Scholars@Duke
Jerrold Henry Levy

Jerrold Henry Levy

Professor of Anesthesiology
Anesthesiology, Cardiothoracic
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Selected Publications

Perioperative considerations in the paediatric patient with congenital and acquired coagulopathy

Journal Article BJA Open · December 1, 2024 Neonates, infants, and children undergoing major surgery or with trauma can develop severe coagulopathy perioperatively. Neonates and infants are at highest risk because their haemostatic system is not fully developed and underlying inherited bleeding diso ... Full text Cite

Heparins May Not Be the Optimal Anticoagulants for Sepsis and Sepsis-Associated Disseminated Intravascular Coagulation.

Journal Article Semin Thromb Hemost · October 2024 Historically, heparin has had the longest historical use as an anticoagulant and continues this day to be the primary therapeutic option for preventing thrombosis and thromboembolism in critically ill hospitalized patients. Heparin is also used to treat se ... Full text Link to item Cite

Incidence of heparin resistance and heparin failure in patients receiving extracorporeal membrane oxygenation: an exploratory retrospective analysis.

Journal Article J Thromb Haemost · October 2024 BACKGROUND: Unfractionated heparin (UFH) is used in most centers for extracorporeal membrane oxygenation (ECMO) anticoagulation. When standard doses do not achieve desired target values, heparin resistance is reported, most commonly defined as doses of UFH ... Full text Link to item Cite

Reversal of direct oral anticoagulants: guidance from the SSC of the ISTH.

Journal Article J Thromb Haemost · October 2024 The currently approved direct oral anticoagulants (DOACs) are increasingly used in clinical practice. Although serious bleeding risks are lower with DOACs than with vitamin K antagonists, bleeding remains the most frequent side effect. Andexanet alfa and i ... Full text Link to item Cite

Impact of Wildfire Smoke on Acute Illness.

Journal Article Anesthesiology · October 1, 2024 Full text Open Access Link to item Cite

Sepsis-induced coagulopathy (SIC) in the management of sepsis.

Journal Article Ann Intensive Care · September 20, 2024 The mortality rate of sepsis remains high and further increases when complicated by disseminated intravascular coagulation (DIC). Consequently, early detection and appropriate management of DIC will be helpful for the management of sepsis. Although overt D ... Full text Link to item Cite

Acquired von Willebrand syndrome during extracorporeal membrane oxygenation support: a comprehensive review of current evidence: communication from the ISTH SSC on perioperative and critical care thrombosis and hemostasis.

Journal Article J Thromb Haemost · September 2024 During extracorporeal membrane oxygenation (ECMO) support, the high shear stress in the ECMO circuit results in increased proteolysis of von Willebrand factor (VWF), loss of VWF high-molecular-weight multimers, and impaired ability to bind to platelets and ... Full text Link to item Cite

Protocol for a phase 3, randomised, active-control study of four-factor prothrombin complex concentrate versus frozen plasma in bleeding adult cardiac surgery patients requiring coagulation factor replacement: the LEX-211 (FARES-II) trial.

Journal Article BMJ Open · August 21, 2024 INTRODUCTION: Reduced thrombin generation is an important component of post cardiopulmonary bypass (CPB) coagulopathy. To replenish coagulation factors and enhance thrombin generation in bleeding surgical patients, frozen plasma (FP) and four-factor prothr ... Full text Link to item Cite

Perioperative anaphylaxis: updates on pathophysiology.

Journal Article Curr Opin Allergy Clin Immunol · August 1, 2024 PURPOSE OF REVIEW: Perioperative anaphylaxis has historically been attributed to IgE/FcεRI-mediated reactions; there is now recognition of allergic and nonallergic triggers encompassing various reactions beyond IgE-mediated responses. This review aims to p ... Full text Link to item Cite

Sepsis-induced coagulopathy: a matter of timeline.

Journal Article Intensive Care Med · August 2024 Full text Link to item Cite

Clot-Targeted Nanogels for Dual-Delivery of AntithrombinIII and Tissue Plasminogen Activator to Mitigate Disseminated Intravascular Coagulation Complications.

Journal Article ACS Nano · June 18, 2024 Disseminated intravascular coagulation (DIC) is a pathologic state that follows systemic injury and other diseases. Often a complication of sepsis or trauma, DIC causes coagulopathy associated with paradoxical thrombosis and hemorrhage. DIC upregulates the ... Full text Link to item Cite

What Role Does Microthrombosis Play in Long COVID?

Journal Article Semin Thromb Hemost · June 2024 Soon after the outbreak of coronavirus disease 2019 (COVID-19), unexplained sustained fatigue, cognitive disturbance, and muscle ache/weakness were reported in patients who had recovered from acute COVID-19 infection. This abnormal condition has been recog ... Full text Link to item Cite

The role of thromboinflammation in acute kidney injury among patients with septic coagulopathy.

Journal Article J Thromb Haemost · June 2024 Inflammation and coagulation are critical self-defense mechanisms for mitigating infection that can nonetheless induce tissue injury and organ dysfunction. In severe cases, like sepsis, a dysregulated thromboinflammatory response may result in multiorgan d ... Full text Link to item Cite

Four years into the pandemic, managing COVID-19 patients with acute coagulopathy: what have we learned?

Journal Article J Thromb Haemost · June 2024 Coagulopathy alongside micro- and macrovascular thrombotic events were frequent characteristics of patients presenting with acute COVID-19 during the initial stages of the pandemic. However, over the past 4 years, the incidence and manifestations of COVID- ... Full text Link to item Cite

2023 ISTH update of the 2022 ISTH guidelines for antithrombotic treatment in COVID-19.

Journal Article J Thromb Haemost · June 2024 Based on emerging evidence from the COVID-19 pandemic, the International Society on Thrombosis and Haemostasis (ISTH) guidelines for antithrombotic treatment in COVID-19 were published in 2022. Since then, at least 16 new randomized controlled trials have ... Full text Link to item Cite

Perioperative considerations in the paediatric patient with congenital and acquired coagulopathy

Journal Article BJA Open · December 1, 2024 Neonates, infants, and children undergoing major surgery or with trauma can develop severe coagulopathy perioperatively. Neonates and infants are at highest risk because their haemostatic system is not fully developed and underlying inherited bleeding diso ... Full text Cite

Heparins May Not Be the Optimal Anticoagulants for Sepsis and Sepsis-Associated Disseminated Intravascular Coagulation.

Journal Article Semin Thromb Hemost · October 2024 Historically, heparin has had the longest historical use as an anticoagulant and continues this day to be the primary therapeutic option for preventing thrombosis and thromboembolism in critically ill hospitalized patients. Heparin is also used to treat se ... Full text Link to item Cite

Incidence of heparin resistance and heparin failure in patients receiving extracorporeal membrane oxygenation: an exploratory retrospective analysis.

Journal Article J Thromb Haemost · October 2024 BACKGROUND: Unfractionated heparin (UFH) is used in most centers for extracorporeal membrane oxygenation (ECMO) anticoagulation. When standard doses do not achieve desired target values, heparin resistance is reported, most commonly defined as doses of UFH ... Full text Link to item Cite

Reversal of direct oral anticoagulants: guidance from the SSC of the ISTH.

Journal Article J Thromb Haemost · October 2024 The currently approved direct oral anticoagulants (DOACs) are increasingly used in clinical practice. Although serious bleeding risks are lower with DOACs than with vitamin K antagonists, bleeding remains the most frequent side effect. Andexanet alfa and i ... Full text Link to item Cite

Impact of Wildfire Smoke on Acute Illness.

Journal Article Anesthesiology · October 1, 2024 Full text Open Access Link to item Cite

Sepsis-induced coagulopathy (SIC) in the management of sepsis.

Journal Article Ann Intensive Care · September 20, 2024 The mortality rate of sepsis remains high and further increases when complicated by disseminated intravascular coagulation (DIC). Consequently, early detection and appropriate management of DIC will be helpful for the management of sepsis. Although overt D ... Full text Link to item Cite

Acquired von Willebrand syndrome during extracorporeal membrane oxygenation support: a comprehensive review of current evidence: communication from the ISTH SSC on perioperative and critical care thrombosis and hemostasis.

Journal Article J Thromb Haemost · September 2024 During extracorporeal membrane oxygenation (ECMO) support, the high shear stress in the ECMO circuit results in increased proteolysis of von Willebrand factor (VWF), loss of VWF high-molecular-weight multimers, and impaired ability to bind to platelets and ... Full text Link to item Cite

Protocol for a phase 3, randomised, active-control study of four-factor prothrombin complex concentrate versus frozen plasma in bleeding adult cardiac surgery patients requiring coagulation factor replacement: the LEX-211 (FARES-II) trial.

Journal Article BMJ Open · August 21, 2024 INTRODUCTION: Reduced thrombin generation is an important component of post cardiopulmonary bypass (CPB) coagulopathy. To replenish coagulation factors and enhance thrombin generation in bleeding surgical patients, frozen plasma (FP) and four-factor prothr ... Full text Link to item Cite

Perioperative anaphylaxis: updates on pathophysiology.

Journal Article Curr Opin Allergy Clin Immunol · August 1, 2024 PURPOSE OF REVIEW: Perioperative anaphylaxis has historically been attributed to IgE/FcεRI-mediated reactions; there is now recognition of allergic and nonallergic triggers encompassing various reactions beyond IgE-mediated responses. This review aims to p ... Full text Link to item Cite

Sepsis-induced coagulopathy: a matter of timeline.

Journal Article Intensive Care Med · August 2024 Full text Link to item Cite

Clot-Targeted Nanogels for Dual-Delivery of AntithrombinIII and Tissue Plasminogen Activator to Mitigate Disseminated Intravascular Coagulation Complications.

Journal Article ACS Nano · June 18, 2024 Disseminated intravascular coagulation (DIC) is a pathologic state that follows systemic injury and other diseases. Often a complication of sepsis or trauma, DIC causes coagulopathy associated with paradoxical thrombosis and hemorrhage. DIC upregulates the ... Full text Link to item Cite

What Role Does Microthrombosis Play in Long COVID?

Journal Article Semin Thromb Hemost · June 2024 Soon after the outbreak of coronavirus disease 2019 (COVID-19), unexplained sustained fatigue, cognitive disturbance, and muscle ache/weakness were reported in patients who had recovered from acute COVID-19 infection. This abnormal condition has been recog ... Full text Link to item Cite

The role of thromboinflammation in acute kidney injury among patients with septic coagulopathy.

Journal Article J Thromb Haemost · June 2024 Inflammation and coagulation are critical self-defense mechanisms for mitigating infection that can nonetheless induce tissue injury and organ dysfunction. In severe cases, like sepsis, a dysregulated thromboinflammatory response may result in multiorgan d ... Full text Link to item Cite

Four years into the pandemic, managing COVID-19 patients with acute coagulopathy: what have we learned?

Journal Article J Thromb Haemost · June 2024 Coagulopathy alongside micro- and macrovascular thrombotic events were frequent characteristics of patients presenting with acute COVID-19 during the initial stages of the pandemic. However, over the past 4 years, the incidence and manifestations of COVID- ... Full text Link to item Cite

2023 ISTH update of the 2022 ISTH guidelines for antithrombotic treatment in COVID-19.

Journal Article J Thromb Haemost · June 2024 Based on emerging evidence from the COVID-19 pandemic, the International Society on Thrombosis and Haemostasis (ISTH) guidelines for antithrombotic treatment in COVID-19 were published in 2022. Since then, at least 16 new randomized controlled trials have ... Full text Link to item Cite

Antithrombin supplementation attenuates heparin resistance in plasma spiked with Gla-domainless factor Xa S195A in vitro.

Journal Article Br J Anaesth · June 2024 BACKGROUND: Andexanet alfa is a Gla-domainless mutant (S195A) factor Xa (GDXa) approved for acute reversal of oral factor Xa inhibitors. Cardiac surgery patients exposed to andexanet before cardiopulmonary bypass often exhibit severe heparin resistance. Th ... Full text Link to item Cite

Managing sepsis and septic shock in an endothelial glycocalyx-friendly way: from the viewpoint of surviving sepsis campaign guidelines.

Journal Article Ann Intensive Care · April 24, 2024 Maintaining tissue perfusion in sepsis depends on vascular integrity provided by the endothelial glycocalyx, the critical layer covering the luminal surface of blood vessels. The glycocalyx is composed of proteoglycans, glycosaminoglycans, and functional p ... Full text Link to item Cite

Finding a common definition of heparin resistance in adult cardiac surgery: communication from the ISTH SSC subcommittee on perioperative and critical care thrombosis and hemostasis.

Journal Article J Thromb Haemost · April 2024 Ensuring adequate anticoagulation for patients requiring cardiac surgery and cardiopulmonary bypass (CPB) is important due to the adverse consequences of inadequate anticoagulation with respect to bleeding and thrombosis. When target anticoagulation is not ... Full text Open Access Link to item Cite

Thromboinflammation and microcirculation damage in heatstroke.

Journal Article Minerva Med · April 2024 Rising temperatures associated with climate change have significantly increased the risk of heatstroke. Unfortunately, the trend is anticipated to persist and increasingly threaten vulnerable populations, particularly older adults. According to Japan's env ... Full text Link to item Cite

Between a rock and a hard place: anticoagulation management for ECMO.

Journal Article Med Klin Intensivmed Notfmed · March 8, 2024 Anticoagulation is an essential component of optimal extracorporeal membrane oxygenation (ECMO) management. Unfractionated heparin is still the anticoagulant of choice in most centers due to longstanding familiarity with the agent. Disadvantages include al ... Full text Link to item Cite

Andexanet alfa or prothrombin complex concentrate for acute reversal of oral factor Xa inhibitors: monitoring of antidote effects.

Journal Article Br J Anaesth · February 2024 This study in vitro comprehensively assessed reversal of the anticoagulant effects of rivaroxaban, an oral factor Xa inhibitor, using andexanet alfa and various prothrombin complex concentrate (PCC) products in a battery of tests. In static coagulation ass ... Full text Link to item Cite

Thromboinflammation in acute injury: infections, heatstroke, and trauma.

Journal Article J Thromb Haemost · January 2024 Tissue microcirculation is essential for the maintenance of organ homeostasis. Following acute infections, activation of coagulation and inflammation, which are critical interconnected responses, lead to thromboinflammation and microthrombosis, thereby con ... Full text Link to item Cite

Droxidopa or Atomoxetine for Refractory Hypotension in Critically Ill Cardiothoracic Surgery Patients.

Journal Article J Cardiothorac Vasc Anesth · January 2024 OBJECTIVE: To evaluate the effects of droxidopa or atomoxetine on intravenous (IV) vasoactive agent discontinuation in cardiothoracic intensive care unit (ICU) patients with hypotension refractory to midodrine. DESIGN: Single-center, retrospective cohort s ... Full text Link to item Cite

Endothelial Glycocalyx Protection in Sepsis

Journal Article Juntendo Medical Journal · 2024 Full text Cite

Why is DIC a Rare Diagnosis in the 21<sup>st</sup> Century?

Journal Article Juntendo Medical Journal · 2024 Full text Cite

Risk stratification utilizing sequential organ failure assessment (SOFA) score, antithrombin activity, and demographic data in sepsis-associated disseminated intravascular coagulation (DIC).

Journal Article Sci Rep · December 15, 2023 Disseminated intravascular coagulation (DIC) is a frequent complication in patients with sepsis and is associated with increased mortality. Anticoagulant therapy may be appropriate for certain patients with DIC, particularly those with increased disease se ... Full text Link to item Cite

Hemostatic capability of ultrafiltrated fresh frozen plasma compared to cryoprecipitate.

Journal Article Sci Rep · December 7, 2023 This in vitro study evaluated the potential hemostatic effect of fresh frozen plasma (FFP) ultrafiltration on clotting factors, coagulation parameters, and plasma properties. ABO-specific units of FFP (n = 40) were prepared for the concentrated FFP and cry ... Full text Link to item Cite

Defining heparin resistance: communication from the ISTH SSC Subcommittee of Perioperative and Critical Care Thrombosis and Hemostasis.

Journal Article J Thromb Haemost · December 2023 The term heparin resistance (HR) is used by clinicians without specific criteria. We performed a literature search and surveyed our SSC membership to better define the term when applied to medical and intensive care unit patients. The most common heparin d ... Full text Open Access Link to item Cite

Mechanisms and management of the coagulopathy of trauma and sepsis: trauma-induced coagulopathy, sepsis-induced coagulopathy, and disseminated intravascular coagulation.

Journal Article J Thromb Haemost · December 2023 Disseminated intravascular coagulation can occur due to different causes but commonly following sepsis. Trauma-induced coagulopathy (TIC) occurs on hospital arrival in approximately 25% of seriously injured patients who initially presents with impaired hem ... Full text Link to item Cite

Dabigatran in Rabbit Cardiopulmonary Bypass: Comment.

Journal Article Anesthesiology · December 1, 2023 Full text Link to item Cite

The antithrombin activity recovery after substitution therapy is associated with improved 28-day mortality in patients with sepsis-associated disseminated intravascular coagulation.

Journal Article Thromb J · November 2, 2023 BACKGROUND: Disseminated intravascular coagulation (DIC) is a common and critical complication in sepsis. Antithrombin activity, which is considered a biomarker for disease severity, was measured in septic DIC treated with antithrombin concentrates in this ... Full text Link to item Cite

Randomized, Active-Control Phase 3 Study of Four-Factor Prothrombin Complex Concentrate Versus Frozen Plasma in Bleeding Adult Cardiac Surgery Patients

Conference Blood · November 2, 2023 Background and Significance: Patients following cardiac surgery often develop coagulopathic bleeding and associated poor outcomes. The development of coagulopathy is multifactorial, including anticoagulation, hemorrhage ... Full text Cite

The role of platelets in heat-related illness and heat-induced coagulopathy.

Journal Article Thromb Res · November 2023 Heat-related illness is becoming more problematic due to ongoing global warming. Heat-related injury causes systemic inflammation and coagulopathy, due to leukocyte, platelet, and vascular endothelial cell activation and injury. Hyperthermia directly modul ... Full text Link to item Cite

Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery.

Journal Article Circulation · October 24, 2023 BACKGROUND: Right ventricular failure (RVF) is a leading driver of morbidity and death after major cardiac surgery for advanced heart failure, including orthotopic heart transplantation and left ventricular assist device implantation. Inhaled pulmonary-sel ... Full text Open Access Link to item Cite

In vitro effects of Gla-domainless factor Xa analog on procoagulant and fibrinolytic pathways in apixaban-treated plasma and whole blood.

Journal Article Thromb Res · October 2023 BACKGROUND: Andexanet alfa is a Gla-domainless FXa (GDXa) analog used as an antidote to FXa inhibitors. Despite its clinical use, laboratory monitoring for anti-Xa reversal and the effect of andexanet on fibrinolysis has not been explored. We used a GDXa w ... Full text Link to item Cite

Perioperative Anaphylaxis: Reply.

Journal Article Anesthesiology · September 1, 2023 Full text Link to item Cite

Management of patients on antithrombotic therapy with severe infections: a joint clinical consensus statement of the ESC Working Group on Thrombosis, the ESC Working Group on Atherosclerosis and Vascular Biology, and the International Society on Thrombosis and Haemostasis.

Journal Article Eur Heart J · August 22, 2023 Patients with severe infections and a pre-existing indication for antithrombotic therapy, i.e. antiplatelet agents, anticoagulant drugs, or their combinations, require integrated clinical counselling among coagulation, infectious disease, and cardiology sp ... Full text Link to item Cite

Epinephrine-induced Effects on Cerebral Microcirculation and Oxygenation Dynamics Using Multimodal Monitoring and Functional Photoacoustic Microscopy.

Journal Article Anesthesiology · August 1, 2023 BACKGROUND: The administration of epinephrine after severe refractory hypotension, shock, or cardiac arrest restores systemic blood flow and major vessel perfusion but may worsen cerebral microvascular perfusion and oxygen delivery through vasoconstriction ... Full text Link to item Cite

Direct oral anticoagulants and their antagonists in perioperative practice.

