ( P  =   .033), endogenous thrombin potential from 211 ± 24 to 197 ± 19 nM × min ( P  =   .01), antithrombin from 0.91 ± 0.07 to 0.79 ± 0.06 10 3 IU/l ( P  =   .002), and aPTT from 37 ± 21 to 21 ± 9 s ( P  =   .017). RIC increased peak thrombin ( P  〈   .001), endogenous thrombin potential ( P  〈   .001), and aPTT ( P  =   .019). Conclusions The local coagulation marker response to musculocutaneous flap ischemia–reperfusion could be measured systemically by moderate hypercoagulation. RIC did not substantially influence coagulation markers following musculocutaneous flap ischemia–reperfusion injury.
    Type of Medium: Online Resource
    ISSN: 0738-1085 , 1098-2752
    URL: Issue
    URL: Article
    DOI: 10.1002/micr.v38.6
    DOI: 10.1002/micr.30287
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1475571-3
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  • 17
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    Fibrin Network Formation and Lysis in Septic Shock Patients
    MDPI AG ; 2021
    In:  International Journal of Molecular Sciences Vol. 22, No. 17 ( 2021-09-02), p. 9540-
    Details
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 22, No. 17 ( 2021-09-02), p. 9540-
    Abstract: Background: Septic shock patients are prone to altered fibrinolysis, which contributes to microthrombus formation, organ failure and mortality. However, characterisation of the individual patient’s fibrinolytic capacity remains a challenge due to a lack of global fibrinolysis biomarkers. We aimed to assess fibrinolysis in septic shock patients using a plasma-based fibrin clot formation and lysis (clot–lysis) assay and investigate the association between clot–lysis parameters and other haemostatic markers, organ dysfunction and mortality. Methods: This was a prospective cohort study including adult septic shock patients (n = 34). Clot–lysis was assessed using our plasma-based in-house assay. Platelet count, activated partial thromboplastin time (aPTT), international normalised ratio (INR), fibrinogen, fibrin D-dimer, antithrombin, thrombin generation, circulating fibrinolysis markers and organ dysfunction markers were analysed. Disseminated intravascular coagulation score, Sequential Organ Failure Assessment (SOFA) score and 30-day mortality were registered. Results: Three distinct clot–lysis profiles emerged in the patients: (1) severely decreased fibrin formation (flat clot–lysis curve), (2) normal fibrin formation and lysis and (3) pronounced lysis resistance. Patients with abnormal curves had lower platelet counts (p = 0.05), more prolonged aPTT (p = 0.04), higher lactate (p 〈 0.01) and a tendency towards higher SOFA scores (p = 0.09) than patients with normal clot–lysis curves. Fibrinogen and fibrin D-dimer were not associated with clot–lysis profile (p ≥ 0.37). Conclusion: Septic shock patients showed distinct and abnormal clot–lysis profiles that were associated with markers of coagulation and organ dysfunction. Our results provide important new insights into sepsis-related fibrinolysis disturbances and support the importance of assessing fibrinolytic capacity in septic shock.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    URL: Article
    DOI: 10.3390/ijms22179540
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 18
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    Thromboelastometry Shows Early Hypercoagulation in Patients with Spontaneous Subarachnoid Hemorrhage
    Elsevier BV ; 2019
    In:  World Neurosurgery Vol. 130 ( 2019-10), p. e140-e149
    Details
    In: World Neurosurgery, Elsevier BV, Vol. 130 ( 2019-10), p. e140-e149
    Type of Medium: Online Resource
    ISSN: 1878-8750
    URL: Article
    DOI: 10.1016/j.wneu.2019.06.019
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2530041-6
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  • 19
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    Bleeding patients on extracorporeal membrane oxygenation have reduced platelet aggregation and plasma fibrinogen: a longitudinal observational study
    Springer Science and Business Media LLC ; 2023
    In:  Scientific Reports Vol. 13, No. 1 ( 2023-09-04)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2023-09-04)
