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[PMID]:29320623
[Au] Autor:Kulic A; Cvetkovic Z; Libek V
[Ti] Título:Primary hyperfibrinolysis as the presenting sign of prostate cancer: A case report.
[So] Source:Vojnosanit Pregl;73(9):877-80, 2016 Sep.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: A bleeding syndrome in the setting of primary hyperfibrinolysis in a prostate cancer patient is only 0.40­ 1.65% of cases. The laboratory diagnosis of primary hyperfibrinolysis is based on the increase of biomarkers like D-dimer, fibrinogen split products, plasminogen, and euglobulin lysis test. These tests are not specific for primary hyperfibrinolysis. We reported a rare case of hemorrhagic syndrome caused by primary hyperfibrinolysis as the first clinical symptom of metastatic prostate cancer. Case report: A 64-year-old male was admitted to our hospital with large hematomas in the right pectoral and axillary areas (20 x 7 cm), right hemiabdomen (30 x 30 cm) and the left lumbal area, (25 x 5 cm). The patient had no subjective symptoms nor used any medication. Initial coagulation testing, prothrombin time (PT), and activated partial thromboplastin time (APTT) were within the normal range, while fibrinogen level was extremely low (1.068 g/L) (normal range 2.0­5.0) and the D-dimer assay result was high 1.122 mg/L (normal range < 0.23). The results obtained by rotation thrombelastometry pointed to primary fibrinolysis. Further clinical and laboratory examination indicated progressive malignant prostate disease. First line treatment for the patient was a combined administration of tranexamic acid (3 x 500 mg iv) and transfusion of ten units of cryoprecipitate (400 mL). Next day, fibrinolytic function measurements by rotation thrombelastometry were within the normal ranges. Fibrinogen level was normalized within two days (2.4 g/L). There were no newly developed hematomas. Conclusion: This case report shows primary hyperfibrinolysis with bleeding symptoms, which is an uncommon paraneoplastic phenomenon within expanded prostate malignancy. Rotation thrombelastometry in this severe complication helped to achieve the prompt and proper diagnosis and treatment.
[Mh] Termos MeSH primário: Adenocarcinoma/complicações
Transtornos da Coagulação Sanguínea/etiologia
Fibrinólise
Síndromes Paraneoplásicas/etiologia
Neoplasias da Próstata/complicações
[Mh] Termos MeSH secundário: Adenocarcinoma/sangue
Adenocarcinoma/secundário
Adenocarcinoma/terapia
Antifibrinolíticos/uso terapêutico
Biomarcadores/sangue
Transtornos da Coagulação Sanguínea/sangue
Transtornos da Coagulação Sanguínea/diagnóstico
Transtornos da Coagulação Sanguínea/tratamento farmacológico
Testes de Coagulação Sanguínea
Neoplasias Ósseas/secundário
Fator VIII/uso terapêutico
Fibrinogênio/uso terapêutico
Fibrinólise/efeitos dos fármacos
Hematoma/etiologia
Hemorragia/etiologia
Seres Humanos
Masculino
Meia-Idade
Síndromes Paraneoplásicas/sangue
Síndromes Paraneoplásicas/diagnóstico
Síndromes Paraneoplásicas/tratamento farmacológico
Neoplasias da Próstata/sangue
Neoplasias da Próstata/patologia
Neoplasias da Próstata/terapia
Ácido Tranexâmico/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 0 (Biomarkers); 0 (cryoprecipitate coagulum); 6T84R30KC1 (Tranexamic Acid); 9001-27-8 (Factor VIII); 9001-32-5 (Fibrinogen)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150525076K


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[PMID]:29314796
[Au] Autor:Sarac M; Marjanovic I; Bezmarevic M; Sarac S; Milic R; Obradovic S; Tomic A
[Ti] Título:Influence of open surgical and endovascular abdominal aortic aneurysm repair on clot quality assessed by ROTEM® test.
