Thrombosis research
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Thrombosis research · Jan 2008
Comparative StudyUsefulness of high-concentration calcium chloride solution for correction of activated partial thromboplastin time (APTT) in patients with high-hematocrit value.
Pseudoprolongation of activated partial thromboplastin time (APTT) is a serious problem in anticoagulation therapy for patients with high hematocrit, such as cyanotic congenital heart diseases. APTT pseudoprolongation occurs when APTT assay is performed using routinely used vacuum sampling tubes containing citrate. Because the plasma fraction is small in high-hematocrit blood, the prescribed volume of citrate would be excessive for APTT assay, resulting in prolongation of clotting or APTT pseudoprolongation. CLSI--The Clinical and Laboratory Standards Institute (formerly NCCLS) method is the established method to correct the pseudoprolongation. However, the CLSI method needs repeated blood drawings and time-consuming, complicate procedures. Thus, alternative simple method is desired. ⋯ High-calcium chloride solution method is useful to correct APTT pseudoprolongation. Because of the simplicity and the need of a single blood drawing, this method would reduce the burdens of not only patients but also clinical laboratory.
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Thrombosis research · Jan 2008
Comparative StudyDiagnostic accuracy of the Triage D-dimer test for exclusion of venous thromboembolism in outpatients.
We evaluated the diagnostic performance of the Triage D-dimer test, a new fast quantitative point-of-care whole blood D-dimer assay and compared it with the Vidas D-dimer assay. ⋯ The Triage and Vidas D-dimer tests show comparable diagnostic accuracy. Vidas showed a significant higher sensitivity. Our findings strongly suggest lowering the cutoff for the Triage D-dimer test from 400 to 350 ng/mL. In this way specificity lowers from 42 to 38%, but, more importantly, sensitivity increases from 91 to 95%.
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Thrombosis research · Jan 2008
ReviewWarfarin-induced bleeding complications - clinical presentation and therapeutic options.
Acute bleeding during oral anticoagulant therapy is a major challenge in medicine -with millions of patients receiving oral anticoagulant therapy worldwide, the frequency of severe bleeding episodes ranges from 2% to 13%, according to clinical trial data. The major risk associated with the use of oral anticoagulants is haemorrhage, which might be severe or even life-threatening. Treatment decisions for the reversal of oral anti-coagulation (OAC) depend on factors such as urgency of the situation, as determined by the international normalised ratios (INR), location and seventy of bleeding, and indication for anticoagulation. ⋯ In addition, PCC is associated with a more rapid normalisation of the INR and a better clinical outcome due to the balanced ratio of four vitamin-K-dependent clotting factors plus the coagulation inhibitors protein C and Protein S. PCC products containing four factors are the preferred option for the emergency reversal of OAC, according to some clinical treatment guidelines. Other advantages of PCC over FFP include smaller infusion volumes, no blood group testing and virus-inactivated blood product.
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Thrombosis research · Jan 2008
Elevated D-dimer concentration identifies patients with incomplete recanalization of pulmonary artery thromboemboli despite 6 months anticoagulation after the first episode of acute pulmonary embolism.
Despite long-term anticoagulation in some patients after acute pulmonary embolism (APE) pulmonary thrombi are not completely resolved. We hypothesized that elevated D-dimer concentration reflecting increased endogenous fibrinolysis may indicate incomplete pulmonary thrombi resolution after the first episode of PE. ⋯ Elevated D-dimer after 6 months anticoagulation and right ventricular dysfunction at the diagnosis predict incomplete recanalization of pulmonary circulation after first episode of APE.
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Thrombosis research · Jan 2008
Hemostatic variation during perioperative period of orthotopic liver transplantation without venovenous bypass.
To measure the variations of different parameters in the hemostatic system and to analyze their roles in the development of hemostatic disorder in patients with orthotopic liver transplantation (OLT) procedures routinely performed without venovenous bypass. ⋯ In the entire process of OLT operation, coagulation defects, hyperfibrinolysis and platelet numbers decrease could develop hemostatic disorder. The data obtained in this study might contribute to a better understanding of the pathophysiology and assessment of bleeding risk in the OLT.