    Abstract: This study investigated changes in coagulation and associations with occurrence of bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy. The study included 100 adult ECMO-patients. Standard coagulation parameters, platelet aggregation and thromboelastometry (ROTEM ® ) were compared with healthy controls. Data on bleeding and thrombosis were collected until recovery or death. Mortality data were collected 30 days after weaning from ECMO. During ECMO therapy, 53 patients experienced at least one moderate or major bleed. Among these, 42 (79%) patients experienced the first bleeding on day 1 or 2. Platelet aggregation and ROTEM ® revealed a hypocoagulable state in ECMO patients when compared with healthy controls. Patients bleeding on day 1 or 2, had lower platelet count (p = 0.04), poorer platelet aggregation and lower levels of fibrinogen (p  〈  0.01) than patients not bleeding on day 1 or 2. Further, ROTEM ® clot propagation was reduced in bleeding patients (p  〈  0.001). Mortality was higher among bleeding patients than patients not bleeding on day 1 or 2 (67% versus 34%, p  〈  0.01). Congruity existed between ROTEM ® measurements and standard coagulation assays, but plasma fibrinogen had a stronger association with bleeding than ROTEM ® measurements. The present study does not support ROTEM ® analysis as a routine part of coagulation monitoring during ECMO therapy.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-023-41773-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2615211-3
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  • 20
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    Lectin pathway proteins of the complement system in normotensive pregnancy and pre‐eclampsia
    Wiley ; 2019
    In:  American Journal of Reproductive Immunology Vol. 81, No. 4 ( 2019-04)
    Details
    In: American Journal of Reproductive Immunology, Wiley, Vol. 81, No. 4 ( 2019-04)
    Abstract: The lectin pathway of the complement system may be involved in the pathogenesis of pre‐eclampsia. We aimed to investigate changes in serum concentrations of a broad range of lectin pathway proteins during normal pregnancy and their association with pre‐eclampsia, placental infarctions and intrauterine growth restriction (IUGR). Method of study We included 51 women with normotensive pregnancies and 54 women with pregnancies complicated by pre‐eclampsia. Blood samples were obtained at gestational weeks 16, 33, 37, and after delivery for the normotensive pregnant women and before and after delivery for women with pre‐eclampsia. Mannose‐binding lectin (MBL), H‐ and M‐ficolin, collectin liver‐1 (CL‐L1), MBL‐associated serine protease (MASP)‐1, MASP‐2 and MASP‐3 and MBL‐associated proteins of 19 (MAp19) and 44 (MAp44) kDa were analysed. Clinical information was obtained from medical records. The placentae were examined by two experienced perinatal pathologists. Results Lectin pathway protein concentrations generally increased during normal pregnancy and decreased after delivery in both normotensive pregnant women and women with pre‐eclampsia. Exceptions were MASP‐3 which increased after delivery in both groups ( P   〈  0.0001) and H‐ficolin which increased after delivery in pre‐eclampsia ( P   〈  0.0001). H‐ficolin ( P   〈  0.0001), M‐ficolin ( P  = 0.005) and MASP‐3 ( P  = 0.03) concentrations were lower in women with pre‐eclampsia than in normotensive pregnant women. Low MASP‐3 concentrations were associated with placental infarction ( P  = 0.03) and IUGR ( P  = 0.04). Low H‐ficolin concentrations were associated with IUGR ( P   〈  0.01). Conclusion In general, lectin pathway protein serum concentrations increased during normal pregnancy. H‐ficolin and MASP‐3 may be involved in the pathophysiology of pre‐eclampsia and IUGR and could be potential future pre‐eclampsia biomarkers.
    Type of Medium: Online Resource
    ISSN: 1046-7408 , 1600-0897
    URL: Issue
    URL: Article
    DOI: 10.1111/aji.2019.81.issue-4
    DOI: 10.1111/aji.13092
    RVK:
    XA 20240
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2024667-5
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