Journal Article Curr Opin Anaesthesiol · August 1, 2023 PURPOSE OF REVIEW: Review management strategies for patients receiving nonvitamin K direct-acting oral anticoagulants (DOACs). RECENT FINDINGS: Updated clinical trials and guidelines continue to further define optimal management for patients on DOACs requi ... Full text Link to item Cite

What's fishy about protamine? Clinical use, adverse reactions, and potential alternatives.

Journal Article J Thromb Haemost · July 2023 Protamine, a highly basic protein isolated from salmon sperm, is the only clinically available agent to reverse the anticoagulation of unfractionated heparin. Following intravenous administration, protamine binds to heparin in a nonspecific electrostatic i ... Full text Open Access Link to item Cite

Sepsis-Induced Coagulopathy and Disseminated Intravascular Coagulation: What We Need to Know and How to Manage for Prolonged Casualty Care.

Journal Article J Spec Oper Med · June 23, 2023 Coagulopathy can occur in trauma, and it can affect septic patients as a host tries to respond to infection. Sometimes, it can lead to disseminated intravascular coagulopathy (DIC) with a high potential for mortality. New research has delineated risk facto ... Full text Link to item Cite

The pathophysiology, diagnosis, and management of sepsis-associated disseminated intravascular coagulation.

Journal Article J Intensive Care · May 23, 2023 BACKGROUND: The International Society on Thrombosis and Haemostasis (ISTH) released overt disseminated intravascular coagulation (DIC) diagnostic criteria in 2001. Since then, DIC has been understood as the end-stage consumptive coagulopathy and not the th ... Full text Link to item Cite

Perioperative Considerations in Management of the Severely Bleeding Coagulopathic Patient.

Journal Article Anesthesiology · May 1, 2023 Inherited and acquired coagulopathy are frequently associated with major bleeding in severe trauma, cardiac surgery with cardiopulmonary bypass, and postpartum hemorrhage. Perioperative management is multifactorial and includes preoperative optimization an ... Full text Open Access Link to item Cite

In Vitro Treatment of Extracorporeal Membrane Oxygenation Coagulopathy with Recombinant von Willebrand Factor or Lyophilized Platelets.

Journal Article J Cardiothorac Vasc Anesth · April 2023 OBJECTIVES: The objective was to compare primary hemostasis between adult ECMO patients and cardiac surgical patients before heparinization and cardiopulmonary bypass. Furthermore, the authors explored whether in vitro treatment of ECMO patient blood sampl ... Full text Link to item Cite

Renal Dysfunction and Arrhythmia Association in Patients Receiving Milrinone After Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · March 2023 OBJECTIVE: The altered pharmacokinetics of milrinone in renal impairment could result in an increased risk of cardiac arrhythmias. This study aimed to determine if there is an association between new-onset arrhythmias and renal impairment after cardiac sur ... Full text Link to item Cite

Inflammation, coagulation, and cellular injury in heat-induced shock.

Journal Article Inflamm Res · March 2023 BACKGROUND: The number of heatstroke victims hit record numbers in 2022 as global warming continues. In heat-induced injuries, circulatory shock is the most severe and deadly complication. This review aims to examine the mechanisms and potential approaches ... Full text Link to item Cite

Communication from the Scientific Standardization Committees of the International Society on Thrombosis and Haemostasis on vascular endothelium-related biomarkers in disseminated intravascular coagulation.

Journal Article J Thromb Haemost · March 2023 Disseminated intravascular coagulation (DIC) is not a disease criterion but a pathomechanistic process that accompanies various underlying diseases. According to the International Society on Thrombosis and Haemostasis definition, endothelial injury is an e ... Full text Link to item Cite

How to manage coagulopathies in critically ill patients.

Journal Article Intensive Care Med · March 2023 Coagulopathy is a severe and frequent complication in critically ill patients, for which the pathogenesis and presentation may be variable depending on the underlying disease. Based on the dominant clinical phenotype, the current review differentiates betw ... Full text Link to item Cite

Platelet Activation and Thrombosis in COVID-19.

Journal Article Semin Thromb Hemost · February 2023 Although thrombosis frequently occurs in infectious diseases, the coagulopathy associated with COVID-19 has unique characteristics. Compared with bacterial sepsis, COVID-19-associated coagulopathy presents with minimal changes in platelet counts, normal pr ... Full text Link to item Cite

Anticoagulation in adult patients supported with extracorporeal membrane oxygenation: guidance from the Scientific and Standardization Committees on Perioperative and Critical Care Haemostasis and Thrombosis of the International Society on Thrombosis and Haemostasis.

Journal Article J Thromb Haemost · February 2023 Anticoagulation of patients supported by extracorporeal membrane oxygenation is challenging because of a high risk of both bleeding and thrombotic complications, and often empirical. Practice in anticoagulation management is therefore highly variable. The ... Full text Link to item Cite

Perioperative Anaphylaxis.

Journal Article Anesthesiology · January 1, 2023 Full text Link to item Cite

Communication from the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis on sepsis-induced coagulopathy in the management of sepsis.

Journal Article J Thromb Haemost · January 2023 Disseminated intravascular coagulation (DIC) is a life-threatening complication in sepsis and other critical conditions. The International Society on Thrombosis and Haemostasis (ISTH) released the diagnostic criteria for overt DIC in 2001. Since then, ISTH ... Full text Link to item Cite

Viscoelastic testing: an illustrated review of technology and clinical applications.

Journal Article Res Pract Thromb Haemost · January 2023 Viscoelastic testing (VET), including thromboelastography and thromboelastometry, provides a rapid and comprehensive picture of whole blood coagulation dynamics and hemostasis that can be reviewed and evaluated at the point-of-care. This technology is over ... Full text Link to item Cite

Thrombin generation, bleeding and hemostasis in humans: Protocol for a scoping review of the literature.

Journal Article PLoS One · 2023 INTRODUCTION: Hemostasis and bleeding are difficult to measure. Thrombin generation assays (TGAs) can measure both procoagulant and anticoagulant contributions to coagulation. TGAs might prove useful for the study of bleeding disorders. There has been much ... Full text Link to item Cite

Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline.

Journal Article Chest · November 2022 BACKGROUND: The American College of Chest Physicians Clinical Practice Guideline on the Perioperative Management of Antithrombotic Therapy addresses 43 Patients-Interventions-Comparators-Outcomes (PICO) questions related to the perioperative management of ... Full text Link to item Cite

Intracellular communication and immunothrombosis in sepsis.

Journal Article J Thromb Haemost · November 2022 Inflammation and coagulation are the critical responses to infection that include leukocytes, platelets, and vascular endothelial cells responding in concert to eradicate the invading pathogen. In sepsis, a variety of cell surface receptors, including toll ... Full text Link to item Cite

Executive Summary: Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline.

Journal Article Chest · November 2022 BACKGROUND: The American College of Chest Physicians Clinical Practice Guideline on the Perioperative Management of Antithrombotic Therapy addresses 43 Patients-Interventions-Comparators-Outcomes (PICO) questions related to the perioperative management of ... Full text Link to item Cite

Disseminated Intravascular Coagulation: The Past, Present, and Future Considerations.

Journal Article Semin Thromb Hemost · November 2022 Disseminated intravascular coagulation (DIC) has been understood as a consumptive coagulopathy. However, impaired hemostasis is a component of DIC that occurs in a progressive manner. The critical concept of DIC is systemic activation of coagulation with v ... Full text Link to item Cite

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of Preoperative Antithrombin Supplementation in Patients at Risk for Antithrombin Deficiency After Cardiac Surgery.

Journal Article Anesth Analg · October 1, 2022 BACKGROUND: Antithrombin (AT) activity is reduced during cardiac operations with cardiopulmonary bypass (CPB), which is associated with adverse outcomes. Preoperative AT supplementation, to achieve >58% and <100% AT activity, may potentially reduce postope ... Full text Link to item Cite

ISTH guidelines for antithrombotic treatment in COVID-19.

Journal Article J Thromb Haemost · October 2022 Antithrombotic agents reduce risk of thromboembolism in severely ill patients. Patients with coronavirus disease 2019 (COVID-19) may realize additional benefits from heparins. Optimal dosing and timing of these treatments and benefits of other antithrombot ... Full text Link to item Cite

Anticoagulation Monitoring with Activated Partial ThromboPlastin Time and Anti-Xa Activity in Intensive Care Unit Patients: Interest of Thrombin Generation Assay.

Journal Article Int J Mol Sci · September 23, 2022 Current guidelines recommend monitoring the anticoagulant effect of unfractionated heparin (UFH) by measuring anti-Xa activity rather than activated partial thromboplastin time (aPTT) in intensive care unit (ICU) patients. The primary objective of this stu ... Full text Link to item Cite

Morphological Changes in Blood Cells in a Rat Model of Heatstroke: A Pilot Study.

Journal Article J Clin Med · August 17, 2022 Despite the increasing threat of heatstroke with global warming, pathophysiologic injury continues to be defined. In addition, morphological changes of the peripheral blood cells in heatstroke have not been well characterized. We evaluated pathophysiologic ... Full text Link to item Cite

The risk of thromboembolic events with early intravenous 2- and 4-g bolus dosing of tranexamic acid compared to placebo in patients with severe traumatic bleeding: A secondary analysis of a randomized, double-blind, placebo-controlled, single-center trial.

Journal Article Transfusion · August 2022 BACKGROUND: Screening for the risk of thromboembolism (TE) due to tranexamic acid (TXA) in patients with severe traumatic injury has not been performed in randomized clinical trials. Our objective was to determine if TXA dose was independently-associated w ... Full text Link to item Cite

Management of urgent invasive procedures in patients treated with direct oral anticoagulants: An observational registry analysis.

Journal Article Thromb Res · August 2022 BACKGROUND: Patients treated with direct oral anticoagulants (DOACs) may require urgent procedures. Managing these patients is challenging due to different bleeding risks and may include laboratory testing, procedural delays, or haemostatic/reversal agent ... Full text Link to item Cite

Thrombosis and thrombocytopenia in COVID-19 and after COVID-19 vaccination.

Journal Article Trends Cardiovasc Med · July 2022 Thrombosis that occurs in coronavirus disease 19 (COVID-19) is a serious complication and a critical aspect of pathogenesis in the disease progression. Although thrombocytopenia is uncommon in the initial presentation, it may also reflect disease severity ... Full text Link to item Cite

The Predictive Value of the 4Ts and HEP Score at Recommended Cutoffs in Patients With Mechanical Circulatory Support Devices.

Journal Article J Cardiothorac Vasc Anesth · July 2022 OBJECTIVES: Despite the increasing utilization of mechanical circulatory support (MCS) devices, the 4Ts and heparin-induced thrombocytopenia (HIT) Expert Probability (HEP) scores have not been validated in patients with suspected HIT requiring MCS. DESIGN: ... Full text Link to item Cite

Suppression of Fibrinolysis and Hypercoagulability, Severity of Hypoxemia, and Mortality in COVID-19 Patients: A Retrospective Cohort Study.

Journal Article Anesthesiology · July 1, 2022 BACKGROUND: COVID-19 causes hypercoagulability, but the association between coagulopathy and hypoxemia in critically ill patients has not been thoroughly explored. This study hypothesized that severity of coagulopathy would be associated with acute respira ... Full text Link to item Cite

Heated Humidified Breathing Circuit Rewarming in Hypothermic Patients Post-Cardiopulmonary Bypass-Pilot Study.

Journal Article J Cardiothorac Vasc Anesth · April 2022 OBJECTIVES: Hypothermia on intensive care unit (ICU) admission after cardiac surgery and cardiopulmonary bypass is common. It contributes to postoperative complications including shivering, coagulopathy, increased blood loss and transfusion requirements, m ... Full text Link to item Cite

Consensus Statement: Hemostasis Trial Outcomes in Cardiac Surgery and Mechanical Support.

Journal Article Ann Thorac Surg · March 2022 BACKGROUND: Research evaluating hemostatic agents for the treatment of clinically significant bleeding has been hampered by inconsistency and lack of standardized primary clinical trial outcomes. Clinical trials of hemostatic agents in both cardiac surgery ... Full text Link to item Cite

Thrombin Generation in Cardiac Versus Noncardiac Surgical Cohorts.

Journal Article Anesth Analg · March 1, 2022 BACKGROUND: Bleeding can be a significant problem after cardiac surgery. As a result, venous thromboembolism (VTE) or anticoagulation or both following mechanical valve implantation are often delayed in these patients. The calibrated automated thrombin (CA ... Full text Link to item Cite

Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management.

Journal Article EClinicalMedicine · February 2022 Heatstroke is increasingly becoming a significant concern due to global warming. Systemic inflammation and coagulopathy are the two major factors that provoke life-threatening organ dysfunction in heatstroke. Dysregulated thermo-control induces cellular in ... Full text Link to item Cite

Nevertheless, the importance of coagulation abnormalities should be emphasized in international sepsis guidelines.

Journal Article J Intensive Care · January 21, 2022 It is generally accepted that a coagulation/fibrinolysis disorder is involved in the pathogenesis of sepsis, and the association of disseminated intravascular coagulation (DIC) and poor outcomes have been reported. Based on these findings, recently release ... Full text Link to item Cite

Recognizing Vaccine-Induced Immune Thrombotic Thrombocytopenia.

Journal Article Crit Care Med · January 1, 2022 OBJECTIVES: Vaccine-induced immune thrombotic thrombocytopenia is an unexpected consequence of the coronavirus disease 2019 pandemic era. We reviewed the pathogenesis, clinical presentation, diagnosis, and treatment of this rare side effect. DATA SOURCES: ... Full text Link to item Cite

Viral-Induced Inflammatory Coagulation Disorders: Preparing for Another Epidemic.

Journal Article Thromb Haemost · January 2022 Several viral infectious diseases have emerged or re-emerged from wildlife vectors that have generated serious threats to global health. Increased international travel and commerce increase the risk of transmission of viral or other infectious diseases. In ... Full text Link to item Cite

The roles of platelets in COVID-19-associated coagulopathy and vaccine-induced immune thrombotic thrombocytopenia.

Journal Article Trends Cardiovasc Med · January 2022 In coronavirus disease 2019 (COVID-19), multiple thromboinflammatory events contribute to the pathophysiology, including coagulation system activation, suppressed fibrinolysis, vascular endothelial cell injury, and prothrombotic alterations in immune cells ... Full text Link to item Cite

The authors reply.

Journal Article Crit Care Med · January 1, 2022 Full text Link to item Cite

Inhaled Pulmonary Vasodilator Therapy in Adult Lung Transplant: A Randomized Clinical Trial.

Journal Article JAMA Surg · January 1, 2022 IMPORTANCE: Inhaled nitric oxide (iNO) is commonly administered for selectively inhaled pulmonary vasodilation and prevention of oxidative injury after lung transplant (LT). Inhaled epoprostenol (iEPO) has been introduced worldwide as a cost-saving alterna ... Full text Open Access Link to item Cite

Therapeutic strategies in patients with coagulopathy and disseminated intravascular coagulation: awareness of the phase-dependent characteristics.

Journal Article Minerva Med · December 2021 INTRODUCTION: Disseminated intravascular coagulation (DIC) has long been understood as a condition where both thrombotic and hemostatic abnormalities coexist. DIC is a difficult complication for clinicians to manage as it is due to multiple underlying comp ... Full text Link to item Cite

Thrombogenicity markers for early diagnosis and prognosis in COVID-19: a change from the current paradigm?

Journal Article Blood Coagul Fibrinolysis · December 1, 2021 Standard biomarkers have been widely used for COVID-19 diagnosis and prognosis. We hypothesize that thrombogenicity metrics measured by thromboelastography will provide better diagnostic and prognostic utility versus standard biomarkers in COVID-19 positiv ... Full text Link to item Cite

Roles of Coagulation Abnormalities and Microthrombosis in Sepsis: Pathophysiology, Diagnosis, and Treatment.

Journal Article Arch Med Res · November 2021 The diagnostic criteria of overt disseminated intravascular coagulation (DIC) were established by the International Society on Thrombosis and Haemostasis (ISTH) in 2001. Since then, DIC has long been associated with adverse outcomes. However, recent advanc ... Full text Link to item Cite

Dabigatran Reversal With Idarucizumab in Patients Requiring Urgent Surgery: A Subanalysis of the RE-VERSE AD Study.

Journal Article Ann Surg · September 1, 2021 OBJECTIVE: To further examine anticoagulation reversal and clinical outcomes in dabigatran treated patients requiring urgent surgery or procedural interventions. BACKGROUND: Idarucizumab, a humanized monoclonal antibody fragment, reverses dabigatran antico ... Full text Link to item Cite

Viscoelastic testing to assess the effects of rapid fibrinogen concentrate administration after cardiopulmonary bypass: insights from the REPLACE study.

Journal Article Blood Coagul Fibrinolysis · September 1, 2021 Haemorrhage during and following surgery results in increased morbidity and mortality. Low plasma fibrinogen levels have been associated with increased blood loss and transfusion requirements. Fibrinogen supplementation has been shown to reduce bleeding in ... Full text Link to item Cite

Managing thrombosis and cardiovascular complications of COVID-19: answering the questions in COVID-19-associated coagulopathy.

Journal Article Expert Rev Respir Med · August 2021 INTRODUCTION: The first patients with Coronavirus disease 2019 (COVID-19) emerged at the end of 2019. This novel viral infection demonstrated unique features that include prothrombotic clinical presentations. However, one year after the first occurrence, t ... Full text Link to item Cite

A new SOFA score calculation to improve the predictive performance for mortality in sepsis-associated disseminated intravascular coagulopathy patients.

Journal Article J Crit Care · August 2021 PURPOSE: The change in the sequential organ failure assessment (SOFA) score from the entry day, a delta-SOFA (SOFAΔ), has been proposed as a better indicator for predicting mortality, and potentially as an endpoint in clinical trials. However, there are so ... Full text Link to item Cite

Recommended primary outcomes for clinical trials evaluating hemostatic blood products and agents in patients with bleeding: Proceedings of a National Heart Lung and Blood Institute and US Department of Defense Consensus Conference.

Journal Article J Trauma Acute Care Surg · August 1, 2021 High-quality evidence guiding optimal transfusion and other supportive therapies to reduce bleeding is needed to improve outcomes for patients with either severe bleeding or hemostatic disorders that are associated with poor outcomes. Alongside challenges ... Full text Link to item Cite

COVID-19: Thrombosis, thromboinflammation, and anticoagulation considerations.

Journal Article Int J Lab Hematol · July 2021 Vascular endothelial injury is a hallmark of acute infection at both the microvascular and macrovascular levels. The hallmark of SARS-CoV-2 infection is the current COVID-19 clinical sequelae of the pathophysiologic responses of hypercoagulability and thro ... Full text Open Access Link to item Cite

Impact of High-Dose Prophylactic Anticoagulation in Critically Ill Patients With COVID-19 Pneumonia.

Journal Article Chest · June 2021 BACKGROUND: Because of the high risk of thrombotic complications (TCs) during SARS-CoV-2 infection, several scientific societies have proposed to increase the dose of preventive anticoagulation, although arguments in favor of this strategy are inconsistent ... Full text Link to item Cite

Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review.

Journal Article J Clin Med · April 16, 2021 Infection by SARS-CoV-2 is associated with a high risk of thrombosis. The laboratory documentation of hypercoagulability and impaired fibrinolysis remains a challenge. Our aim was to assess the potential usefulness of viscoelastometric testing (VET) to pre ... Full text Link to item Cite

Key Pathogenic Factors in Coronavirus Disease 2019-Associated Coagulopathy and Acute Lung Injury Highlighted in a Patient With Copresentation of Acute Myelocytic Leukemia: A Case Report.

Journal Article A A Pract · March 30, 2021 The role of concurrent illness in coronavirus disease 2019 (COVID-19) is unknown. Patients with leukemia may display altered thromboinflammatory responses. We report a 53-year-old man presenting with acute leukemia and COVID-19 who developed thrombotic com ... Full text Open Access Link to item Cite

Ethnic differences in thromboprophylaxis for COVID-19 patients: should they be considered?