[So] Source:Vojnosanit Pregl;73(7):643-50, 2016 Jul.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction/Aim: The disturbances in hemostasis are often in open surgical repair (OR) and endovascular repair (EVAR) of an abdominal aortic aneurysm (AAA). These changes may influence the perioperative and early postoperative period inducing serious complications. The aim of this study was to compare the impact of OR and EVAR of AAA on clot quality assessed by rotational thromboelastometry (ROTEM®) tests. Methods: The study included 40 patients who underwent elective AAA surgery and were devided into two groups (the OR and the EVAR group - 20 patients in each group). The ROTEM ® test was performed in 4 points: point 1 - 10 min before starting anesthesia in both groups; point 2 - 10 min after aortic clapming in the OR group and 10 min after the stent-graft trunk release in the EVAR group; point 3 - 10 min after the releasing of aortic clamp in the OR group and 10 min after stentgraft placement and releasing the femoral clamp in the EVAR group; point 4 - one hour after the procedure in both groups. Three ROTEM® tests were performed as: extrinsically activated assay with tissue factor (EXTEM), intrinsically activated test using kaolin (INTEM), and extrinsically activated test with tissue factor and the platelet inhibitor cytochalasin D (FIBTEM). All tests included the assessment of the maximum clot firmness (MCF) and the platelet component of clot strength was presented as maximal clot elasticity (MCE). Results: No significant difference in age, gender and diameter of AAA between groups was found. The time required for the procedure was significantly longer and loss of blood was greater in the OR group than in the EVAR group (p < 0.001). The significant deviation of MCF values in EXTEM test was found mainly in the point 3 (p ≤ 0.004) with significant difference between groups (p < 0.001). A significant difference of MCF values in INTEM test between groups was found in the points 3 and 4 (p < 0.001), which were dose-dependent by heparin sulfate. The MCF values in FIBTEM test were more prominent in the OR group than in the EVAR group without significant difference. The significant changes of MCF values in the FIBTEM test were found during time in both groups (p < 0.001). The values of MCE were lower in both groups, but without significant changes and difference between groups (p = 0.105). Conclusion: The disorders of hemostatic parameters assessed by ROTEM® tests are present in both the OR and the EVAR groups being more prominent in OR of AAA. Vigilant monitoring of hemostatic parameters evaluated by ROTEM® tests could help in administration of the adequate and target therapy in patients who underwent EVAR or OR of AAA.
[Mh] Termos MeSH primário: Aneurisma da Aorta Abdominal/sangue
Aneurisma da Aorta Abdominal/cirurgia
Coagulação Sanguínea
Procedimentos Endovasculares
[Mh] Termos MeSH secundário: Idoso
Transtornos da Coagulação Sanguínea/etiologia
Testes de Coagulação Sanguínea
Procedimentos Endovasculares/efeitos adversos
Feminino
Seres Humanos
Masculino
Complicações Pós-Operatórias
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150510123S


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[PMID]:29241232
[Au] Autor:Nates JL; Cattano D; Costa FS; Chelly JE; Doursout MF
[Ad] Endereço:Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 112, Houston, TX 77030, USA, jlnates@mdanderson.org.
[Ti] Título:Thromboelastographic assessment of the impact of mexiletine on coagulation abnormalities induced by air or normal saline intravenous injections in conscious rats.
[So] Source:Diving Hyperb Med;47(4):228-232, 2017 Dec.
[Is] ISSN:1833-3516
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Thromboelastography (TEG) in venous air embolism (VAE) has been poorly studied. We induced coagulation abnormalities by VAE in a rat model, assessed by TEG with and without mexiletine, a lidocaine analogue local anesthetic. METHODS: Twenty-three Sprague Dawley rats instrumented under isoflurane anesthesia and allowed to recover five days prior to the experiments were randomized into three experimental groups: 1) VAE (n = 6); 2) VAE and mexiletine (n = 9); and 3) normal saline (NS) alone (control group, n = 8). Blood samples were collected at baseline, one hour (h) and 24 h in all groups and analyzed by TEG to record the R, K, angle α and MA parameters. RESULTS: In Group 1, VAE decreased significantly R at 1 h (31%), K at 1 h (59%) and 24 h (34%); α increased significantly at 1 h (30%) and 24 h (22%). While R returned to baseline values within 24 h, K, MA and α did not. In group-2 (Mexiletine + VAE), K and R decreased at 1 h (48% and 29%, respectively) and at 24 h the changes were non-significant. Angle α increased at 1 h (28%) and remained increased for 24 h (25%). In group 3 (NS), only R was temporarily affected. MA increased significantly at 24 h only in the VAE alone group. CONCLUSION: As expected, VAE produced a consistent and significant hypercoagulable response diagnosed/confirmed by TEG. Mexiletine prevented the MA elevation seen with VAE and corrected R and K time at 24 h, whereas angle α remained unchanged. Mexiletine seemed to attenuate the hypercoagulability associated with VAE in this experiment. These results may have potential clinical applications and deserve further investigation.