Journal Article Int J Hematol · March 2021 Thromboembolic events contribute to morbidity and mortality in coronavirus disease 2019 (COVID-19). As a result, thromboprophylaxis using low-molecular-weight heparin (LMWH) is universally recommended for hospitalized patients based on multiple guidelines. ... Full text Link to item Cite

COVID-19-associated Coagulopathy.

Journal Article Anesthesiology · March 1, 2021 Full text Link to item Cite

Fibrin-modulating nanogels for treatment of disseminated intravascular coagulation.

Journal Article Blood Adv · February 9, 2021 Disseminated intravascular coagulation (DIC) is a pathological coagulopathy associated with infection that increases mortality. In DIC, excessive thrombin generation causes symptoms from formation of microthrombi to multiorgan failure; bleeding risks can a ... Full text Open Access Link to item Cite

Proposal of the Definition for COVID-19-Associated Coagulopathy.

Journal Article J Clin Med · January 7, 2021 Thrombotic events are common complications in COVID-19 patients that include both thrombus formation in large vessels and the microvasculature of the lung and other organs. COVID-19-associated coagulopathy (CAC) and disseminated intravascular coagulation ( ... Full text Link to item Cite

Development and implementation of common data elements for venous thromboembolism research: on behalf of SSC Subcommittee on official Communication from the SSC of the ISTH.

Journal Article J Thromb Haemost · January 2021 Clinical research in venous thromboembolism (VTE) is hindered by variability in the collection and reporting of data and outcomes. A consistent data language facilitates efficiencies, leads to higher quality data, and permits between-study comparisons and ... Full text Link to item Cite

Recent advances in the research and management of sepsis-associated DIC.

Journal Article Int J Hematol · January 2021 Disseminated intravascular coagulation (DIC) is a common and life-threatening complication in sepsis. Sepsis-associated DIC is recognized as the systemic activation in coagulation with suppressed fibrinolysis that leads to organ dysfunction in combination ... Full text Link to item Cite

Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ... Full text Open Access Link to item Cite

Inhaled Selective Pulmonary Vasodilators for Adult Lung Transplantation

Conference JOURNAL OF HEART AND LUNG TRANSPLANTATION · 2021 Cite

Inhaled Selective Pulmonary Vasodilators for Advanced Heart Failure Therapies

Conference JOURNAL OF HEART AND LUNG TRANSPLANTATION · 2021 Cite

Coagulopathy and Bleeding Management for Aortic Dissection Surgery

Chapter · January 1, 2021 In patients following aortic surgery, the prevention and treatment of bleeding requires a multimodal approach that includes targeting fibrinogen and platelet repletion, the use of anti-fibrinolytic agents, and evaluating surgical sources of bleeding. Proth ... Full text Cite

Newly Developed Recombinant Antithrombin Protects the Endothelial Glycocalyx in an Endotoxin-Induced Rat Model of Sepsis.

Journal Article Int J Mol Sci · December 26, 2020 (1) Background: The endothelial glycocalyx is a primary target during the early phase of sepsis. We previously reported a newly developed recombinant non-fucosylated antithrombin has protective effects in vitro. We further evaluated the effects of this rec ... Full text Link to item Cite

The coagulopathy, endotheliopathy, and vasculitis of COVID-19.

Journal Article Inflamm Res · December 2020 BACKGROUND: COVID-19-associated coagulopathy (CAC) characterized by the elevated D-dimer without remarkable changes of other global coagulation markers is associated with various thrombotic complications and disease severity. The purpose of this review is ... Full text Link to item Cite

Management of hemostatic complications in acute leukemia: Guidance from the SSC of the ISTH.

Journal Article J Thromb Haemost · December 2020 Patients with acute leukemia frequently develop thrombocytopenia and hemostatic complications caused by coagulopathy. Coagulopathy complicates the management of these patients and can lead to significant morbidity and mortality. This guidance document aims ... Full text Link to item Cite

The authors reply.

Journal Article Crit Care Med · November 2020 Full text Link to item Cite

Management of chronically anticoagulated patients

Chapter · October 12, 2020 Anticoagulant therapies are widely used for the prevention of thrombotic events but are associated with the potential risk of bleeding as in the case of vitamin K antagonists including warfarin. The nonvitamin K oral anticoagulants (NOACs) are target speci ... Full text Cite

The authors reply.

Journal Article Crit Care Med · October 2020 Full text Link to item Cite

Coagulopathy of Coronavirus Disease 2019.

Journal Article Crit Care Med · September 2020 OBJECTIVES: Recent studies have reported a high prevalence of thrombotic events in coronavirus disease 2019. However, the significance of thromboembolic complications has not been widely appreciated. The purpose of this review is to provide current knowled ... Full text Link to item Cite

Coagulopathy in COVID-19.

Journal Article J Thromb Haemost · September 2020 The COVID-19 pandemic has become an urgent issue in every country. Based on recent reports, the most severely ill patients present with coagulopathy, and disseminated intravascular coagulation (DIC)-like massive intravascular clot formation is frequently s ... Full text Link to item Cite

ISTH DIC subcommittee communication on anticoagulation in COVID-19.

Journal Article J Thromb Haemost · September 2020 Hypercoagulability is an increasingly recognized complication of SARS-CoV-2 infection. As such, anticoagulation has become part and parcel of comprehensive COVID-19 management. However, several uncertainties exist in this area, including the appropriate ty ... Full text Link to item Cite

Underlying disorders of disseminated intravascular coagulation: Communication from the ISTH SSC Subcommittees on Disseminated Intravascular Coagulation and Perioperative and Critical Care Thrombosis and Hemostasis.

Journal Article J Thromb Haemost · September 2020 BACKGROUND: Disseminated intravascular coagulation (DIC), a systemic activation of coagulation, presents with multiple clinical and laboratory manifestations. In this International Society on Thrombosis and Haemostasis (ISTH) communication, we examined the ... Full text Link to item Cite

Cryoprecipitate transfusion in bleeding patients.

Journal Article CJEM · September 2020 OBJECTIVES: The management of acquired coagulopathy in multiple clinical settings frequently involves fibrinogen supplementation. Cryoprecipitate, a multidonor product, is widely used for the treatment of acquired hypofibrinogenemia following massive bleed ... Full text Link to item Cite

Newly Proposed Sepsis-Induced Coagulopathy Precedes International Society on Thrombosis and Haemostasis Overt-Disseminated Intravascular Coagulation and Predicts High Mortality.

Journal Article J Intensive Care Med · July 2020 BACKGROUND: Disseminated intravascular coagulation (DIC) has been recognized as an urgent and critical condition in patients with sepsis. Therefore, unfamiliar and time-consuming tests or a complex scoring system are not suitable for diagnosis. Sepsis-indu ... Full text Link to item Cite

The influence of hyperglycemia on neutrophil extracellular trap formation and endothelial glycocalyx damage in a mouse model of type 2 diabetes.

Journal Article Microcirculation · July 2020 OBJECTIVES: Hyperglycemia induces vascular dysfunction that is thought to be initiated by neutrophils. Neutrophil activation produces endothelial injury by pathways that include NETosis, a type of specific cell death. In this study, we investigated the eff ... Full text Link to item Cite

Prevention of thrombotic risk in hospitalized patients with COVID-19 and hemostasis monitoring.

Journal Article Crit Care · June 19, 2020 COVID-19 is an infection induced by the SARS-CoV-2 coronavirus, and severe forms can lead to acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) management. Severe forms are associated with coagulation changes, mainly characteriz ... Full text Link to item Cite

The unique characteristics of COVID-19 coagulopathy.

Journal Article Crit Care · June 18, 2020 Thrombotic complications and coagulopathy frequently occur in COVID-19. However, the characteristics of COVID-19-associated coagulopathy (CAC) are distinct from those seen with bacterial sepsis-induced coagulopathy (SIC) and disseminated intravascular coag ... Full text Link to item Cite

COVID-19 and its implications for thrombosis and anticoagulation.

Journal Article Blood · June 4, 2020 Severe acute respiratory syndrome coronavirus 2, coronavirus disease 2019 (COVID-19)-induced infection can be associated with a coagulopathy, findings consistent with infection-induced inflammatory changes as observed in patients with disseminated intravas ... Full text Link to item Cite

Levosimendan in patients with reduced left ventricular function undergoing isolated coronary or valve surgery.

Journal Article J Thorac Cardiovasc Surg · June 2020 OBJECTIVE: In the Levosimendan in Patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass (LEVO-CTS) trial, no differences in clinical outcomes were observed between levosimendan and placebo in a broa ... Full text Link to item Cite

Restarting Therapeutic Anticoagulation After Elective Craniotomy for Patients with Chronic Atrial Fibrillation: A Review of the Literature.

Journal Article World Neurosurg · May 2020 The decision to restart systemic anticoagulation after surgery requires a nuanced risk-benefit analysis. The potential for surgical site bleeding must be balanced against the risk of thromboembolic events. In the context of postoperative neurosurgical pati ... Full text Link to item Cite

Management of oral anticoagulants prior to emergency surgery or with major bleeding: A survey of perioperative practices in North America: Communication from the Scientific and Standardization Committees on Perioperative and Critical Care Haemostasis and Thrombosis of the International Society on Thrombosis and Haemostasis.

Journal Article Res Pract Thromb Haemost · May 2020 BACKGROUND: There is limited information on real-world practice versus current clinical practice guidelines for oral anticoagulant reversal before emergency surgery. OBJECTIVE: To identify current practice/knowledge gaps for oral anticoagulant reversal eme ... Full text Open Access Link to item Cite

In Response.

Other Anesth Analg · May 2020 Full text Link to item Cite

More on Venous Thrombosis during Spaceflight.

Journal Article N Engl J Med · April 2, 2020 Full text Link to item Cite

Controlled Multifactorial Coagulopathy: Effects of Dilution, Hypothermia, and Acidosis on Thrombin Generation In Vitro.

Journal Article Anesth Analg · April 2020 BACKGROUND: Coagulopathy and hemostatic abnormalities remain a challenge in patients following trauma and major surgery. Coagulopathy in this setting has a multifactorial nature due to tissue injury, hemodilution, hypothermia, and acidosis, the severity of ... Full text Link to item Cite

Horseshoe Crab Aquaculture as a Sustainable Endotoxin Testing Source

Journal Article Frontiers in Marine Science · April 1, 2020 Horseshoe crab (HSC) hemolymph is the source of Limulus amebocyte lysate (LAL), a critical component in sterility testing that ensures drug and medical device safety for millions of patients every year. Wild HSC populations have been declining as a result ... Full text Cite

Diagnosis and management of heparin-induced thrombocytopenia.

Journal Article Anaesth Crit Care Pain Med · April 2020 Full text Link to item Cite

Pathophysiological Response to Trauma-Induced Coagulopathy: A Comprehensive Review.

Journal Article Anesth Analg · March 2020 Hypercoagulability can occur after severe tissue injury, that is likely related to tissue factor exposure and impaired endothelial release of tissue plasminogen activator (tPA). In contrast, when shock and hypoperfusion occur, activation of the protein C p ... Full text Link to item Cite

Sepsis-Induced Coagulopathy and Disseminated Intravascular Coagulation.

Journal Article Semin Thromb Hemost · February 2020 Disseminated intravascular coagulation (DIC) has been recognized as a deadly complication in sepsis, and its early recognition followed by appropriate management of the underlying infection are the current management strategies. The activation of coagulati ... Full text Link to item Cite

Using Plasma and Prothrombin Complex Concentrates.

Journal Article Semin Thromb Hemost · February 2020 Surgical patients, following procedural interventions or traumatic injury, often bleed due to ongoing blood loss or coagulopathy. Volume resuscitation and transfusion management are critical for the massively bleeding patient. While transfusions may correc ... Full text Link to item Cite

Perioperative Thrombosis and Hemostasis.

Journal Article Semin Thromb Hemost · February 2020 Full text Link to item Cite

Clinical controversies in anticoagulation monitoring and antithrombin supplementation for ECMO.

Journal Article Crit Care · January 20, 2020 During extracorporeal membrane oxygenation (ECMO), a delicate balance is required to titrate systemic anticoagulation to prevent thrombotic complications within the circuit and prevent bleeding in the patient. Despite focused efforts to achieve this balanc ... Full text Link to item Cite

The Developing Balance of Thrombosis and Hemorrhage in Pediatric Surgery: Clinical Implications of Age-Related Changes in Hemostasis.

Journal Article Clin Appl Thromb Hemost · 2020 Bleeding and thrombosis in critically ill infants and children is a vexing clinical problem. Despite the relatively low incidence of bleeding and thrombosis in the overall pediatric population relative to adults, these critically ill children face unique c ... Full text Link to item Cite

The Immunologic Effect of Early Intravenous Two and Four Gram Bolus Dosing of Tranexamic Acid Compared to Placebo in Patients With Severe Traumatic Bleeding (TAMPITI): A Randomized, Double-Blind, Placebo-Controlled, Single-Center Trial.

Journal Article Front Immunol · 2020 BACKGROUND: The hemostatic properties of tranexamic acid (TXA) are well described, but the immunological effects of TXA administration after traumatic injury have not been thoroughly examined. We hypothesized TXA would reduce monocyte activation in bleedin ... Full text Link to item Cite

Thrombomodulin in disseminated intravascular coagulation and other critical conditions-a multi-faceted anticoagulant protein with therapeutic potential.

Journal Article Crit Care · August 15, 2019 Thrombomodulin plays a vital role in maintaining intravascular patency due to its anticoagulant, antiinflammatory, and cytoprotective properties. However, under pathological conditions such as sepsis and systemic inflammation, endothelial thrombomodulin ex ... Full text Open Access Link to item Cite

Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations.

Journal Article JAMA Surg · August 1, 2019 Enhanced Recovery After Surgery (ERAS) evidence-based protocols for perioperative care can lead to improvements in clinical outcomes and cost savings. This article aims to present consensus recommendations for the optimal perioperative management of patien ... Full text Link to item Cite

Advance in the Management of Sepsis-Induced Coagulopathy and Disseminated Intravascular Coagulation.

Journal Article J Clin Med · May 22, 2019 Coagulopathy commonly occurs in sepsis as a critical host response to infection that can progress to disseminated intravascular coagulation (DIC) with an increased mortality. Recent studies have further defined factors responsible for the thromboinflammato ... Full text Link to item Cite

Three-factor prothrombin complex concentrates for refractory bleeding after cardiovascular surgery within an algorithmic approach to haemostasis.

Journal Article Vox Sang · May 2019 BACKGROUND/OBJECTIVES: Prothrombin complex concentrates (PCC) are increasingly administered off-label in the United States to treat bleeding in cardiovascular surgical patients and carry the potential risk for acquired thromboembolic side-effects after sur ... Full text Open Access Link to item Cite

Randomized evaluation of fibrinogen versus placebo in complex cardiovascular surgery: post hoc analysis and interpretation of phase III results.

Journal Article Interact Cardiovasc Thorac Surg · April 1, 2019 OBJECTIVES: In a multicentre, randomized-controlled, phase III trial in complex cardiovascular surgery (Randomized Evaluation of Fibrinogen vs Placebo in Complex Cardiovascular Surgery: REPLACE), single-dose human fibrinogen concentrate (FCH) was associate ... Full text Link to item Cite

Effects of blood storage age on immune, coagulation, and nitric oxide parameters in transfused patients undergoing cardiac surgery.

Journal Article Transfusion · April 2019 BACKGROUND: Retrospective studies suggested that storage age of RBCs is associated with inflammation and thromboembolism. The Red Cell Storage Duration Study (RECESS) trial randomized subjects undergoing complex cardiac surgery to receive RBCs stored for s ... Full text Link to item Cite

Patient Blood Management: Recommendations From the 2018 Frankfurt Consensus Conference.

Journal Article JAMA · March 12, 2019 IMPORTANCE: Blood transfusion is one of the most frequently used therapies worldwide and is associated with benefits, risks, and costs. OBJECTIVE: To develop a set of evidence-based recommendations for patient blood management (PBM) and for research. EVIDE ... Full text Link to item Cite

Derangement of the endothelial glycocalyx in sepsis.

Journal Article J Thromb Haemost · February 2019 The vascular endothelial surface is coated by the glycocalyx, a ubiquitous gel-like layer composed of a membrane-binding domain that contains proteoglycans, glycosaminoglycan side-chains, and plasma proteins such as albumin and antithrombin. The endothelia ... Full text Link to item Cite

Predicting mortality in patients with disseminated intravascular coagulation after cardiopulmonary bypass surgery by utilizing two scoring systems.

Journal Article Blood Coagul Fibrinolysis · January 2019 : We evaluated clinical and laboratory biomarkers of disseminated intravascular coagulation (DIC) following cardiac surgery in the cardiothoracic surgical ICU (CTICU) to predict mortality. We retrospectively analyzed CTICU patients with suspected DIC ident ... Full text Link to item Cite

Usefulness of Measuring Changes in SOFA Score for the Prediction of 28-Day Mortality in Patients With Sepsis-Associated Disseminated Intravascular Coagulation.

Journal Article Clin Appl Thromb Hemost · 2019 The primary end point for sepsis trial is 28-day mortality. However, additional methods for determining the efficacy may have benefits. The purpose of this study was to search a useful indicator of anticoagulant therapy in patients with sepsis with dissemi ... Full text Link to item Cite

The impact of prothrombin complex concentrates when treating DOAC-associated bleeding: a review.

Journal Article Int J Emerg Med · December 3, 2018 BACKGROUND: Bleeding complications are a risk associated with all anticoagulants. Currently, the treatment options for the management of direct oral anticoagulant (DOAC)-associated bleeding are limited. Prothrombin complex concentrates (PCCs) have been pro ... Full text Link to item Cite

Prothrombin Complex Concentrates for Perioperative Vitamin K Antagonist and Non-vitamin K Anticoagulant Reversal.

Journal Article Anesthesiology · December 2018 Vitamin K antagonist therapy is associated with an increased bleeding risk, and clinicians often reverse anticoagulation in patients who require emergency surgical procedures. Current guidelines for rapid anticoagulation reversal for emergency surgery reco ... Full text Link to item Cite

Prediction of Early Death in Patients With Sepsis-Associated Coagulation Disorder Treated With Antithrombin Supplementation.

Journal Article Clin Appl Thromb Hemost · December 2018 For success in clinical trials, eliminating inclusion of patients with irreversible recovery is important. The purpose of this study was to identify the patient population who do not survive for more than 3 days. A total of 449 patients with sepsis suspect ... Full text Link to item Cite

Protection of the endothelial glycocalyx by antithrombin in an endotoxin-induced rat model of sepsis.

Journal Article Thromb Res · November 2018 INTRODUCTION: Injury and loss of the endothelial glycocalyx occur during the early phase of sepsis. We previously showed that antithrombin has a protective effect on this structure in vitro. Here, we investigated the possible protective effects of antithro ... Full text Link to item Cite

Bacterial contamination of platelets for transfusion: strategies for prevention.

Journal Article Crit Care · October 27, 2018 Platelet transfusions carry greater risks of infection, sepsis, and death than any other blood product, owing primarily to bacterial contamination. Many patients may be at particular risk, including critically ill patients in the intensive care unit. This ... Full text Link to item Cite

Sepsis-Induced Coagulopathy and Japanese Association for Acute Medicine DIC in Coagulopathic Patients with Decreased Antithrombin and Treated by Antithrombin.

Journal Article Clin Appl Thromb Hemost · October 2018 Disseminated intravascular coagulation (DIC) in patients with sepsis represents a critical condition. Thus, a simple and rapid diagnosis is required. The purpose of this study was to compare the performances of a recently developed Sepsis-Induced Coagulopa ... Full text Link to item Cite

Sugammadex hypersensitivity and underlying mechanisms: a randomised study of healthy non-anaesthetised volunteers.

Journal Article Br J Anaesth · October 2018 BACKGROUND: We investigated potential for hypersensitivity reactions after repeated sugammadex administration and explored the mechanism of hypersensitivity. METHODS: In this double-blind, placebo-controlled study (NCT00988065), 448 healthy volunteers were ... Full text Link to item Cite

Perioperative coagulation management: Evolving strategies.