[Mh] Termos MeSH primário: Anestésicos Locais/farmacologia
Transtornos da Coagulação Sanguínea/diagnóstico
Transtornos da Coagulação Sanguínea/etiologia
Embolia Aérea/sangue
Mexiletina/farmacologia
Tromboelastografia
[Mh] Termos MeSH secundário: Análise de Variância
Animais
Transtornos da Coagulação Sanguínea/prevenção & controle
Distribuição Aleatória
Ratos
Ratos Sprague-Dawley
Cloreto de Sódio
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local); 1U511HHV4Z (Mexiletine); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.28920/dhm47.4.228-232


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[PMID]:29235792
[Au] Autor:Danilova VM; Vynogradova RP; Chernysh IY
[Ti] Título:[Inventive activity of the Departments of Chemistry and Biochemistry of Enzymes, and Protein Structure and Function of the Palladin Institute of Biochemistry of NAS of Ukraine. Part III. Diagnostic test-systems for analysis of fibrinolysis blood system and novel approaches to thrombosis treatment].
[So] Source:Ukr Biochem J;88(4):129-37, 2016 Jul-Aug.
[Is] ISSN:2409-4943
[Cp] País de publicação:Ukraine
[La] Idioma:rus; ukr
[Ab] Resumo:This article continues analysis of scientific achievements of the Institute of Biochemistry in the study of hemostasis system. Two previous articles were focused on the studies of blood coagulation proteins and development of the immune-enzyme test-systems for evaluation of the risk of thrombosis upon various pathologies. This article highlights the research on the blood fibrinolysis system and new approaches to thrombosis treatment, which were developed (and are under development) in the Palladin Institute of Biochemistry of the NAS of Ukraine, in particular, in the Department of Chemistry and Biochemistry of Enzymes headed previously by Dr.Sci.(Biol.) S. O. Kudinov and now by Dr.Sci.(Biol.) T .V. Grinenko, and also in the Department of Protein Structure and Function headed by Dr.Biol.Sci. E. M. Makogonenko. The fundamental knowledge of protein molecule functions and mechanisms of regulation of blood coagulation and fibrinolysis opens up new opportunities to diagnose hemostasis disorders and control the effectiveness of the cardiovascular disease treatment and also contributes to development of new techniques for isolation of new proteins ­ promising therapeutic agents.
[Mh] Termos MeSH primário: Academias e Institutos/história
Bioquímica/história
Transtornos da Coagulação Sanguínea/diagnóstico
Testes Diagnósticos de Rotina/história
Invenções/história
[Mh] Termos MeSH secundário: Bioquímica/recursos humanos
Transtornos da Coagulação Sanguínea/história
Fibrinólise/fisiologia
História do Século XX
História do Século XXI
Seres Humanos
Ucrânia
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.15407/ubj88.04.129


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[PMID]:29235336
[Au] Autor:Lugovska NE
[Ti] Título:[Inventive activity of the Departments of Protein Structure and Function, and Molecular Immunology of the Palladin Institute of Biochemistry of NAS of Ukraine. Part II. National breakthrough in the study and diagnostics of human hemostasis system].
[So] Source:Ukr Biochem J;88(3):106-18, 2016 May-Jun.