Journal Article Anaesth Crit Care Pain Med · August 2018 Full text Link to item Cite

Management of antiplatelet therapy in patients undergoing elective invasive procedures. Proposals from the French Working Group on perioperative haemostasis (GIHP) and the French Study Group on thrombosis and haemostasis (GFHT). In collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR).

Journal Article Anaesth Crit Care Pain Med · August 2018 The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR) drafted up-to-date proposals for the ma ... Full text Link to item Cite

Reversal agents for non-vitamin K antagonist oral anticoagulants.

Journal Article Nat Rev Cardiol · May 2018 The non-vitamin K antagonist oral anticoagulants (NOACs) include dabigatran, which inhibits thrombin, and apixaban, betrixaban, edoxaban, and rivaroxaban, which inhibit coagulation factor Xa. Although clinical studies of NOACs were conducted without antido ... Full text Link to item Cite

Antifibrinolytic Therapy and Perioperative Considerations.

Journal Article Anesthesiology · March 2018 Fibrinolysis is a physiologic component of hemostasis that functions to limit clot formation. However, after trauma or surgery, excessive fibrinolysis may contribute to coagulopathy, bleeding, and inflammatory responses. Antifibrinolytic agents are increas ... Full text Link to item Cite

Inflammation and thrombosis: roles of neutrophils, platelets and endothelial cells and their interactions in thrombus formation during sepsis.

Journal Article J Thromb Haemost · February 2018 The inflammatory response and the activation of coagulation are two important responses in a host's defense against infection. These mechanisms do not work independently, but cooperate in a complex and synchronous manner. Recent research has also shed ligh ... Full text Link to item Cite

Rivaroxaban reversal with prothrombin complex concentrate or tranexamic acid in healthy volunteers.

Journal Article J Thromb Haemost · January 2018 UNLABELLED: Essentials Specific reversal agents for managing severe factor Xa inhibitor-associated bleeding are lacking. We assessed 4-factor-prothrombin complex concentrate (4F-PCC) and tranexamic acid (TXA). 4F-PCC, but not TXA, reduced the prothrombin t ... Full text Link to item Cite

Blood and coagulation

Chapter · January 1, 2018 Hemostasis is a critical homeostatic mechanism of survival that involves vascular, cellular, and plasma components that interact to stop bleeding. Vascular effects include vasoconstriction, expression of procoagulant factors such as tissue factor, and loss ... Full text Cite

What is the evidence for platelet transfusion in perioperative settings?

Journal Article Vox Sang · November 2017 BACKGROUND AND OBJECTIVES: Platelet transfusions are widely administered to restore perioperative haemostasis in haemorrhagic patients; however, the role of platelet transfusion is not well understood and administration is often based on empiric data. This ... Full text Link to item Cite

Adjuncts to Blood Component Therapies for the Treatment of Bleeding in the Intensive Care Unit.

Journal Article Transfus Med Rev · October 2017 Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recog ... Full text Link to item Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal Article Anesth Analg · October 2017 BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ... Full text Open Access Link to item Cite

Technology: Is There Sufficient Evidence to Change Practice in Point-of-Care Management of Coagulopathy?

Journal Article J Cardiothorac Vasc Anesth · October 2017 Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the ... Full text Link to item Cite

New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: a retrospective analysis of a nationwide survey.

Journal Article BMJ Open · September 27, 2017 OBJECTIVE: Recent clinical studies have shown that anticoagulant therapy might be effective only in specific at-risk subgroups of patients with sepsis and coagulation dysfunction. The definition of sepsis was recently modified, and as such, old scoring sys ... Full text Link to item Cite

Idarucizumab for Dabigatran Reversal - Full Cohort Analysis.

Journal Article N Engl J Med · August 3, 2017 BACKGROUND: Idarucizumab, a monoclonal antibody fragment, was developed to reverse the anticoagulant effect of dabigatran. METHODS: We performed a multicenter, prospective, open-label study to determine whether 5 g of intravenous idarucizumab would be able ... Full text Link to item Cite

Adult extracorporeal membrane oxygenation: an international survey of transfusion and anticoagulation techniques.

Journal Article Vox Sang · July 2017 BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a method of life support for either isolated cardiac failure or respiratory failure, with or without cardiac failure. When used for hemodynamic support, the ECMO circuit presents a no ... Full text Link to item Cite

The recommended dose of idarucizumab may not always be sufficient for sustained reversal of dabigatran.

Journal Article J Thromb Haemost · July 2017 UNLABELLED: Essentials Reversal of anticoagulant effects of dabigatran may occur despite application of idarucizumab. Monitoring of dabigatran level after antidote application is crucial to detect rebound. Repeated doses of idarucizumab may be necessary in ... Full text Link to item Cite

Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery.

Journal Article N Engl J Med · May 25, 2017 BACKGROUND: Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery. METHODS: In a multicenter, randomized, placebo-controlled, phase 3 trial, we evaluated the effica ... Full text Link to item Cite

Healthcare resource utilization in patients receiving idarucizumab for reversal of dabigatran anticoagulation due to major bleeding, urgent surgery, or procedural interventions: interim results from the RE-VERSE AD™ study.

Journal Article J Med Econ · May 2017 AIMS: Patients treated with anticoagulants may experience serious bleeding or require urgent surgery or intervention, and may benefit from rapid anticoagulant reversal. This exploratory analysis assessed healthcare resource utilization (HCRU) in patients t ... Full text Link to item Cite

Therapeutic Plasma Transfusion in Bleeding Patients: A Systematic Review.

Journal Article Anesth Analg · April 2017 Plasma products, including fresh frozen plasma, are administered extensively in a variety of settings from massive transfusion to vitamin K antagonist reversal. Despite the widespread use of plasma as a hemostatic agent in bleeding patients, its effect in ... Full text Link to item Cite

In Response.

Journal Article Anesth Analg · February 2017 Full text Link to item Cite

In Response.

Journal Article Anesth Analg · February 2017 Full text Link to item Cite

Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement.

Journal Article J Thorac Cardiovasc Surg · December 2016 BACKGROUND: Moderate (MHCA) versus deep (DHCA) hypothermia for circulatory arrest in aortic arch surgery has been purported to reduce coagulopathy and bleeding complications, although there are limited data supporting this claim. This study aimed to compar ... Full text Link to item Cite

Levosimendan in patients with left ventricular systolic dysfunction undergoing cardiac surgery on cardiopulmonary bypass: Rationale and study design of the Levosimendan in Patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass (LEVO-CTS) trial.

Journal Article Am Heart J · December 2016 BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropi ... Full text Link to item Cite

Perioperative management of the bleeding patient.

Journal Article Br J Anaesth · December 2016 Perioperative bleeding remains a major complication during and after surgery, resulting in increased morbidity and mortality. The principal causes of non-vascular sources of haemostatic perioperative bleeding are a preexisting undetected bleeding disorder, ... Full text Open Access Link to item Cite

Discontinuation and Management of Direct-Acting Anticoagulants for Emergency Procedures.

Other Am J Med · November 2016 Patients taking direct oral anticoagulants (DOACs) who then need an emergency invasive procedure require specialized management strategies. Appropriate patient evaluation includes assessment of the current anticoagulation state, including timing of the las ... Full text Link to item Cite

Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial.

Journal Article Can J Anaesth · November 2016 PURPOSE: Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral in ... Full text Link to item Cite

Discontinuation and management of direct-acting anticoagulants for emergency procedures.

Journal Article Am J Emerg Med · November 2016 Patients taking direct oral anticoagulants (DOACs) who then need an emergency invasive procedure require specialized management strategies. Appropriate patient evaluation includes assessment of the current anticoagulation state, including timing of the las ... Full text Link to item Cite

Nonvitamin K antagonist oral anticoagulant activity: challenges in measurement and reversal.

Journal Article Crit Care · September 23, 2016 BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) are approved for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of venous thromboembolism. These include the direct thrombin inhibitor dab ... Full text Link to item Cite

Idarucizumab for dabigatran overdose.

Journal Article Clin Toxicol (Phila) · September 2016 CONTEXT: An overdose of oral anticoagulants represents a challenging scenario for emergency physicians. Dabigatran, an oral direct thrombin inhibitor, is increasingly used in place of warfarin. The lack of an antidote is a concern in patients who overdose ... Full text Link to item Cite

A Step Toward Balance: Thrombin Generation Improvement via Procoagulant Factor and Antithrombin Supplementation.

Journal Article Anesth Analg · September 2016 BACKGROUND: The use of prothrombin complex concentrates in trauma- and surgery-induced coagulopathy is complicated by the possibility of thromboembolic events. To explore the effects of these agents on thrombin generation (TG), we investigated combinations ... Full text Link to item Cite

In Reply.

Journal Article Anesthesiology · August 2016 Full text Link to item Cite

Randomized evaluation of fibrinogen vs placebo in complex cardiovascular surgery (REPLACE): a double-blind phase III study of haemostatic therapy.

Journal Article Br J Anaesth · July 2016 BACKGROUND: Single-dose human fibrinogen concentrate (FCH) might have haemostatic benefits in complex cardiovascular surgery. METHODS: Patients undergoing elective aortic surgery requiring cardiopulmonary bypass were randomly assigned to receive FCH or pla ... Full text Link to item Cite

Prothrombin Complex Concentrates for Bleeding in the Perioperative Setting.

Other Anesth Analg · May 2016 Prothrombin complex concentrates (PCCs) contain vitamin K-dependent clotting factors (II, VII, IX, and X) and are marketed as 3 or 4 factor-PCC formulations depending on the concentrations of factor VII. PCCs rapidly restore deficient coagulation factor co ... Full text Open Access Link to item Cite

Edoxaban in the secondary prevention of VTE.

Journal Article Lancet Haematol · May 2016 Full text Link to item Cite

Efficacy of prothrombin complex concentrates for the emergency reversal of dabigatran-induced anticoagulation.

Journal Article Crit Care · April 28, 2016 Dabigatran is effective in decreasing the risk of ischaemic stroke in patients with atrial fibrillation. However, like all anticoagulants, it is associated with a risk of bleeding. In cases of trauma or emergency surgery, emergency reversal of dabigatran-i ... Full text Link to item Cite

Antithrombin: anti-inflammatory properties and clinical applications.

Other Thromb Haemost · April 2016 Many humoral and cellular components participate in bidirectional communication between the coagulation and inflammation pathways. Natural anticoagulant proteins, including antithrombin (AT), tissue factor pathway inhibitor, and protein C, suppress proinfl ... Full text Link to item Cite

The Judicious Use of Recombinant Factor VIIa.

Other Semin Thromb Hemost · March 2016 Recombinant activated factor VIIa (rFVIIa) is a prohemostatic agent initially approved for use in hemophilia patients with inhibitors and recently for Glanzmann thrombasthenia. Despite its approval indications, rFVIIa has also been used for a diverse range ... Full text Link to item Cite

Edoxaban in the secondary prevention of VTE

Other Lancet Haematology · March 2016 Cite

Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery.

Journal Article Anesthesiology · February 2016 BACKGROUND: Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperat ... Full text Open Access Link to item Cite

Andexanet alfa for the reversal of Factor Xa inhibitor related anticoagulation.

Other Expert Rev Hematol · 2016 Andexanet alfa is a specific reversal agent for Factor Xa inhibitors. The molecule is a recombinant protein analog of factor Xa that binds to Factor Xa inhibitors and antithrombin:LMWH complex but does not trigger prothrombotic activity. In ex vivo, animal ... Full text Open Access Link to item Cite

Letter to the Editor: Managing Dabigatran-Related Bleeding.

Journal Article J Intensive Care Med · January 2016 Full text Link to item Cite

Sugammadex: Hypersensitivity and exploration of underlying mechanisms (In Preparation)

Journal Article Annals of Allergy, Asthma & Immunology · 2016 Cite

Management of chronically anticoagulated patients

Chapter · January 1, 2016 Anticoagulant therapies are widely used for the prevention of thrombotic events, but are associated with a risk of bleeding. The advent of the newer oral anticoagulants (NOACs) that are target specific (i.e., factor IIa or Xa inhibitors) further compounds ... Full text Cite

Concentration-Dependent Dual Role of Thrombin in Protection of Cultured Rat Cortical Neurons.

Journal Article Neurochem Res · November 2015 Thrombin's role in the nervous system is not well understood. Under conditions of blood-brain barrier compromise (e.g., neurosurgery or stroke), thrombin can result in neuroapoptosis and the formation of glial scars. Despite this, preconditioning with thro ... Full text Link to item Cite

Idarucizumab for Dabigatran Reversal.

Journal Article N Engl J Med · August 6, 2015 BACKGROUND: Specific reversal agents for non-vitamin K antagonist oral anticoagulants are lacking. Idarucizumab, an antibody fragment, was developed to reverse the anticoagulant effects of dabigatran. METHODS: We undertook this prospective cohort study to ... Full text Link to item Cite

Design and rationale for RE-VERSE AD: A phase 3 study of idarucizumab, a specific reversal agent for dabigatran.

Journal Article Thromb Haemost · July 2015 Idarucizumab, a Fab fragment directed against dabigatran, produced rapid and complete reversal of the anticoagulation effect of dabigatran in animals and in healthy volunteers. The Study of the REVERSal Effects of Idarucizumab in Patients on Active Dabigat ... Full text Link to item Cite

Evaluation of dynamic parameters of thrombus formation measured on whole blood using rotational thromboelastometry in children undergoing cardiac surgery: a descriptive study.

Journal Article Paediatr Anaesth · June 2015 BACKGROUND: Total thrombus formation velocity calculated using amplitude parameters obtained at different times could be used to estimate the amplification and the propagation phases observed during coagulation processes, and therefore might be useful to p ... Full text Link to item Cite

Novel oral anticoagulants and reversal agents: Considerations for clinical development.

Other Am Heart J · June 2015 This white paper provides a summary of presentations and discussions that were held at an Anticoagulant-Induced Bleeding and Reversal Agents Think Tank co-sponsored by the Cardiac Safety Research Consortium and the US Food and Drug Administration (FDA) at ... Full text Link to item Cite

Anticoagulation management associated with extracorporeal circulation.

Other Best Pract Res Clin Anaesthesiol · June 2015 The use of extracorporeal circulation requires anticoagulation to maintain blood fluidity throughout the circuit, and to prevent thrombotic complications. Additionally, adequate suppression of hemostatic activation avoids the unnecessary consumption of coa ... Full text Link to item Cite

Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants.

Other Crit Care · April 29, 2015 Perioperative management of patients treated with the non-vitamin K antagonist oral anticoagulants is an ongoing challenge. Due to the lack of good clinical studies involving adequate monitoring and reversal therapies, management requires knowledge and und ... Full text Link to item Cite

Effects of red-cell storage duration on patients undergoing cardiac surgery.

Journal Article N Engl J Med · April 9, 2015 BACKGROUND: Some observational studies have reported that transfusion of red-cell units that have been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoing cardiac surgery may be especially vulnerabl ... Full text Link to item Cite

Protocol adherence when managing massive bleeding following complex cardiac surgery: a study design pilot.

Journal Article J Cardiothorac Vasc Anesth · April 2015 OBJECTIVE: High-quality prospective trials of hemostatic "rescue" therapy to control massive bleeding in cardiac surgery are lacking. Wide variability in the care of patients with severe bleeding following cardiopulmonary bypass has precluded accurate comp ... Full text Link to item Cite

Physiology of blood and hemostasis

Chapter · March 23, 2015 Cite

Blood products and blood components

Chapter · March 23, 2015 Cite

Procoagulants

Chapter · March 23, 2015 Cite

Point of care and factor concentrate-based coagulation algorithms.

Other Transfus Med Hemother · March 2015 In the last years it has become evident that the use of blood products should be reduced whenever possible. There is increasing evidence regarding serious adverse events, including higher mortality and morbidity, related to transfusions. The use of point o ... Full text Link to item Cite

How I use fibrinogen replacement therapy in acquired bleeding.

Other Blood · February 26, 2015 Fibrinogen is a critical protein for hemostasis and clot formation. However, transfusion guidelines have variable recommendations for maintaining fibrinogen levels in bleeding patients. An increasing number of studies support the practice of fibrinogen rep ... Full text Link to item Cite

Anticoagulants

Journal Article · February 4, 2015 Cite

Coagulation in trauma

Journal Article Trends in Anaesthesia and Critical Care · February 1, 2015 Uncontrollable bleeding is the major cause of possible preventable death after traumatic injury. Up to one third of patients admitted to the emergency room will develop the so-called trauma induced coagulopathy (TIC) which has been shown to be associated w ... Full text Cite

Anticoagulants

Chapter · 2015 Cite

Cryoprecipitate therapy.

Other Br J Anaesth · December 2014 Cryoprecipitate, originally developed as a therapy for patients with antihaemophilic factor deficiency, or haemophilia A, has been in use for almost 50 yr. However, cryoprecipitate is no longer administered according to its original purpose, and is now mos ... Full text Link to item Cite

Effects of a plasma-derived C1 esterase inhibitor on hemostatic activation, clot formation, and thrombin generation.

Journal Article Blood Coagul Fibrinolysis · December 2014 Hereditary angioedema (HAE) is a rare, autosomal dominant disease in which C1 esterase inhibitor (C1 INH) is deficient or dysfunctional. Package inserts for nanofiltered C1 esterase inhibitor (C1 INH-nf) products contain warnings about thrombotic events. T ... Full text Link to item Cite

Direct oral anticoagulants: new drugs and new concepts.

Other JACC Cardiovasc Interv · December 2014 Direct oral anticoagulants (DOACs) are approved for multiple thromboembolic disorders and provide advantages over existing agents. As with all anticoagulants, management protocols for the eventuality of bleeding are important. Randomized phase III studies ... Full text Link to item Cite

[Efficacy and safety of tranexamic acid administration for the prevention and/or the treatment of post-partum haemorrhage: a systematic review with meta-analysis].

Journal Article Ann Fr Anesth Reanim · November 2014 OBJECTIVE(S): Assess the efficacy and safety of tranexamic acid administration for the prevention and/or the treatment of postpartum haemorrhage. STUDY DESIGN: Systematic review with meta-analysis. MATERIAL AND METHODS: Systematic review of the literature ... Full text Link to item Cite

Effect of two doses of tranexamic acid on fibrinolysis evaluated by thromboelastography during cardiac surgery: a randomised, controlled study.

Journal Article Eur J Anaesthesiol · September 2014 BACKGROUND: Tranexamic acid is used to decrease bleeding and transfusions during cardiac surgery. However, dosing based on pharmacokinetic data to optimally inhibit fibrinolysis is unknown. With increasing concerns regarding seizures associated with higher ... Full text Link to item Cite

Comparison of three-factor and four-factor prothrombin complex concentrates regarding reversal of the anticoagulant effects of rivaroxaban in healthy volunteers.

Journal Article J Thromb Haemost · September 2014 BACKGROUND: Four-factor prothrombin complex concentrates (PCCs), which contain factor II, FVII, FIX, and FX, have shown the potential to reverse the anticoagulant effect of rivaroxaban in healthy volunteers. The purpose of this study was to determine wheth ... Full text Link to item Cite

Pharmacology and safety of new oral anticoagulants: the challenge of bleeding persists.

Other Clin Lab Med · September 2014 New oral anticoagulants (NOACs) are increasingly replacing vitamin K antagonists and older parenteral agents in clinical practice. NOACs offer several advantages compared with standard agents, including rapid onset of action, fixed dosing, and no requireme ... Full text Link to item Cite

Clinical use of the activated partial thromboplastin time and prothrombin time for screening: a review of the literature and current guidelines for testing.

Other Clin Lab Med · September 2014 Although the activated partial thromboplastin time, prothrombin time, and international normalized ratio are widely used in routine preoperative testing, these hemostatic tests are not reliable predictors of perioperative bleeding in patients without known ... Full text Link to item Cite

Perioperative management of patients receiving new oral anticoagulants: an international survey.

Journal Article Clin Lab Med · September 2014 New oral anticoagulants (NOACs) are increasingly replacing standard anticoagulants. These new drugs have been recently introduced in clinical practice, and specific knowledge regarding preoperative interruption, anticoagulation assessment, and reversal the ... Full text Link to item Cite

Anticoagulation strategies for the management of postoperative atrial fibrillation.

Other Clin Lab Med · September 2014 Patients undergoing thoracic and cardiac procedures are at the highest risk for postoperative atrial fibrillation (POAF). POAF is associated with poor short-term and long-term outcomes, including high rates of early and late stroke, and late mortality. Pat ... Full text Link to item Cite

Anticoagulants.

Journal Article Clin Lab Med · September 2014 Full text Link to item Cite

New oral anticoagulant-induced bleeding: clinical presentation and management.

Other Clin Lab Med · September 2014 Bleeding is a significant complication of anticoagulant therapy. With the emergence of new oral anticoagulants (NOACs; ie, direct factor IIa or Xa inhibitors), this risk is further compounded by the lack of validated reversal strategies for these agents. E ... Full text Link to item Cite

The influence of various patient characteristics on D-dimer concentration in critically ill patients and its role as a prognostic indicator in the intensive care unit setting.

Journal Article Clin Lab Med · September 2014 This study examines the relationship between D-dimer concentration and patient age, gender, race, and renal function, and the role of D-dimer concentration as a predictor of in-hospital mortality, in a critically ill patient population. The results demonst ... Full text Link to item Cite

Off-label use of recombinant human factor VIIa.

Journal Article Ann Thorac Surg · August 2014 Full text Link to item Cite

A cost analysis of the impact of a new intravenous antihypertensive in managing perioperative blood pressure during cardiac surgery.

Journal Article Hosp Pract (1995) · August 2014 OBJECTIVE: To examine the impact of intravenous antihypertensive selection on hospital health resource utilization using data from the Evaluation of CLevidipine In the Perioperative Treatment of Hypertension Assessing Safety Events (ECLIPSE) trials. METHOD ... Full text Link to item Cite

Off-label use of recombinant human factor VIIa

Other The Annals of Thoracic Surgery · August 2014 Invited commentary ... Cite

Heparin-Induced Thrombocytopenia

Chapter · June 3, 2014 Heparin-induced thrombocytopenia (HIT) is an immune-mediated complication of heparin adminictyation that occurs in approximately 0.5-5% of patients receiving heparin. HIT is a prothrombotic disorder that presents with a 50% decrease in platelet count and/o ... Full text Cite

Impact of perioperative blood pressure variability on health resource utilization after cardiac surgery: an analysis of the ECLIPSE trials.

Journal Article J Cardiothorac Vasc Anesth · June 2014 OBJECTIVE: To examine the impact of blood pressure control on hospital health resource utilization using data from the ECLIPSE trials. DESIGN: Post-hoc analysis of data from 3 prospective, open-label, randomized clinical trials (ECLIPSE trials). SETTING: S ... Full text Link to item Cite

Safe application of a restrictive transfusion protocol in moderate-risk patients undergoing cardiac operations.

Journal Article Ann Thorac Surg · May 2014 BACKGROUND: Perioperative red blood cell transfusion is associated with adverse outcomes after cardiac operations. Although restrictive transfusion protocols have been developed, their safety and efficacy are not well demonstrated, and considerable variati ... Full text Link to item Cite

In reply.

Journal Article Transfusion · May 2014 Full text Link to item Cite

Fibrinogen as a therapeutic target for bleeding: a review of critical levels and replacement therapy.

Other Transfusion · May 2014 Fibrinogen plays a critical role in achieving and maintaining hemostasis and is fundamental to effective clot formation. There is increasing awareness of the important role of fibrinogen as a key target for the treatment and prevention of acquired bleeding ... Full text Link to item Cite

Extracorporeal membrane oxygenation in the adult: a review of anticoagulation monitoring and transfusion.

Journal Article Anesth Analg · April 2014 Extracorporeal membrane oxygenation (ECMO) is a method of life support to maintain cardiopulmonary function. Its use as a medical application has increased since its inception to treat multiple conditions including acute respiratory distress syndrome, myoc ... Full text Link to item Cite

In reply.

Journal Article Anesthesiology · January 2014 Full text Link to item Cite

Procoagulants

Chapter · 2014 Cite

Anaphylactic Reactions in Anesthesia and Intensive Care

Book · October 22, 2013 Anaphylactic shock in the monkey. Respiratory ... Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet 1977 ... 336. 337. 338. 162 Anaphylactic Reactions in Anesthesia and Intensive Care. ... Cite

Efficacy and safety of recombinant factor XIII on reducing blood transfusions in cardiac surgery: a randomized, placebo-controlled, multicenter clinical trial.

Journal Article J Thorac Cardiovasc Surg · October 2013 OBJECTIVES: Cardiac surgery with cardiopulmonary bypass frequently leads to excessive bleeding, obligating blood product transfusions. Because low factor XIII (FXIII) levels have been associated with bleeding after cardiac surgery, we investigated whether ... Full text Link to item Cite

An ex vivo evaluation of the hemostatic effects of plasma-derived C1 inhibitor

Journal Article JOURNAL OF THROMBOSIS AND HAEMOSTASIS · July 1, 2013 Link to item Cite

In vitro effects of recombinant activated factor VII on thrombin generation and coagulation following inhibition of platelet procoagulant activity by prasugrel.

Journal Article Thromb Res · July 2013 INTRODUCTION: Prasugrel is a thienopyridyl P2Y12 antagonist with potent antiplatelet effects. At present, little is known about its effects on thrombin generation or what strategies may emergently reverse its anticoagulant effects. In the current study we ... Full text Link to item Cite

Managing new oral anticoagulants in the perioperative and intensive care unit setting.

Other Anesthesiology · June 2013 Managing patients in the perioperative setting receiving novel oral anticoagulation agents for thromboprophylaxis or stroke prevention with atrial fibrillation is an important consideration for clinicians. The novel oral anticoagulation agents include dire ... Full text Link to item Cite

Concepts of blood transfusion in adults.

Other Lancet · May 25, 2013 Recent progress has been made in the identification and implementation of best transfusion practices on the basis of evidence-based clinical trials, published clinical practice guidelines, and process improvements for blood use and clinical patient outcome ... Full text Link to item Cite

Biology of Factor XIII and clinical manifestations of Factor XIII deficiency.

Other Transfusion · May 2013 Factor XIII (FXIII) is activated by thrombin to form a transglutaminase (FXIIIa) that stabilizes clot formation by the cross-linking of fibrin monomers and antifibrinolytic proteins. Although rare, FXIII deficiency is characterized by variable bleeding man ... Full text Link to item Cite

Transfusion outcomes in patients undergoing coronary artery bypass grafting treated with prasugrel or clopidogrel: TRITON-TIMI 38 retrospective data analysis.

Journal Article J Thorac Cardiovasc Surg · April 2013 OBJECTIVE: Coronary artery bypass grafting-related bleeding and associated transfusion is a concern with dual antiplatelet therapy in patients with acute coronary syndromes. The objective of the present study was to characterize a potential risk-adjusted d ... Full text Link to item Cite

Point of care devices for assessing bleeding and coagulation in the trauma patient.

Other Anesthesiol Clin · March 2013 Severe trauma is associated with bleeding, coagulopathy, and transfusion of blood and blood products, all contributing to higher rates of morbidity and mortality. The aim of this review is to focus on point-of-care devices to monitor coagulation in trauma. ... Full text Link to item Cite

Perioperative coagulation management in the intensive care unit.

Other Curr Opin Anaesthesiol · February 2013 PURPOSE OF REVIEW: Coagulopathy in an ICU setting is multifactorial, but newer anticoagulation agents are the potentially contributing causes. Critically ill patients may suffer from disorders because of surgery or trauma, in addition to acquired causes in ... Full text Link to item Cite

Blood and Coagulation

Journal Article · January 1, 2013 Full text Cite

Multicenter trial of desirudin for the prophylaxis of thrombosis: an alternative to heparin-based anticoagulation (DESIR-ABLE).

Journal Article Clin Appl Thromb Hemost · 2013 Desirudin, a subcutaneously (SC) administered direct thrombin inhibitor, is indicated for prevention of venous thromboembolic events (VTEs) after total joint replacement surgery. DESIR-ABLE (multicenter trial of desirudin for the prophylaxis of thrombosis: ... Full text Link to item Cite

A case series of recombinant platelet factor 4 for heparin reversal after cardiopulmonary bypass.

Journal Article Anesth Analg · December 2012 BACKGROUND: Platelet factor 4 (PF4) is released by activated platelets and has a strong affinity for heparin. Recombinant PF4 (rPF4) has been previously considered as an alternative to protamine for heparin reversal. However, it has been demonstrated that ... Full text Link to item Cite

Is the incidence of heparin-induced thrombocytopenia affected by the increased use of heparin for VTE prophylaxis?

Journal Article Chest · November 2012 BACKGROUND: The increased exposure to heparin products for thromboprophylaxis against VTE in hospitalized patients raises concerns for an increase in the incidence of heparin-induced thrombocytopenia(HIT). METHODS: We analyzed, among 90,875 patients expose ... Full text Link to item Cite

Complement activation and cardiac surgery: a novel target for improving outcomes.

Other Anesth Analg · October 2012 Complement activation and the resulting inflammatory response is an important potential mechanism for multisystem organ injury in cardiac surgery. Novel therapeutic strategies using complement inhibitors may hold promise for improving outcomes for cardiac ... Full text Link to item Cite

Hemoglobin drift after cardiac surgery

Other The Annals of Thoracic Surgery · September 2012 Invited commentary ... Cite

Invited commentary.

Journal Article Ann Thorac Surg · September 2012 Full text Link to item Cite

The effects of MDCO-2010, a serine protease inhibitor, on activated clotting time in blood obtained from volunteers and cardiac surgical patients.

Journal Article Anesth Analg · August 2012 BACKGROUND: The activated clotting time (ACT) is widely used for monitoring heparin anticoagulation during cardiac surgery. Celite-based ACT values are prolonged when aprotinin is administered. MDCO-2010, a novel serine protease inhibitor, is currently bei ... Full text Link to item Cite

Mortality benefit with prasugrel in the TRITON-TIMI 38 coronary artery bypass grafting cohort: risk-adjusted retrospective data analysis.

Journal Article J Am Coll Cardiol · July 31, 2012 OBJECTIVES: The objective of this study was to characterize the bleeding, transfusion, and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting (CABG). BACKGROUND: There is little ev ... Full text Link to item Cite

Interference of thrombin in immunological assays for hirudin specific antibodies.

Journal Article J Immunol Methods · July 31, 2012 Recombinant hirudins (desirudin, lepirudin) are direct thrombin inhibitors administered as anticoagulants for heparin-induced thrombocytopenia (HIT) and venous thromboembolism (VTE) prophylaxis. Although these small polypeptides are widely used, concern ex ... Full text Link to item Cite

A phase 2 prospective, randomized, double-blind trial comparing the effects of tranexamic acid with ecallantide on blood loss from high-risk cardiac surgery with cardiopulmonary bypass (CONSERV-2 Trial).

Journal Article J Thorac Cardiovasc Surg · May 2012 OBJECTIVE: Ecallantide is a recombinant peptide in the same class as aprotinin that inhibits plasma kallikrein, a major component of the contact coagulation and inflammatory cascades. Therefore, ecallantide was expected to reduce blood loss associated with ... Full text Link to item Cite

Recognition of heparin-induced thrombocytopenia and initiation of argatroban therapy after cardiothoracic surgery in the intensive care unit.

Journal Article J Thorac Cardiovasc Surg · May 2012 OBJECTIVE: Patients recovering from cardiothoracic surgery are known to be at increased risk of heparin-induced thrombocytopenia. Postoperatively, if heparin-induced thrombocytopenia is suspected, heparin is discontinued immediately and an alternative anti ... Full text Link to item Cite

Prohemostatic treatment in cardiac surgery.

Other Semin Thromb Hemost · April 2012 Cardiac surgical patients represent a unique group of patients where coagulopathy occurs due to multiple causes besides simple hemorrhagic blood loss. Hemodilution, inflammation, and hemostatic activation while on cardiopulmonary bypass all contribute to t ... Full text Link to item Cite

Fibrinogen and hemostasis: a primary hemostatic target for the management of acquired bleeding.

Other Anesth Analg · February 2012 Fibrinogen plays several key roles in the maintenance of hemostasis. Its cleavage by thrombin and subsequent polymerization to form fibrin strands provides the structural network required for effective clot formation. During cases of acute blood loss, atte ... Full text Link to item Cite

Managing clotting: a North American perspective.

Other Curr Opin Anaesthesiol · February 2012 PURPOSE OF REVIEW: Bleeding in a perioperative setting occurs due to multiple causes, but newer anticoagulant and antiplatelet therapies are increasingly used preoperatively. As a result, patients often can present for surgery with underlying hemostatic di ... Full text Link to item Cite

Measurements of the T2K neutrino beam properties using the INGRID on-axis near detector

Journal Article Nucl.Instrum.Meth. · 2012 http://arxiv.org/abs/1111.3119 ... Full text Link to item Cite

A comparative evaluation of rotation thromboelastometry and standard coagulation tests in hemodilution-induced coagulation changes after cardiac surgery.

Journal Article Transfusion · January 2012 BACKGROUND: Coagulopathy after cardiopulmonary bypass (CPB) is caused by multiple perturbations in cellular and humoral elements of coagulation. A timely and comprehensive method to evaluate hemostasis would be helpful in the management of bleeding patient ... Full text Link to item Cite

A diagnosis of heparin-induced thrombocytopenia with combined clinical and laboratory methods in cardiothoracic surgical intensive care unit patients.

Journal Article Anesth Analg · October 2011 BACKGROUND: Diagnosing postoperative heparin-induced thrombocytopenia (HIT) in cardiothoracic surgical patients is complicated because of the profound thrombocytopenia that occurs with cardiopulmonary bypass (CPB). CPB predisposes patients to develop a fre ... Full text Link to item Cite

A hemorrhage of off-label use.

Journal Article Ann Intern Med · September 6, 2011 Full text Link to item Cite

A hemorrhage of off-label use

Other Annals of Internal Medicine · September 2011 Cite

Bleeding and management of coagulopathy.

Other J Thorac Cardiovasc Surg · September 2011 Bleeding after cardiac surgery remains a significant problem, increasing both length of stay and mortality, and is caused by multiple factors including dilutional changes, ongoing fibrinolysis, and platelet dysfunction. The evaluation of coagulopathy is pr ... Full text Link to item Cite

Factor Xa induces tissue factor expression in endothelial cells by P44/42 MAPK and NF-κB-dependent pathways.

Journal Article J Surg Res · August 2011 BACKGROUND: Tissue factor (TF) is an initiator of coagulation. The serine protease factor Xa (FXa) is the convergence point of the extrinsic and intrinsic components of the coagulation cascade. In addition to its hemostatic function, FXa elicits inflammato ... Full text Link to item Cite

Effects of C5 complement inhibitor pexelizumab on outcome in high-risk coronary artery bypass grafting: combined results from the PRIMO-CABG I and II trials.

Journal Article J Thorac Cardiovasc Surg · July 2011 OBJECTIVE: The previous Pexelizumab for Reduction of Infarction and Mortality in Coronary Artery Bypass Graft Surgery I (PRIMO-CABG I) trial (n = 3099) indicated that C5 complement inhibition with pexelizumab might reduce myocardial infarction (MI) and pos ... Full text Link to item Cite

Affecting perceptions of harm and addiction among college waterpipe tobacco smokers.

Journal Article Nicotine Tob Res · July 2011 INTRODUCTION: The spread of waterpipe tobacco use among youth may be due in part to perceptions that waterpipe tobacco use is safer than other tobacco products, such as cigarettes. In two pilot studies, we sought to modify college waterpipe smokers' percei ... Full text Link to item Cite

Does perioperative systolic blood pressure variability predict mortality after cardiac surgery? An exploratory analysis of the ECLIPSE trials.

Journal Article Anesth Analg · July 2011 BACKGROUND: Few studies describe an association of perioperative blood pressure stability with postoperative outcome. We tested the hypothesis that systolic blood pressure (SBP) variability in patients undergoing cardiac surgery is associated with 30-day m ... Full text Link to item Cite

The authors reply

Journal Article New England Journal of Medicine · February 10, 2011 Cite

Association of myocardial enzyme elevation and survival following coronary artery bypass graft surgery.

Journal Article JAMA · February 9, 2011 CONTEXT: Several small studies have suggested that cardiac enzyme elevation in the 24 hours following coronary artery bypass graft (CABG) surgery is associated with worse prognosis, but a definitive study is not available. Also, the long-term prognostic im ... Full text Link to item Cite

Elevated factor VIII enhances thrombin generation in the presence of factor VIII-deficiency, factor XI-deficiency or fondaparinux.

Journal Article Thromb Res · February 2011 BACKGROUND: Increased levels of factor VIII occur as a response to vascular injury and/or inflammation, and may increase thrombotic risks. In contrast, factor VIII deficiency poses a major hemostatic challenge. The role of factor VIII in modulating hemosta ... Full text Link to item Cite

Allergy

Chapter · 2011 Cite

Preface

Book · January 1, 2011 Cite

Etiology and assessment of hypercoagulability with lessons from heparin-induced thrombocytopenia.

Other Anesth Analg · January 2011 Hypercoagulability, or thrombophilia, is a condition associated with an abnormally increased tendency toward blood clotting. Affected individuals are prone to developing venous or arterial thrombosis and often require thromboprophylaxis. Hypercoagulability ... Full text Link to item Cite

Safety of recombinant activated factor VII in randomized clinical trials.

Journal Article N Engl J Med · November 4, 2010 BACKGROUND: The use of recombinant activated factor VII (rFVIIa) on an off-label basis to treat life-threatening bleeding has been associated with a perceived increased risk of thromboembolic complications. However, data from placebo-controlled trials are ... Full text Link to item Cite

Measuring addiction propensity and severity: the need for a new instrument.

Journal Article Drug Alcohol Depend · September 1, 2010 Drug addiction research requires but lacks a valid and reliable way to measure both the risk (propensity) to develop addiction and the severity of manifest addiction. This paper argues for a new measurement approach and instrument to quantify propensity to ... Full text Link to item Cite

Novel oral anticoagulants: implications in the perioperative setting.

Other Anesthesiology · September 2010 Patients undergoing surgery receive anticoagulation for perioperative thromboprophylaxis or ischemic cardiovascular disease. Because anticoagulants may also potentiate bleeding, clinicians need to understand the implications of anticoagulation in periopera ... Full text Link to item Cite

The anticoagulant effect of protamine sulfate is attenuated in the presence of platelets or elevated factor VIII concentrations.

Journal Article Anesth Analg · September 2010 BACKGROUND: Protamine sulfate is the antidote for heparin, but in excess it exerts weak anticoagulation. METHODS: We evaluated the effects of increasing protamine concentrations (0 to 24 microg/mL) on prothrombin time and diluted Russell's viper venom time ... Full text Link to item Cite

Addressing the question of the effect of RBC storage on clinical outcomes: the Red Cell Storage Duration Study (RECESS) (Section 7).

Journal Article Transfus Apher Sci · August 2010 The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes which occur while RBCs are stored have led to several physiologi ... Full text Link to item Cite

The role of thrombin and protease-activated receptors in pain mechanisms.

Journal Article Thromb Haemost · June 2010 As our knowledge of the mechanisms underlying the sensation of pain continues to expand, researchers are constantly searching for novel therapeutic targets. One such novel pain pathway involves thrombin and its associated protease-activated receptor (PAR). ... Full text Link to item Cite

Anesthetic concerns for patients with coagulopathy.

Journal Article Curr Opin Anaesthesiol · June 2010 PURPOSE OF REVIEW: Patients often receive preoperative therapies that interfere with hemostasis, and can present for surgery with underlying hemostatic disorders because of pre-existing preoperative anticoagulation or antiplatelet therapy. Perioperative bl ... Full text Link to item Cite

In vitro comparative study of hemostatic components in warfarin-treated and fibrinogen-deficient plasma.