[Is] ISSN:2409-4943
[Cp] País de publicação:Ukraine
[La] Idioma:rus; ukr
[Ab] Resumo:The scientists of Protein Structure and Function, and Molecular Immunology Departments of the Palladin Institute of Biochemistry (NAS of Ukraine) under the supervision of member of NASU and NAMSU, prof. S. V. Komisarenko and corresponding member of NASU prof. E. V. Lugovskoy have made the real breakthrough in the field of research of the mechanisms of fibrin polymerization and formation of fibrin framework of thrombi. The immunodiagnostic test-systems for the evaluation of the risk of thrombus formation were developed for the first time. Researches have obtained the monoclonal antibodies to fibrinogen, fibrin, D-dimer and their fragments. These monoclonal antibodies were used as molecular probes for the localization of newly detected fibrin polymerization sites. Obtained antibodies with high affinity interact with fibrinogen, D-dimer and soluble fibrin ­ main markers of the risk of thrombus formation. They were used for the development of the immunodiagnostic test-systems to quantify these markers in human blood plasma for the evaluation of the state of haemostasis system, detection of prethrombotic states, disseminated intravascular coagulation, detection of thrombosis and monitoring of antithrombotic and fibrinolytic therapy. The successful trial of developed test-systems was carried out in clinics of Ukraine, and the State registration was obtained for the implementation of them into the clinical practice. Presented works were awarded State prize of Ukraine in Science and technology.
[Mh] Termos MeSH primário: Academias e Institutos/história
Alergia e Imunologia/história
Bioquímica/história
Transtornos da Coagulação Sanguínea/diagnóstico
Invenções/história
[Mh] Termos MeSH secundário: Alergia e Imunologia/recursos humanos
Bioquímica/recursos humanos
Transtornos da Coagulação Sanguínea/história
História do Século XX
História do Século XXI
Seres Humanos
Ucrânia
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.15407/ubj88.03.106


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[PMID]:29261771
[Au] Autor:Naumann DN; Hazeldine J; Dinsdale RJ; Bishop JR; Midwinter MJ; Harrison P; Hutchings SD; Lord JM
[Ad] Endereço:Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom.
[Ti] Título:Endotheliopathy is associated with higher levels of cell-free DNA following major trauma: A prospective observational study.
[So] Source:PLoS One;12(12):e0189870, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cell free deoxyribonucleic acid (cfDNA) has been proposed as a biomarker of secondary complications following trauma. Raised thrombomodulin and syndecan-1 levels have been used to indicate endotheliopathy, and are associated with inflammation, coagulopathy, and mortality. The current study aimed to analyse the association between cfDNA and biomarkers of endotheliopathy in a cohort of trauma patients, and whether raised levels of cfDNA were associated with poorer clinical outcomes. METHODS: Serum thrombomodulin and syndecan-1 were used as biomarkers of endotheliopathy and compared to plasma cfDNA in trauma patients from two prospective longitudinal observational studies. Cohort A (n = 105) had a predicted injury severity score (ISS) >8, and had blood sampled within 1h of injury and at 4-12h. Cohort B (n = 17) had evidence of haemorrhagic shock, and had blood sampled at a median time of 3.5h after injury. Relationships between biomarkers were tested using multivariable linear regression models that included the covariates of gender, age, ISS, Glasgow Coma Scale, lactate, systolic blood pressure, and heart rate. A model was fitted to investigate whether changes in cfDNA were associated with similar changes in endothelial biomarkers. RESULTS: The mean age was 41 (SD 19), and the median ISS was 25 (IQR 12-34). There was a significant association between cfDNA levels and both syndecan-1 and thrombomodulin levels (both p<0.001). This was independent of all covariates except for ISS, which significantly correlated with cfDNA levels. 50 ng/ml change in syndecan-1 and 1 ng/ml change in thrombomodulin corresponded to 15% and 20% increases in cfDNA levels respectively (both p<0.001). Patients who died had significantly higher prehospital and in-hospital cfDNA levels (both p<0.05). CONCLUSIONS: Raised cfDNA levels are associated with markers of endotheliopathy following trauma, and are associated with mortality. This relationship is present within the first hour of injury, and a change in one biomarker level is reflected by similar changes in the others. These findings are in keeping with the hypothesis that circulating DNA and endothelial injury share a common pathway following trauma.
[Mh] Termos MeSH primário: Ácidos Nucleicos Livres/sangue
Endotélio Vascular/patologia
Ferimentos e Lesões/sangue
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Transtornos da Coagulação Sanguínea/sangue
Transfusão de Sangue
Feminino
Seres Humanos
Tempo de Internação
Masculino
Estudos Prospectivos
Sindecana-1/sangue
Trombomodulina/metabolismo
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0 (Cell-Free Nucleic Acids); 0 (Syndecan-1); 0 (THBD protein, human); 0 (Thrombomodulin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189870


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[PMID]:29245350
[Au] Autor:Wu X; Zhao P; Dong L; Zhang X
[Ad] Endereço:aDepartment of Pharmacy, Ruijin Hospital Suzhou Branch Affiliated to Shanghai Jiaotong University School of MedicinebDepartment of Pharmacy, Jiangsu Shengze Hospital, SuzhoucDepartment of Critical Care MedicinedDepartment of Pharmacy, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, PR China.