Journal Article J Cardiothorac Vasc Anesth · June 2010 OBJECTIVE: The authors hypothesized that various hemostatic products may differently affect viscoelastic clot formation depending on their respective procoagulant activity and fibrinogen content. DESIGN: In vitro coagulopathy modeling using warfarin-treate ... Full text Link to item Cite

Thrombin generation and fibrinolysis in anti-factor IX treated blood and plasma spiked with factor VIII inhibitor bypassing activity or recombinant factor VIIa.

Journal Article Haemophilia · May 2010 Activated prothrombin complex concentrates (aPCC) and recombinant activated factor VIIa (rFVIIa) are two important therapies in haemophilia patients with inhibitors and improve clot stability. We hypothesized that potential differences in procoagulant and ... Full text Link to item Cite

Anti-factor IXa Aptamer reduces propagation of thrombin generation in plasma anticoagulated with warfarin.

Journal Article Thromb Res · May 2010 BACKGROUND: Warfarin is routinely used in the prevention and treatment of prothrombotic events. During initiation of warfarin therapy levels of factor (F) VII and protein C decrease rapidly but prothrombin, FIX and FX decline much slower. Therefore, propag ... Full text Link to item Cite

Hereditary angioedema: current and emerging treatment options.

Other Anesth Analg · May 1, 2010 Angioedema can result from allergic, hereditary, and acquired conditions. Hereditary angioedema (HAE) attacks are disabling at the time of occurrence and can be life threatening; they often result in hospitalization and intensive care unit admission. Altho ... Full text Link to item Cite

Haemodilution-induced profibrinolytic state is mitigated by fresh-frozen plasma: implications for early haemostatic intervention in massive haemorrhage.

Journal Article Br J Anaesth · March 2010 BACKGROUND: Fibrinolysis contributes to coagulopathy after major trauma and surgery. We hypothesized that progressive haemodilution is responsible, at least in part, for increased fibrinolytic tendency of blood clot. METHODS: The study was performed in two ... Full text Link to item Cite

Multidisciplinary approach to the challenge of hemostasis.

Other Anesth Analg · February 1, 2010 A multidisciplinary panel consisting of experts chosen by the 2 chairs of the group representing experts in anesthesiology, blood banking, hematology, critical care medicine, and various surgical disciplines (trauma, cardiac, pediatric, neurologic, obstetr ... Full text Link to item Cite

Heparin-induced thrombocytopenia and cardiac surgery.

Other Curr Opin Anaesthesiol · February 2010 PURPOSE OF REVIEW: Heparin-induced thrombocytopenia (HIT) is an important, increasingly recognized antibody-mediated complication of heparin therapy occurring in approximately 0.5-5% of patients receiving heparin for at least 5 days. HIT is a prothrombotic ... Full text Link to item Cite

Anticoagulation, Preoperative

Chapter · January 1, 2010 Full text Cite

Repletion of factor XIII following cardiopulmonary bypass using a recombinant A-subunit homodimer. A preliminary report.

Journal Article Thromb Haemost · October 2009 Bleeding following cardiac surgery involving cardiopulmonary bypass (CPB) remains a major concern. Coagulation factor XIII (FXIII) functions as a clot-stabilising factor by cross-linking fibrin. Low post-operative levels of FXIII correlate with increased p ... Full text Link to item Cite

2009 Anesthesia & Analgesia Guide for Authors

Journal Article Anesthesia & Analgesia · July 2009 Full text Cite

Finding the optimal concentration range for fibrinogen replacement after severe haemodilution: an in vitro model.

Journal Article Br J Anaesth · June 2009 BACKGROUND: Replacement of fibrinogen is presumably the key step in managing dilutional coagulopathy. We performed an in vitro study hypothesizing that there is a minimal fibrinogen concentration in diluted whole blood above which the rate of clot formatio ... Full text Link to item Cite

In-vitro evaluation of anti-factor IXa aptamer on thrombin generation, clotting time, and viscoelastometry.

Journal Article Thromb Haemost · May 2009 The REG1 system consists of factor IXa inhibitor, RB006, an aptamer-based anticoagulant and its antidote, RB007. The optimal use of RB006 can be facilitated by understanding its effect on the formation of thrombin and fibrin, and other standard tests of co ... Link to item Cite

Blood coagulation: hemostasis and thrombin regulation.

Other Anesth Analg · May 2009 Perioperative bleeding is a major challenge particularly because of increasing clinical use of potent antithrombotic drugs. Understanding current concepts of coagulation is important in determining the preoperative bleeding risk of patients, and in managin ... Full text Link to item Cite

Antifibrinolytic agents reduce tissue plasminogen activator-mediated neuronal toxicity in vitro.

Journal Article Acta Anaesthesiol Scand · March 2009 INTRODUCTION: Serine proteases and their inhibitors play an important role in physiological homeostasis including neuronal activity, hemostasis, and wound healing. Tissue plasminogen activator (tPA) is involved in normal neuronal plasticity and memory form ... Full text Link to item Cite

Perioperative hemostatic management of patients treated with vitamin K antagonists.

Other Anesthesiology · November 2008 Clinicians, including anesthesiologists, surgeons, and intensivists, are frequently called on to correct coagulopathy in patients receiving oral anticoagulation therapy. Before elective surgery, anticoagulation reversal may be undertaken over several days ... Full text Link to item Cite

The ECLIPSE trials: comparative studies of clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine for acute hypertension treatment in cardiac surgery patients.

Journal Article Anesth Analg · October 2008 BACKGROUND: Acute hypertension during cardiac surgery can be difficult to manage and may adversely affect patient outcomes. Clevidipine is a novel, rapidly acting dihydropyridine L-type calcium channel blocker with an ultrashort half-life that decreases ar ... Full text Link to item Cite

Prohemostatic agents to prevent perioperative blood loss.

Other Semin Thromb Hemost · July 2008 Surgical patients represent a unique group of patients where therapeutic approaches can be preemptively administered. Pharmacologic strategies to prevent or decrease perioperative bleeding function to attenuate inflammatory responses, reduce hemostatic act ... Full text Link to item Cite

Epidural analgesia in hepatic resection.

Journal Article J Am Coll Surg · June 2008 BACKGROUND: Randomized trials show equivocal benefit of epidural analgesia (EA) for patients undergoing abdominal operations. Partial hepatectomy is often performed using low central venous pressure anesthesia to reduce intraoperative blood loss. We examin ... Full text Link to item Cite

Antithrombin affects hemostatic response to recombinant activated factor VII in factor VIII deficient plasma.

Journal Article Anesth Analg · March 2008 BACKGROUND: Thromboembolic complications can occur with recombinant activated factor VII (rFVIIa) treatment in trauma and surgical patients but they are infrequent in hemophiliacs. Bleeding diathesis in these conditions is often attributed to reduced throm ... Full text Link to item Cite

Antithrombin deficiency increases thrombin activity after prolonged cardiopulmonary bypass.

Journal Article Anesth Analg · March 2008 BACKGROUND: Antithrombin (AT) levels decrease during cardiopulmonary bypass (CPB), particularly when combined with deep hypothermic circulatory arrest (DHCA). Low AT levels might lead to imbalance of pro- and anticoagulant factors promoting systemic thromb ... Full text Link to item Cite

Effects of recombinant activated factor VII on thrombin-mediated feedback activation of coagulation.

Journal Article Blood Coagul Fibrinolysis · March 2008 Thrombin is a key hemostatic enzyme, which propagates its own generation by activating factors V, VIII, and XI. Sustained thrombin generation also activates thrombin-activatable fibrinolysis inhibitor (TAFI), which stabilizes fibrin clot against fibrinolys ... Full text Link to item Cite

Improved clot formation by combined administration of activated factor VII (NovoSeven) and fibrinogen (Haemocomplettan P).

Journal Article Anesth Analg · March 2008 BACKGROUND: Recombinant activated factor VII (rFVIIa) is increasingly used for treating refractory bleeding after cardiac surgery. However, hemostasis also depends on coagulation factors, including fibrinogen, which stabilizes platelet plugs at sites of va ... Full text Link to item Cite

Anaphylaxis during cardiac surgery: implications for clinicians.

Other Anesth Analg · February 2008 During surgery, patients are exposed to multiple foreign substances including anesthetic drugs, antibiotics, blood products, heparin, polypeptides (aprotinin, latex, and protamine), and intravascular volume expanders, which have the potential to produce li ... Full text Link to item Cite

Management of surgical hemostasis: systemic agents.

Journal Article Vascular · 2008 Despite improvements in surgical techniques, the risk for perioperative bleeding remains significant. Transfusion of allogeneic red blood cells, platelets, and hemostatic factors remains the mainstay of current therapy strategy for management of perioperat ... Link to item Cite

Effects of prothrombin complex concentrate and recombinant activated factor VII on vitamin K antagonist induced anticoagulation.

Journal Article Thromb Res · 2008 INTRODUCTION: Warfarin and its derivatives are widely used for prevention of thrombotic incidents. Prothrombin complex concentrate (PCC) and recombinant activated factor VII (rFVIIa) have been used clinically for the acute reversal of this agent but there ... Full text Link to item Cite

Thrombin-activated thrombelastography for evaluation of thrombin interaction with thrombin inhibitors.

Journal Article Blood Coagul Fibrinolysis · December 2007 For intravenous anticoagulation, heparin has been the mainstay drug, but its use may be contraindicated in heparin-induced thrombocytopenia and thrombosis. Heparin alternatives including direct thrombin inhibitors are available, but clotting assays (e.g. p ... Full text Link to item Cite

Perioperative hypertension

Journal Article · December 1, 2007 Full text Cite

Cardiothoracic Critical Care

Journal Article Cardiothoracic Critical Care · December 1, 2007 This new bedside manual guides you through all the practical aspects of managing patients following cardiothoracic surgery and critically ill cardiology patients. Primarily designed to use in cardiothoracic intensive care units and coronary care units, it ... Cite

Clevidipine effectively and rapidly controls blood pressure preoperatively in cardiac surgery patients: the results of the randomized, placebo-controlled efficacy study of clevidipine assessing its preoperative antihypertensive effect in cardiac surgery-1.

Journal Article Anesth Analg · October 2007 BACKGROUND: Clevidipine is an ultrashort-acting, third-generation IV dihydropyridine calcium channel blocker that exerts rapid and titratable arterial blood pressure reduction, with fast termination of effect due to metabolism by blood and tissue esterases ... Full text Link to item Cite

The anticoagulated patient: strategies for effective blood loss management.

Other Surgery · October 2007 Anticoagulant therapy is challenging to modern surgical practice because it complicates risks of bleeding and the need for allogeneic blood transfusions. In an aging population, there is extensive use of antiplatelet agents, and patients present for operat ... Full text Link to item Cite

Thrombin generation assay and viscoelastic coagulation monitors demonstrate differences in the mode of thrombin inhibition between unfractionated heparin and bivalirudin.

Journal Article Anesth Analg · October 2007 BACKGROUND: Coagulation tests, such as activated partial thromboplastin time and activated clotting time, are used to monitor the effects of unfractionated heparin and the direct thrombin inhibitor, bivalirudin. These tests reflect only the initial phase o ... Full text Link to item Cite

Reducing thrombotic complications in the perioperative setting: an update on heparin-induced thrombocytopenia.

Other Anesth Analg · September 2007 Heparins are widely used in the perioperative setting. Immune heparin-induced thrombocytopenia (HIT) is a serious, antibody-mediated complication of heparin therapy that occurs in approximately 0.5%-5% of patients treated with heparin for at least 5 days. ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · September 2007 Full text Link to item Cite

Comparison of relaxation responses to multiple vasodilators in TxA(2)-analog and endothelin-1-precontracted pulmonary arteries.

Journal Article Acta Anaesthesiol Scand · July 2007 BACKGROUND: Peri-operative pulmonary hypertension can lead to right ventricular dysfunction and to an increase in morbidity and mortality. Altered function of the pulmonary vascular endothelium and vasoconstriction play a crucial role in the development of ... Full text Link to item Cite

Heparin resistance and the potential impact on maintenance of therapeutic coagulation

Other European Journal of Anaesthesiology · June 1, 2007 Background and objectives: The main aim of this review is to summarize the literature with respect to the impact of anticoagulation monitoring strategies and therapeutic strategies to manage heparin resistance and optimize anticoagulation with cardiac surg ... Full text Cite

Myocardial infarction following coronary artery bypass graft surgery increases healthcare resource utilization.

Journal Article Crit Care Med · May 2007 OBJECTIVE: To assess the health economic impact of perioperative myocardial infarction in a cohort of patients undergoing coronary artery bypass graft surgery. DESIGN: Retrospective cohort analysis using data from hospital bills and uniform billing forms. ... Full text Link to item Cite

Coagulopathy after cardiopulmonary bypass in Jehovah's Witness patients: management of two cases using fractionated components and factor VIIa.

Journal Article Anesth Analg · April 2007 BACKGROUND: Changes in the Jehovah's Witness (JW) blood refusal policy now give members the personal choice to accept certain processed fractions of blood, such as factor concentrates and cryoprecipitate. METHODS: Two JW patients undergoing complex aortic ... Full text Link to item Cite

A phase II, double-blind, placebo-controlled, ascending-dose study of Eritoran (E5564), a lipid A antagonist, in patients undergoing cardiac surgery with cardiopulmonary bypass.

Journal Article Anesth Analg · February 2007 BACKGROUND: Lipid A, the toxic moiety of endotoxin, is linked to multiple complications after cardiac surgery, including fever, vasodilation, and pulmonary and renal dysfunction. The lipid A antagonist eritoran (or E5564) prevents endotoxin-induced systemi ... Full text Link to item Cite

Anti-inflammatory strategies and hemostatic agents: old drugs, new ideas.

Other Hematol Oncol Clin North Am · February 2007 Hemostatic abnormalities occur following injury associated with both cardiac and noncardiac surgery. These changes are part of inflammatory pathways with signaling mechanisms that link these diverse pathways. The inflammatory response to surgery is exacerb ... Full text Link to item Cite

Heparin-induced thrombocytopenia, a prothrombotic disease.

Other Hematol Oncol Clin North Am · February 2007 Heparin-induced thrombocytopenia (HIT) is a serious, yet treatable prothrombotic disease that develops in approximately 0.5% to 5% of heparin-treated patients and dramatically increases their risk of thrombosis (odds ratio, 37). The antibodies that mediate ... Full text Link to item Cite

Preface

Journal Article Hematology/Oncology Clinics of North America · February 1, 2007 Full text Cite

Regulation of thrombin activity--pharmacologic and structural aspects.

Other Hematol Oncol Clin North Am · February 2007 Thrombin is an essential serine protease for survival. Since the discovery of heparin in the early twentieth century, significant advances have been made in the understanding of thrombin structure and function in coagulation system. Endogenous anticoagulan ... Full text Link to item Cite

Use of aprotinin in extrapleural pneumonectomy: effect on hemostasis and incidence of complications

Other The Annals of Thoracic Surgery · 2007 Invited commentary ... Cite

Cardiothoracic Critical Care

Book · January 1, 2007 This new bedside manual guides you through all the practical aspects of managing patients following cardiothoracic surgery and critically ill cardiology patients. Primarily designed to use in cardiothoracic intensive care units and coronary care units, it ... Full text Cite

Allergy and anaphylaxis in trauma

Chapter · January 1, 2007 Trauma and critically ill patients encounter numerous foreign antigens during their medical care, by parenteral exposure (e.g., drugs, blood products, contrast agents, preservatives) or environmental contact (e.g., latex and skin preparation solutions), as ... Cite

Heparin anticoagulation in patients undergoing off-pump and on-pump coronary bypass surgery.

Journal Article J Anesth · 2007 PURPOSE: The authors analyzed the coagulation data of patients who underwent on-pump coronary artery bypass graft (CABG) or off-pump coronary artery bypass surgery (OPCAB) in a randomized prospective trial. METHODS: CABG and OPCAB patients received heparin ... Full text Link to item Cite

Preface

Journal Article Cardiothoracic Critical Care · January 1, 2007 Full text Cite

Cardiovascular Pharmacology

Journal Article · January 1, 2007 Full text Cite

Full-dose aprotinin use in coronary artery bypass graft surgery: an analysis of perioperative pharmacotherapy and patient outcomes.

Journal Article Anesth Analg · November 2006 BACKGROUND: Inappropriate activation of hemostasis and inflammation may contribute to postoperative morbidity and mortality. The serine protease inhibitor, aprotinin, has been shown to prevent tissue and organ injury in laboratory and animal studies. In th ... Full text Link to item Cite

Effect of pexelizumab in coronary artery bypass graft surgery with extended aortic cross-clamp time.

Journal Article Ann Thorac Surg · September 2006 BACKGROUND: Prolonged cross-clamp time during cardiac surgery increases the risk of postoperative mortality and myocardial injury. This subanalysis from the pexelizumab for reduction of infarction and mortality in coronary artery bypass grafting surgery (P ... Full text Link to item Cite

The therapeutic potential of a kallikrein inhibitor for treating hereditary angioedema.

Other Expert Opin Investig Drugs · September 2006 Hereditary angioedema (HAE) manifests as intermittent, painful attacks of submucosal oedema affecting the larynx, gastrointestinal tract or limbs. Currently, acute treatment is available in Europe but not USA, and requires intravenous administration of a p ... Full text Link to item Cite

Pexelizumab reduces death and myocardial infarction in higher risk cardiac surgical patients.

Journal Article Ann Thorac Surg · August 2006 BACKGROUND: Morbidity and mortality after coronary artery bypass graft surgery are directly related to specific preoperative risk factors. We assessed the influence of preoperative risk factors on the effect of pexelizumab, a C5 complement inhibitor, to re ... Full text Link to item Cite

Effect of pexelizumab on mortality in patients with acute myocardial infarction or undergoing coronary artery bypass surgery: a systematic overview.

Journal Article Am Heart J · August 2006 BACKGROUND: Recent trials evaluating the C5 complement inhibitor, pexelizumab, have shown that modulation of inflammation during ischemia/reperfusion in patients with acute myocardial infarction (MI) or undergoing coronary artery bypass graft (CABG) surger ... Full text Link to item Cite

Should aprotinin continue to be used during cardiac surgery? Commentary

Other Nature Clinical Practice Cardiovascular Medicine · July 1, 2006 Full text Cite

The effect of aprotinin on activated protein C-mediated downregulation of endogenous thrombin generation.

Journal Article Br J Haematol · July 2006 Thrombin plays a central role in coagulation and haemostasis. Binding of thrombin to thrombomodulin generates activated protein C (APC), which exerts a negative feedback on thrombin formation. Aprotinin, a natural proteinase inhibitor is used extensively d ... Full text Link to item Cite

To the editor [9]

Other New England Journal of Medicine · June 19, 2006 Cite

Recombinant factor VIIa in patients with coagulopathy secondary to anticoagulant therapy, cirrhosis, or severe traumatic injury: review of safety profile.

Journal Article Transfusion · June 2006 BACKGROUND: In recent years, the hemostatic agent recombinant factor VIIa (rFVIIa) has emerged as a potentially new therapeutic agent for management of coagulopathy in patients with cirrhosis or following severe traumatic injury, a complex problem for clin ... Full text Link to item Cite

Inflammation: An old problem with new solutions

Journal Article Anesthesia and Analgesia · March 13, 2006 Cite

Inhibition of complement activation by pexelizumab reduces death in patients undergoing combined aortic valve replacement and coronary artery bypass surgery.

Journal Article J Thorac Cardiovasc Surg · February 2006 OBJECTIVE: We sought to evaluate the effects of pexelizumab, a C5 complement inhibitor, on death and myocardial infarction in patients undergoing combined aortic valve replacement and coronary artery bypass grafting surgery. METHODS: The Pexelizumab for Re ... Full text Link to item Cite

A double-blind, placebo-controlled trial of epsilon-aminocaproic acid for reducing blood loss in coronary artery bypass grafting surgery.