[Ti] Título:A case report of patient with severe acute cholangitis with tigecycline treatment causing coagulopathy and hypofibrinogenemia.
[So] Source:Medicine (Baltimore);96(49):e9124, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Tigecycline is the first member of the glycylcycline family. There are rarely reports of tigecycline causing coagulopathy and hypofibrinogenemia until now. We report a case on tigecycline-associated coagulopathy and hypofibrinogenemia and discuss the characteristics of the adverse reaction. PATIENT CONCERNS: A 47-year-old male patient with severe acute cholangitis who developed sepsis was treated with a high dosage (100 mg twice daily) of tigecycline. He experienced coagulopathy and hypofibrinogenemia as substantiated by increased levels of prolonged prothrombin time (PT), the international normalized ratio (INR) and activated partial thromboplastin time (APTT), and in particular, the fibrinogen (FIB) levels obviously decreased. DIAGNOSES: Coagulopathy and hypofibrinogenemia. INTERVENTIONS: We discontinued tigecycline and gave the patient several blood products to prevent spontaneous bleeding. OUTCOMES: The adverse reaction disappeared after the withdrawal of tigecycline. After 30 days of hospitalization, the patient discharged with symptom free. LESSONS: We suggest that coagulation parameters should be closely monitored in patients treated with tigecycline, specifically in patients who may be renal insufficiency, female or use the high-dose.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Transtornos da Coagulação Sanguínea/induzido quimicamente
Minociclina/análogos & derivados
[Mh] Termos MeSH secundário: Afibrinogenemia/induzido quimicamente
Antibacterianos/uso terapêutico
Colangite/complicações
Seres Humanos
Masculino
Meia-Idade
Minociclina/efeitos adversos
Minociclina/uso terapêutico
Sepse/tratamento farmacológico
Sepse/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 70JE2N95KR (tigecycline); FYY3R43WGO (Minocycline)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009124


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[PMID]:29190254
[Au] Autor:Moore HB; Moore EE; Huebner BR; Dzieciatkowska M; Stettler GR; Nunns GR; Lawson PJ; Ghasabyan A; Chandler J; Banerjee A; Silliman C; Sauaia A; Hansen KC
[Ad] Endereço:From the Department of Surgery (H.B.M., E.E.M., B.R.H., M.D., G.R.S., G.R.N., P.J.L., A.B., C.S., A.S., K.C.H.), University of Colorado; Denver Health Medical Center (E.E.M., A.G., J.C.); and University of Colorado School of Public Health (A.S.), Denver, Colorado.
[Ti] Título:Fibrinolysis shutdown is associated with a fivefold increase in mortality in trauma patients lacking hypersensitivity to tissue plasminogen activator.
[So] Source:J Trauma Acute Care Surg;83(6):1014-1022, 2017 Dec.