Journal Article J Am Coll Surg · February 2006 BACKGROUND: Epsilon-aminocaproic acid is a plasmin inhibitor that potentially reduces perioperative bleeding when administered prophylactically to cardiac surgery patients. To evaluate the efficacy of epsilon-aminocaproic acid, a prospective placebo-contro ... Full text Link to item Cite

Aprotinin in cardiac surgery

Other The New England journal of medicine · 2006 Cite

Aprotinin is useful as a hemostatic agent in cardiac surgery

Other Journal of Thrombosis and Haemostasis · 2006 Invited commentary ... Cite

Massive transfusion coagulopathy.

Other Semin Hematol · January 2006 Coagulopathy following massive transfusion is a consequence of post-traumatic and surgical hemorrhage. Bleeding following massive transfusion can occur due to hypothermia, dilutional coagulopathy, platelet dysfunction, fibrinolysis, or hypofibrinogenemia. ... Full text Link to item Cite

Effects of antithrombin and heparin cofactor II levels on anticoagulation with Intimatan.

Journal Article Thromb Haemost · October 2005 Heparin is the current mainstay drug for anticoagulation during cardiac surgery, but it requires normal levels of antithrombin (AT) for optimal anticoagulation. Heparin anticoagulation may be less effective in cardiac surgical patients because of decreased ... Full text Link to item Cite

Overview of clinical efficacy and safety of pharmacologic strategies for blood conservation.

Other Am J Health Syst Pharm · September 15, 2005 PURPOSE: The pharmacologic management of hemostasis in patients undergoing surgery with cardiopulmonary bypass is discussed. SUMMARY: Nearly 45 studies involving 7,000 patients have reported efficacy of aprotinin in blood conservation. Both in primary coro ... Full text Link to item Cite

Evaluation and management of bleeding during cardiac surgery.

Other Curr Hematol Rep · September 2005 Patients undergoing cardiac surgery with and potentially without cardiopulmonary bypass (CPB) are at risk for excessive microvascular bleeding. This bleeding often leads to transfusion of allogeneic blood and blood components as well as reexploration. Exce ... Link to item Cite

Effectiveness of a city-wide program to prevent mother-to-child HIV transmission in Lusaka, Zambia.

Journal Article AIDS · August 12, 2005 OBJECTIVE: To determine the population effectiveness of a city-wide perinatal HIV prevention program. DESIGN: An anonymous surveillance of newborn cord blood for HIV serology and nevirapine (NVP). METHODS: All 10 public-sector delivery centers in Lusaka, Z ... Full text Link to item Cite

Preemptive use of bivalirudin for urgent on-pump coronary artery bypass grafting in patients with potential heparin-induced thrombocytopenia.

Journal Article Ann Thorac Surg · July 2005 PURPOSE: The use of heparin in patients with heparin-induced thrombocytopenia (HIT) may result in severe complications or death. The diagnosis of HIT is frequently uncertain, however. Alternative anticoagulants in at-risk patients undergoing cardiac surger ... Full text Link to item Cite

Recombinant human antithrombin III restores heparin responsiveness and decreases activation of coagulation in heparin-resistant patients during cardiopulmonary bypass.

Journal Article J Thorac Cardiovasc Surg · July 2005 OBJECTIVES: We sought to evaluate the efficacy of recombinant human antithrombin III for restoration of heparin responsiveness in heparin-resistant patients scheduled for cardiac surgery. METHODS: This was a multicenter, randomized, double-blind, placebo-c ... Full text Link to item Cite

The effects of platelet count on clot retraction and tissue plasminogen activator-induced fibrinolysis on thrombelastography.

Journal Article Anesth Analg · June 2005 Clot retraction and fibrinolysis may present as a decrease in amplitude on thrombelastography (TEG). The former represents normal or hyperactive platelet function, and the latter represents a fibrinolytic state. It is important to distinguish clot retracti ... Full text Link to item Cite

Early experience with activated recombinant factor VII for intractable hemorrhage after cardiovascular surgery.

Journal Article Ann Thorac Surg · April 2005 BACKGROUND: Intractable hemorrhage after complex cardiovascular operations is a serious and potentially lethal complication. We report our experience with the use of activated recombinant factor VIIa (rFVIIa) as rescue therapy for patients with refractory ... Full text Link to item Cite

Novel concepts in treatment and prevention of bleeding

Journal Article Anesthesia and Analgesia · March 1, 2005 Cite

A phase III, double-blind, placebo-controlled, multicenter study on the efficacy of recombinant human antithrombin in heparin-resistant patients scheduled to undergo cardiac surgery necessitating cardiopulmonary bypass.

Journal Article Anesthesiology · February 2005 BACKGROUND: The study evaluated the efficacy of recombinant human antithrombin (rhAT) for restoring heparin responsiveness in heparin resistant patients undergoing cardiac surgery. METHODS: This was a multicenter, randomized, double-blind, placebo-controll ... Full text Link to item Cite

Symposium on the Definition and Management of Anaphylaxis: Summary report

Journal Article Journal of Allergy and Clinical Immunology · 2005 Cite

Activated recombinant factor VII in cardiac surgery

Other Current Opinion in Anaesthesiology · January 1, 2005 Purpose of review: Severe bleeding after cardiac surgery is a potential problem that poses major risks and challenges. Severe bleeding after cardiac surgery still occurs despite many pharmacological approaches to decrease bleeding and reduce transfusion re ... Full text Cite

Management of systemic and pulmonary hypertension.

Other Tex Heart Inst J · 2005 The major therapeutic approach to systemic and pulmonary hypertension and vasospasm in cardiac surgery patients involves the use of parenteral agents that reverse systemic vasoconstriction and produce vasodilation. Potential pharmacologic approaches includ ... Link to item Cite

Hemostatic agents.

Journal Article Transfusion · December 2004 Full text Link to item Cite

A novel method to assess platelet inhibition by eptifibatide with thrombelastograph.

Journal Article Anesth Analg · December 2004 We examined a novel method to detect platelet inhibition with thrombelastography (TEG). We hypothesized that this method would be suitable for monitoring the antiplatelet effects of eptifibatide (Integrilin). Whole blood from healthy volunteers was anticoa ... Full text Link to item Cite

Prevention and management of bleeding

Journal Article Revista Mexicana de Anestesiologia · December 1, 2004 Cite

Allergic reactions in anesthesia

Journal Article Revista Mexicana de Anestesiologia · December 1, 2004 Cite

The effects of argatroban on thrombin generation and hemostatic activation in vitro.

Journal Article Anesth Analg · November 2004 We evaluated argatroban, a direct thrombin inhibitor, as a heparin adjunct for anticoagulation. Platelet-poor plasma (PPP) was isolated from blood collected from 12 volunteers. Thrombin generation measurements were performed in donor PPP that was mixed wit ... Full text Link to item Cite

In vitro effects of antihypertensive drugs on thromboxane agonist (U46619)-induced vasoconstriction in human internal mammary artery.

Journal Article Br J Anaesth · August 2004 BACKGROUND: Hypertension is a major problem in the perioperative period of cardiac and non-cardiac surgery. The vascular endothelium plays a crucial role in modulating vascular tone by producing vasodilators as well as vasoconstrictors. Thromboxane A2 (TxA ... Full text Link to item Cite

Clopidogrel (Plavix) and cardiac surgical patients: implications for platelet function monitoring and postoperative bleeding.

Journal Article Platelets · August 2004 The use of clopidogrel (Plavix), an inhibitor of adenosine diphosphate (ADP)-induced platelet aggregation, has been proven to reduce ischemic events in cardiovascular patients, but little information is available for optimal monitoring of platelet function ... Full text Link to item Cite

Platelet transfusions during coronary artery bypass graft surgery are associated with serious adverse outcomes.

Journal Article Transfusion · August 2004 BACKGROUND: Platelet (PLT) transfusions are administered in cardiac surgery to prevent or treat bleeding, despite appreciation of the risks of blood component transfusion. The current analysis investigates the hypothesis that PLT transfusion is associated ... Full text Link to item Cite

Aprotinin: a pharmacologic overview.

Other Orthopedics · June 2004 Aprotinin is a polypeptide with serine protease inhibitory activity of key enzymes associated with inflammatory, fibrinolytic, and hemostatic pathways. The drug binds directly to the fibrinolytic plasmin at the lower plasmin-inhibiting dose (plasma concent ... Full text Link to item Cite

Efficacy and safety of aprotinin in cardiac surgery.

Other Orthopedics · June 2004 Cardiac surgery and cardiopulmonary bypass produces bleeding and the need for allogenic blood product transfusions in many patients. Blood conservation is important in the perioperative management of patients. Aprotinin, a serine protease inhibitor isolate ... Full text Link to item Cite

Effects of tirofiban on haemostatic activation in vitro

Journal Article British Journal of Anaesthesia · May 28, 2004 Full text Cite

Terminal complement blockade with pexelizumab during coronary artery bypass graft surgery requiring cardiopulmonary bypass: a randomized trial.

Journal Article JAMA · May 19, 2004 CONTEXT: Inflammation and ischemia-reperfusion injury during coronary artery bypass graft (CABG) surgery requiring cardiopulmonary bypass are associated with postoperative myocardial infarction (MI) and mortality. OBJECTIVE: To determine the efficacy and s ... Full text Link to item Cite

The influence of red wine or white wine intake on platelet function and viscoelastic property of blood in volunteers.

Journal Article Platelets · February 2004 Since the consumption of wine in the United States has increased in recent years, a number of patients may be admitted to the hospital on the morning of their elective surgery after having consumed wine with dinner the evening before. Research indicates th ... Full text Link to item Cite

Hemostatic agents

Other Transfusion · 2004 Cite

Heparin resistance and antithrombin: Can we stop calling it heparin resistance?

Other Journal of Cardiothoracic and Vascular Anesthesia · 2004 Cite

Quantitative assessment of fibrinogen cross-linking by epsilon aminocaproic acid in patients with end-stage liver disease.

Journal Article Liver Transpl · January 2004 Analysis of the effectiveness of antifibrinolytic therapy for liver transplant recipients is hampered by lack of quantitative assays for assessing drug effects. We adapted chemical engineering tools used in polymerization studies to quantify fibrinogen cro ... Full text Link to item Cite

Evaluation of a novel kallikrein inhibitor on hemostatic activation in vitro.

Journal Article Thromb Res · 2004 BACKGROUND: DX-88 is a potent kallikrein inhibitor that is being studied for the treatment of hereditary angioedema (HAE) and represents a potential alternative to aprotinin in cardiac surgical patients. The current study was designed to evaluate in vitro ... Full text Link to item Cite

Tissue factor-activated thromboelastograms in children undergoing cardiac surgery: baseline values and comparisons.

Journal Article Anesth Analg · November 2003 UNLABELLED: Activation of clotting with tissue factor (TF) allows rapid evaluation of thromboelastograms but alters the values of thromboelastogram variables. We have performed TF-activated thromboelastograms in 250 children <2 yr old undergoing cardiac su ... Full text Link to item Cite

The use of haemoglobin glutamer-250 (HBOC-201) as an oxygen bridge in patients with acute anaemia associated with surgical blood loss.

Other Expert Opin Biol Ther · June 2003 For the treatment of substantial blood loss in surgery, allogeneic blood is transfused to maintain stability and organ perfusion and function. Continued concerns about the availability, safety, efficacy and storage-related problems of allogeneic blood prod ... Full text Link to item Cite

The vasodilatory effects of hydralazine, nicardipine, nitroglycerin, and fenoldopam in the human umbilical artery.

Journal Article Anesth Analg · February 2003 We studied the effects of hydralazine, nicardipine, nitroglycerin, and fenoldopam (a dopamine D1-agonist) on isolated human umbilical arteries (HUA) from patients classified as normotensive and with pregnancy-induced hypertension (PIH). Umbilical artery ri ... Full text Link to item Cite

Inflammatory response to cardiopulmonary bypass.

Other Ann Thorac Surg · February 2003 Inflammation in cardiac surgical patients is produced by complex humoral and cellular interactions with numerous pathways including activation, generation, or expression of thrombin, complement, cytokines, neutrophils, adhesion molecules, mast cells, and m ... Full text Link to item Cite

Novel pharmacologic approaches to reducing bleeding

Other Canadian Journal of Anesthesia / Journal canadien d'anesthésie · 2003 Cite

Stroke after cardiac surgery: a retrospective analysis of the effect of aprotinin dosing regimens

Other The Annals of Thoracic Surgery · 2003 Invited commentary ... Cite

Integrating database information in microarray expression analyses: Application to melanoma cell lines profiled in the NCI60 data set.

Journal Article Journal of biomolecular techniques : JBT · December 2002 A series of successful microarray experiments typically results in a data matrix containing a list of a few thousand genes and their measured expression values across various conditions tested. The understanding of why some genes are clustered in their exp ... Cite

Treatment of persistent tachycardia with dexmedetomidine during off-pump cardiac surgery.

Journal Article Anesth Analg · August 2002 After unsuccessful treatment of intraoperative tachycardia with esmolol during off-pump revascularization, heart rate was successfully reduced with a bolus and infusion of dexmedetomidine. ... Full text Link to item Cite

Polymerized bovine hemoglobin solution as a replacement for allogeneic red blood cell transfusion after cardiac surgery: results of a randomized, double-blind trial.

Journal Article J Thorac Cardiovasc Surg · July 2002 BACKGROUND: Blood loss leading to reduced oxygen-carrying capacity is usually treated with red blood cell transfusions. This study examined the hypothesis that a hemoglobin-based oxygen-carrying solution can serve as an initial alternative to red blood cel ... Full text Link to item Cite

The plasma supplemented modified activated clotting time for monitoring of heparinization during cardiopulmonary bypass: a pilot investigation.

Journal Article Anesth Analg · July 2002 UNLABELLED: The standard celite or kaolin activated clotting time (ACT) correlates poorly with heparin levels during cardiopulmonary bypass (CPB). We compared a modified kaolin ACT, in which plasma was supplemented, to a standard undiluted kaolin ACT for m ... Full text Link to item Cite

Clevidipine in adult cardiac surgical patients: a dose-finding study.

Journal Article Anesthesiology · May 2002 BACKGROUND: Treatment of elevated blood pressure is frequently necessary after cardiac surgery to minimize postoperative bleeding and to attenuate afterload changes associated with hypertension. The purpose of this study was to investigate the pharmacodyna ... Full text Link to item Cite

Recombinant human transgenic antithrombin in cardiac surgery: a dose-finding study.

Journal Article Anesthesiology · May 2002 BACKGROUND: Acquired antithrombin III (AT) deficiency may render heparin less effective during cardiac surgery and cardiopulmonary bypass (CPB). The authors examined the pharmacodynamics and optimal dose of recombinant human AT (rh-AT) needed to maintain n ... Full text Link to item Cite

The use of bovine hemoglobin glutamer-250 (Hemopure) in surgical patients: results of a multicenter, randomized, single-blinded trial.

Journal Article Anesth Analg · April 2002 UNLABELLED: Hemoglobin-based oxygen carrier-201 (HBOC-201, hemoglobin glutamer-250 [bovine], Hemopure; Biopure Corporation, Cambridge, MA) is polymerized hemoglobin of bovine origin being developed as an oxygen therapeutic. In this study, we evaluated the ... Full text Link to item Cite

Intravenous milrinone in cardiac surgery.

Other Ann Thorac Surg · January 2002 Phosphodiesterase inhibitors including milrinone produce positive inotropic effects by slowing the hydrolysis of cyclic adenosine monophosphate in the myocardium. With a loading dose of 50 microg/kg followed by an infusion of 0.5 microg x kg(-1) x min(-1), ... Full text Link to item Cite

Anaphylactic reactions in cardiac surgical patients: Et tu, Brute?

Journal Article J Cardiothorac Vasc Anesth · December 2001 Full text Link to item Cite

The in vitro reversal of histamine-induced vasodilation in the human internal mammary artery.

Journal Article Anesth Analg · December 2001 UNLABELLED: Anaphylactic shock therapy includes the use of catecholamines but they may not always be effective. Because vasodilation during anaphylaxis is a result of the endothelial release of multiple mediators, we investigated the effects of epinephrine ... Full text Link to item Cite

Anaphylaxis. What is monitored to make a diagnosis? How is therapy monitored?

Other Anesthesiol Clin North Am · December 2001 Anaphylaxis is one of the most life-threatening emergencies that can occur in the perioperative period. Multiple agents can be responsible, and nonallergic reactions can mimic anaphylaxis. Developing a therapeutic plan for the acute therapy of anaphylaxis ... Link to item Cite

Pharmacologic preservation of the hemostatic system during cardiac surgery.

Other Ann Thorac Surg · November 2001 Bleeding after cardiac surgery remains a major potential problem. Numerous pharmacologic approaches to attenuating hemostatic system activation in cardiac surgery patients have been studied to further improve patient management. Therapeutic approaches stud ... Full text Link to item Cite

Warfarin therapy does not increase bleeding in patients undergoing heart transplantation.

Journal Article Ann Thorac Surg · September 2001 BACKGROUND: Historically, warfarin has been discontinued or rapidly reversed with fresh frozen plasma in patients awaiting heart transplantation because of concerns regarding excessive bleeding. Because preoperative warfarin may have effects on bleeding af ... Full text Link to item Cite

Recombinant antithrombin: production and role in cardiovascular disorder.

Journal Article Semin Thromb Hemost · August 2001 Plasma-derived antithrombin (AT) concentrates have been used for the management of hereditary and acquired deficiencies since the early 1980s. Recombinant versions of other blood factors and their derivatives are increasingly becoming available, providing ... Full text Link to item Cite

Aprotinin and the systemic inflammatory response after cardiopulmonary bypass.

Journal Article Ann Thorac Surg · February 2001 Cardiopulmonary bypass is associated with a systemic inflammatory response, a spectrum of pathophysiologic changes ranging from mild organ dysfunction to multisystem organ failure. Complications include coagulation disorders (bleeding diathesis, hyperfibri ... Full text Link to item Cite

Heart failure

Chapter · 2001 Cite

Recombinant antithrombin, production: role in cardiovascular disorders

Other Seminars in Thrombosis and Hemostasis · 2001 Cite

Anaphylactic reactions during cardiac surgery: Et tu brute?

Other Journal of Cardiothoracic and Vascular Anesthesia · 2001 Cite

Pharmacological comparison of human internal mammary artery and radial artery in terms of conduits for revascularization

Journal Article Acta Medica Nagasakiensia · December 1, 2000 Internal mammary arteries (IMA) are routinely used for coronary artery bypass grafting (CABG). but can exhibit impairment of endothelium-dependent vascular relaxation. The use of radial artery (RA) grafts for CABG has been recently reintroduced. The long-t ... Cite

Weal and flare responses to intradermal rocuronium and cisatracurium in humans.

Journal Article Br J Anaesth · December 2000 Thirty volunteers underwent intradermal skin testing with increasing concentrations of rocuronium and cisatracurium to evaluate weal and flare responses, and whether either agent would cause mast cell degranulation and sensitization upon re-exposure. We fo ... Full text Link to item Cite

Platelet inhibitors and bleeding in cardiac surgical patients.

Other Ann Thorac Surg · August 2000 A variety of measures may affect bleeding and transfusion requirements in abciximab-treated patients. These measures include recognition of the risk factors for increased bleeding and transfusion requirements, use of proper transfusion practices, conservat ... Full text Link to item Cite

Perioperative blood pressure control: a prospective survey of patient management in cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · June 2000 OBJECTIVE: To conduct a survey of current cardiac anesthetic practice in Europe and the United States, as a first step toward establishing guidelines for the management of perioperative hypertension. DESIGN: Prospective, multicenter study. SETTING: Univers ... Link to item Cite

Rapid evaluation of coagulopathies after cardiopulmonary bypass in children using modified thromboelastography.