[Is] ISSN:2163-0763
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fibrinolysis shutdown (SD) is an independent risk factor for increased mortality in trauma. High levels of plasminogen activator inhibitor-1 (PAI-1) directly binding tissue plasminogen activator (t-PA) is a proposed mechanism for SD; however, patients with low PAI-1 levels present to the hospital with a rapid TEG (r-TEG) LY30 suggestive SD. We therefore hypothesized that two distinct phenotypes of SD exist, one, which is driven by t-PA inhibition, whereas another is due to an inadequate t-PA release in response to injury. METHODS: Trauma activations from our Level I center between 2014 and 2016 with blood collected within an hour of injury were analyzed with r-TEG and a modified TEG assay to quantify fibrinolysis sensitivity using exogenous t-PA (t-TEG). Using the existing r-TEG thresholds for SD (<0.9%), physiologic (LY30 0.9-2.9%), and hyperfibrinolysis (LY30 > 2.9%) patients were stratified into phenotypes. A t-TEG LY30 greater than 95th percentile of healthy volunteers (n = 140) was classified as t-PA hypersensitive and used to subdivide phenotypes. A nested cohort had t-PA and PAI-1 activity levels measured in addition to proteomic analysis of additional fibrinolytic regulators. RESULTS: This study included 398 patients (median New Injury Severity Score, 18), t-PA-Sen was present in 27% of patients. Shutdown had the highest mortality rate (20%) followed by hyperfibinolysis (16%) and physiologic (9% p = 0.020). In the non-t-PA hypersensitive cohort, SD had a fivefold increase in mortality (15%) compared with non-SD patients (3%; p = 0.003) which remained significant after adjusting for Injury Severity Score and age (p = 0.033). Overall t-PA activity (p = 0.002), PAI-1 (p < 0.001), and t-PA/PAI-1 complex levels (p = 0.006) differed between the six phenotypes, and 54% of fibrinolytic regulator proteins analyzed (n = 19) were significantly different. CONCLUSION: In conclusion, acute fibrinolysis SD is not caused by a single etiology, and is clearly associated with PAI-1 activity. The differential phenotypes require an ongoing investigation to identify the optimal resuscitation strategy for these patients. LEVEL OF EVIDENCE: Prognostic, level III.
[Mh] Termos MeSH primário: Transtornos da Coagulação Sanguínea/sangue
Fibrinólise/fisiologia
Inibidor 1 de Ativador de Plasminogênio/sangue
Ferimentos e Lesões/complicações
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Transtornos da Coagulação Sanguínea/etiologia
Transtornos da Coagulação Sanguínea/mortalidade
Ensaio de Imunoadsorção Enzimática
Feminino
Seguimentos
Seres Humanos
Escala de Gravidade do Ferimento
Masculino
Meia-Idade
Fenótipo
Prognóstico
Estudos Prospectivos
Proteômica
Tromboelastografia
Ferimentos e Lesões/sangue
Ferimentos e Lesões/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0 (Plasminogen Activator Inhibitor 1)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1097/TA.0000000000001718


  9 / 13468 MEDLINE  
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[PMID]:29132583
[Au] Autor:Harris T; Davenport R; Mak M; Brohi K
[Ad] Endereço:Emergency Medicine, Barts Health NHS Trust, Queen Mary University of London, London, UK.
[Ti] Título:The Evolving Science of Trauma Resuscitation.
[So] Source:Emerg Med Clin North Am;36(1):85-106, 2018 Feb.
[Is] ISSN:1558-0539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This review summarizes the evolution of trauma resuscitation from a one-size-fits-all approach to one tailored to patient physiology. The most dramatic change is in the management of actively bleeding patients, with a balanced blood product-based resuscitation approach (avoiding crystalloids) and surgery focused on hemorrhage control, not definitive care. When hemostasis has been achieved, definitive resuscitation to restore organ perfusion is initiated. This approach is associated with decreased mortality, reduced duration of stay, improved coagulation profile, and reduced crystalloid/vasopressor use. This article focuses on the tools and methods used for trauma resuscitation in the acute phase of trauma care.
[Mh] Termos MeSH primário: Ressuscitação
Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Pesquisa Biomédica
Transtornos da Coagulação Sanguínea/etiologia
Transtornos da Coagulação Sanguínea/terapia
Lesões Encefálicas Traumáticas/complicações
Lesões Encefálicas Traumáticas/terapia
Hemorragia/etiologia
Hemorragia/terapia
Seres Humanos
Ressuscitação/métodos
Choque/diagnóstico
Choque/etiologia
Choque/terapia
Ferimentos e Lesões/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171115
[St] Status:MEDLINE


  10 / 13468 MEDLINE  
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[PMID]:28957937
[Au] Autor:Bidwell J
[Ad] Endereço:Josie Bidwell is assistant professor of nursing at the University of Mississippi Medical Center and a member of the Cochrane Nursing Care Field.
[Ti] Título:Plasma Transfusions Prior to Central Line Placement in People with Abnormal Coagulation.
[So] Source:Am J Nurs;117(10):67, 2017 Oct.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.
[Mh] Termos MeSH primário: Transtornos da Coagulação Sanguínea/enfermagem
Transfusão de Componentes Sanguíneos/enfermagem
Cateterismo Venoso Central/enfermagem
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000525882.97348.0a



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