Journal Article Anesth Analg · June 2000 UNLABELLED: Complex coagulopathies follow cardiopulmonary bypass (CPB) in children. However, objective laboratory data that can be acquired rapidly to guide their management are lacking. Because thromboelastography has proven useful in this regard, we eval ... Full text Link to item Cite

The in vitro effects of antithrombin III on the activated coagulation time in patients on heparin therapy.

Journal Article Anesth Analg · May 2000 UNLABELLED: Heparin requires antithrombin III (AT) to achieve anticoagulation, and patients on continuous small-dose heparin preoperatively experience decreased levels of AT-causing heparin resistance. When this occurs, 2-4 units of fresh frozen plasma ( a ... Full text Link to item Cite

Mechanisms of nonimmunological histamine and tryptase release from human cutaneous mast cells.

Journal Article Anesthesiology · April 2000 BACKGROUND: If mast cells are stimulated they release multiple mediators that delineate markers for immunologic and nonimmunologic reactions; histamine and tryptase are the two best known. Although histamine can be assayed in plasma, it is a nonspecific ma ... Full text Link to item Cite

Pharmacokinetics of recombinant transgenic antithrombin in volunteers.

Journal Article Anesth Analg · March 2000 UNLABELLED: Adequate levels of antithrombin (AT) III are essential for anticoagulation during cardiopulmonary bypass. Levels of AT are often decreased in patients receiving heparin before surgery. In these patients supplementation with exogenous AT can sup ... Full text Link to item Cite

Fast tracking for cardiovascular surgery

Other Seminars in Anesthesia, Perioperative Medicine and Pain · 2000 Cite

Cardiovascular safety issues and the use of neuromuscular blocking agents

Other Seminars in Anesthesia, Perioperative Medicine and Pain · 2000 Cite

Skin testing with newer neuromuscular blocking agents in humans

Journal Article BJA: British Journal of Anaesthesia · 2000 Cite

Anticoagulation monitoring during cardiac surgery: a review of current and emerging techniques.

Journal Article Anesthesiology · October 1999 The literature does not consistently support the importance of anticoagulation monitoring techniques during CPB. This is best reflected by studies that have evaluated the impact of the ACT method on blood loss and transfusion outcomes. Inconsistent finding ... Full text Link to item Cite

Hemostatic agents and their safety.

Other J Cardiothorac Vasc Anesth · August 1999 The pharmacologic management of hemostasis in patients undergoing cardiopulmonary bypass may be accompanied by adverse responses. Evaluating the safety profile of hemostatic agents (eg, lysine analogs, aprotinin, protamine, or even donor blood) should be d ... Link to item Cite

The effects of rapacuronium on histamine release and hemodynamics in adult patients undergoing general anesthesia.

Journal Article Anesth Analg · August 1999 UNLABELLED: Neuromuscular blocking drugs may have variable effects on heart rate (HR) and blood pressure. Rapacuronium is a rapid-acting, steroidal-derived neuromuscular blocking drug whose hemodynamic effects have not been characterized. We studied the ef ... Full text Link to item Cite

Fenoldopam: a new parenteral antihypertensive: consensus roundtable on the management of perioperative hypertension and hypertensive crises.

Other Am J Hypertens · July 1999 A panel of clinicians from anesthesiology, surgery, nephrology, hypertension, cardiology, and pharmacology was convened to discuss pharmacologic therapeutics in the management of hypertensive crisis and perioperative hypertension. The panel discussed the a ... Full text Link to item Cite

Adenosine A(3)-receptor stimulation attenuates postischemic dysfunction through K(ATP) channels.

Journal Article Am J Physiol · July 1999 We tested the hypothesis that selective adenosine A(3)-receptor stimulation reduces postischemic contractile dysfunction through activation of ATP-sensitive potassium (K(ATP)) channels. Isolated, buffer-perfused rat hearts (n = 8/group) were not drug pretr ... Full text Link to item Cite

Superoxide production, risk factors, and endothelium-dependent relaxations in human internal mammary arteries.

Journal Article Circulation · January 5, 1999 BACKGROUND: In a variety of disease states, endothelium-dependent vasodilation is abnormal. Reduced nitric oxide (NO) production, increased destruction of NO by superoxide, diminished cellular levels of L-arginine or tetrahydrobiopterin, and alterations in ... Full text Link to item Cite

Anaphylactic reactions in anesthesia and intensive care

Other Acta Anaesthesiologica Scandinavica · 1999 Cite

Treatment of perioperative hypertension

Other Anesthesiology Clinics of North America · January 1, 1999 Perioperative hypertension during cardiac or noncardiac surgery is a unique clinical problem characterized by systemic vasoconstriction often with intravascular hypovolemia that usually requires acute short-term intravenous therapy. β-Adrenergic blockers a ... Full text Cite

Analyses of coronary graft patency after aprotinin use: results from the International Multicenter Aprotinin Graft Patency Experience (IMAGE) trial.

Journal Article J Thorac Cardiovasc Surg · November 1998 OBJECTIVE: We examined the effects of aprotinin on graft patency, prevalence of myocardial infarction, and blood loss in patients undergoing primary coronary surgery with cardiopulmonary bypass. METHODS: Patients from 13 international sites were randomized ... Full text Link to item Cite

Protamine reversal of heparin affects platelet aggregation and activated clotting time after cardiopulmonary bypass.

Journal Article Anesth Analg · October 1998 UNLABELLED: Bleeding after cardiopulmonary bypass (CPB) is related to multiple factors. Excess protamine weakens clot structure and decreases platelet function; therefore, an increased activated clotting time (ACT) after protamine reversal of heparin may b ... Full text Link to item Cite

Hematologic and economic impact of aprotinin in reoperative pediatric cardiac operations.

Journal Article Ann Thorac Surg · August 1998 BACKGROUND: Aprotinin consistently reduces blood loss and transfusion requirements in adults during and after cardiac surgical procedures, but its effectiveness in children is debated. We evaluated the hemostatic and economic effects of aprotinin in childr ... Full text Link to item Cite

A bolus dose of 1.5 mg/kg amrinone effectively improves low cardiac output state following separation from cardiopulmonary bypass in cardiac surgical patients.

Journal Article Acta Anaesthesiol Scand · August 1998 BACKGROUND: The aim of this study was to evaluate the efficacy of 1.5 mg/kg bolus of amrinone on low cardiac output (CO) state following emergence from cardiopulmonary bypass (CPB) in cardiac surgical patients. METHODS: Immediately after emergency from CPB ... Full text Link to item Cite

A comparative evaluation of the effects of multiple vasodilators on human internal mammary artery.

Journal Article Anesthesiology · June 1998 BACKGROUND: Vasospasm of arterial grafts represents an unpredictable complication of coronary artery surgery and may compromise myocardial revascularization, and treatment is based on empirical therapy with nitroglycerin. Because of the potential for toler ... Full text Link to item Cite

Protamine reactions

Chapter · 1998 Cite

Monitoring coagulation

Chapter · 1998 Cite

The CD8+ cell non-cytotoxic, anti-HIV response is associated with protection in HIV-exposed, uninfected individuals

Conference FASEB Journal · 1998 Several multiply HIV-exposed, uninfected cohorts were studied for evidence of correlates of protective immunity. This uninfected high risk population was comprised of the IV drug-sharing and/or sexual partners of infected individuals. Genotyping of cells f ... Cite

Consensus discussion on trasylol use in pediatric surgery: Current knowledge

Journal Article Annals of Thoracic Surgery · January 1, 1998 Full text Cite

Current hematologic issues in cardiac surgery and cardiopulmonary bypass

Journal Article Seminars in Cardiothoracic and Vascular Anesthesia · January 1, 1998 Recently, new attempts have been made to fight old problems of coagulation and hemostasis as they relate to cardiac surgery. These discoveries are timely because the practice of both internists and surgeons has begun to change. Newer and more potent medica ... Full text Cite

Anaphylactic emergencies

Other Seminars in Anesthesia · January 1, 1998 Anaphylaxis represents one of the most life-threatening emergencies that can occur in the perioperative period. Multiple agents are potentially responsible, and nonallergic reactions can mimic anaphylaxis. Developing a therapeutic plan for the acute therap ... Full text Cite

Predicting and treating coagulopathies after cardiopulmonary bypass in children.

Journal Article Anesth Analg · December 1997 UNLABELLED: Coagulopathies in children after cardiopulmonary bypass (CPB) are complex. There are very limited data correlating coagulation tests with postoperative bleeding. We evaluated coagulation changes after CPB and after the administration of coagula ... Full text Link to item Cite

The vasodilator effects of clevidipine on human internal mammary artery.

Journal Article Anesth Analg · November 1997 UNLABELLED: Endothelial dysfunction and platelet activation with thromboxane release may contribute to spasm or alterations in internal mammary artery (IMA) graft flow during coronary artery surgery. Clevidipine, an ultrashort-acting dihydropyridine calciu ... Full text Link to item Cite

The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass.

Journal Article Anesth Analg · July 1997 Although milrinone effectively increases cardiac function, few studies have specifically evaluated its efficacy during cardiac surgery. We investigated the effects of milrinone on hemodynamics and left ventricular function in cardiac surgical patients who ... Full text Link to item Cite

The inflammatory response to cardiopulmonary bypass.

Other J Cardiothorac Vasc Anesth · May 1997 The inflammatory response to cardiopulmonary bypass is the product of a complex interplay of humoral and cellular components. Contact activation cascades, the complement system, and cytokines comprise the humoral elements and interact in such a way as to p ... Full text Link to item Cite

Functional maturity of the coagulation system in children: an evaluation using thrombelastography.

Journal Article Anesth Analg · April 1997 There are quantitative deficiencies in the coagulation system for at least the first 6 mo of life. Clinical experience, however, does not indicate an increased risk of excessive bleeding during surgical procedures. Thrombelastography, a test providing a fu ... Full text Link to item Cite

Prevention of chronic cerebral vasospasm in dogs with milrinone.

Journal Article Neurosurgery · February 1997 OBJECTIVE: Delayed cerebral ischemia resulting from vasospasm is a major cause of morbidity and death in patients with aneurysmal subarachnoid hemorrhage. Milrinone, because it inhibits Type IV cyclic adenosine monophosphate-specific phosphodiesterase enzy ... Full text Link to item Cite

The allergic response

Chapter · 1997 Cite

ACT and antithrombin effects

Other Circulation · 1997 Cite

Anaphylaxis and coronary disease.

Other N Engl J Med · December 19, 1996 Link to item Cite

Aprotinin in primary valve replacement and reconstruction: a multicenter, double-blind, placebo-controlled trial.

Journal Article J Thorac Cardiovasc Surg · October 1996 BACKGROUND: Patients having cardiac operations often require blood transfusions. Aprotinin reduces the need for blood transfusions during coronary artery bypass graft operations. To determine the safety and effectiveness of aprotinin in reducing the use of ... Full text Link to item Cite

Heparin neutralization with methylene blue, hexadimethrine, or vancomycin after cardiopulmonary bypass.

Journal Article Anesth Analg · August 1996 There are no clinically available alternatives for reversing heparin in protamine-allergic patients. This study examined the ability of methylene blue, hexadimethrine, and vancomycin to reverse circulating heparin so that these compounds can be carefully e ... Full text Link to item Cite

Heparinase I (neutralase) reversal of systemic anticoagulation.

Journal Article Anesthesiology · August 1996 BACKGROUND: Protamine causes multiple adverse reactions. Heparinase I, a specific enzyme that inactivates heparin, is a possible alternative to protamine. In this study, the authors examined the efficacy of heparinase I to reverse heparin-induced anticoagu ... Full text Link to item Cite

The in vitro effects of phosphodiesterase inhibitors on the human internal mammary artery.

Journal Article Anesth Analg · May 1996 The internal mammary artery (IMA) is the preferred conduit for myocardial revascularization, but it changes diameter in response to injury or thromboxane release to decrease myocardial blood supply. Papaverine, a phosphodiesterase (PDE) inhibitor, is injec ... Full text Link to item Cite

Pharmacodynamics and pharmacokinetics of milrinone administration to increase oxygen delivery in critically ill patients.

Journal Article Chest · May 1996 OBJECTIVES: The positive inotropic and vasodilator actions of phosphodiesterase (PDE) inhibitor drugs may offer therapeutic alternatives to beta-agonists in critically ill patients. We hypothesized that milrinone administration would increase cardiac index ... Full text Link to item Cite

Allergy and anesthesia

Chapter · 1996 Cite

Placental transfer of milrinone in the nonhuman primate (baboon)

Journal Article American Journal of Obstetrics & Gynecology · 1996 Cite

Evaluation of the developmental neuroendocrine and reproductive toxicology of aluminium.

Journal Article Food Chem Toxicol · January 1996 Two experiments evaluating functional endpoints pertaining to the developmental neuroendocrine effects of aluminum in the rat are reported. A total of 31 timed mated dams were fed by daily gastric gavage 0, 5, 25, 50, 250, 500 or 1000 mg/kg body weight/day ... Full text Link to item Cite

The human inflammatory response.

Other J Cardiovasc Pharmacol · 1996 Inflammation is a protective response of vascularized tissue normally elicited toward nonself-determinants or tissue injury. Inflammation functions as part of normal host surveillance mechanisms to destroy or quarantine both harmful agents and damaged tiss ... Full text Link to item Cite

A multicenter, double-blind, placebo-controlled trial of aprotinin for reducing blood loss and the requirement for donor-blood transfusion in patients undergoing repeat coronary artery bypass grafting.

Journal Article Circulation · October 15, 1995 BACKGROUND: Aprotinin is a serine protease inhibitor that reduces blood loss and transfusion requirements when administered prophylactically to cardiac surgical patients. To examine the safety and dose-related efficacy of aprotinin, a prospective, multicen ... Full text Link to item Cite

Heparin neutralization by recombinant platelet factor 4 and protamine.

Journal Article Anesth Analg · July 1995 Protamine is the only available drug to reverse heparin-induced anticoagulation. Platelet factor 4 (PF4) is a basic polypeptide stored in platelets that reverses heparin. To investigate its potential as a reversal drug, we studied recombinant PF4 on antico ... Full text Link to item Cite

The effects of milrinone on platelets in patients undergoing cardiac surgery.

Journal Article Anesth Analg · July 1995 Although amrinone produces thrombocytopenia, no information is available regarding the acute effects of milrinone on platelets. Therefore, we evaluated the effects of milrinone on platelet number and function in cardiac surgical patients. Twenty-seven pati ... Full text Link to item Cite

Birth order, delivery route, and concordance in the transmission of human immunodeficiency virus type 1 from mothers to twins. International Registry of HIV-Exposed Twins.

Journal Article J Pediatr · April 1995 BACKGROUND: We evaluated data from prospectively identified twins to understand better the mechanisms and covariates of mother-to-infant transmission of human immunodeficiency virus (HIV). METHODS: Using data obtained from an international collaboration an ... Full text Link to item Cite

New cardiac drugs

Chapter · 1995 Cite

Allergy and anesthesia

Chapter · 1995 Cite

Heparin neutralization by recombinant factor 4 and heparinase

Other Anaesthetic Pharmacology Review · 1995 Cite

New cardiac drugs.

Journal Article Int Anesthesiol Clin · 1995 The positive inotropic agents, including beta-adrenergic receptor agonists and PDE III inhibitors, are reviewed to explain their mechanisms of action, pharmacology, and clinical usage. New cardiotonic drugs, such as dopexamine and dobutamine (beta-adrenerg ... Link to item Cite

Heparin neutralisation by recombinant platelet factor 4 and heparinase

Journal Article Anaesthetic Pharmacology Review · January 1, 1995 Our clinical armamentarium requires alternatives to protamine. Initial human data with rPF4 reveal an effective safe agent. The adverse haemodynamic effects in lambs may derive from species variability, or may represent a cause for concern. Data from human ... Cite

Treatment of postoperative hypertension after coronary artery bypass surgery. Double-blind comparison of intravenous isradipine and sodium nitroprusside.

Journal Article Circulation · November 1994 BACKGROUND: Hypertension commonly occurs after cardiac surgery and requires therapy to prevent the potentially deleterious effects. METHODS AND RESULTS: After coronary artery bypass graft surgery (CABG), 177 patients with elevated blood pressure > or = 90 ... Link to item Cite

Pharmacokinetics of intravenous milrinone in patients undergoing cardiac surgery.

Journal Article Anesthesiology · September 1994 BACKGROUND: Milrinone is a phosphodiesterase inhibitor with positive inotropic and vasodilator effects that are useful in the treatment of ventricular dysfunction after cardiac surgery. However, the pharmacokinetics of the drug have been investigated only ... Full text Link to item Cite

Pharmacokinetics of aprotinin in preoperative cardiac surgical patients.

Journal Article Anesthesiology · May 1994 BACKGROUND: Aprotinin, a polypeptide protease inhibitor, reduces bleeding and transfusion requirements during cardiac surgery. To investigate aprotinin's pharmacokinetics, we administered therapeutic doses to patients scheduled to undergo cardiac surgery. ... Full text Link to item Cite

Determination of the hemodynamics and histamine release of rocuronium (Org 9426) when administered in increased doses under N2O/O2-sufentanil anesthesia.

Journal Article Anesth Analg · February 1994 The cardiovascular effects, histamine release potential, and pharmacodynamics of rocuronium were determined in adult patients randomized to receive rapid (5 s) intravenous (i.v.) bolus doses of 600, 900, or 1200 micrograms/kg (2.0, 3.0, and 4.0 times the E ... Full text Link to item Cite

New cardiac drugs

Journal Article International Anesthesiology Clinics · January 1, 1994 Full text Cite

Allergy and immunology

Chapter · 1994 Cite

Treatment of postoperative hypertension after coronary artery bypass surgery: Double-blind comparison of intravenous isradipine and sodium nitroprusside

Journal Article Circulation · January 1, 1994 Background: Hypertension commonly occurs after cardiac surgery and requires therapy to prevent the potentially deleterious effects. Methods and Results: After coronary artery bypass graft surgery (CABG), 177 patients with elevated blood pressure ≥90 mm Hg ... Cite

Intraoperative assessment of myocardial function

Journal Article Current Opinion in Anaesthesiology · January 1, 1994 Techniques and clinical applications for assessing left ventricular global and regional function during cardiovascular anesthesia are reviewed. Transesophageal echocardiography has provided an important and novel method for the assessment of myocardial fun ... Full text Cite

Amrinone: its effect on vascular resistance and capacitance in human subjects.

Journal Article Chest · January 1994 Reports evaluating amrinone's effects in normal (intact) human subjects are complex and difficult to interpret because of the drug's diverse effects on myocardial function, resistance vessels, and vascular capacitance. In this study, 1.5 mg/kg of amrinone ... Full text Link to item Cite

Support of the perioperative failing heart with preexisting ventricular dysfunction: currently available options.

Other J Cardiothorac Vasc Anesth · August 1993 Perioperative support of the patient with preexisting biventricular failure requires simultaneous optimal manipulation of heart rate and rhythm, loading conditions, and contractility. Patients with preexisting ventricular dysfunction will have alterations ... Full text Link to item Cite

Adverse reactions to protamine.

Other Coron Artery Dis · May 1993 Full text Link to item Cite

Pharmacologic and mechanical methods of discontinuing extracorporeal circulation in patients with heart failure.

Journal Article J Cardiothorac Vasc Anesth · April 1993 Separation from EC requires simultaneous optimal manipulation of heart rate and rhythm, loading conditions, afterload, and contractility. Patients with preexisting ventricular dysfunction will have alterations in beta-adrenergic receptors and responsivenes ... Full text Link to item Cite

Perioperative Hypertension

Journal Article Acta Anaesth Scand · 1993 Cite

New concepts in the treatment of anaphylactoid reactions in anaesthesia

Other Acta Anaesthesiologica Scandinavica · January 1, 1993 Full text Cite

Anaphylactic reaction to thiopental

Other Journal of the American Medical Association · January 1, 1993 Full text Cite

Treatment of hypersensitivity reactions during anaesthesia and surgery

Journal Article Acta Anaesthesiologica Scandinavica · January 1, 1993 Full text Cite

The ideal agent for perioperative hypertension and potential cytoprotective effects.

Other Acta Anaesthesiol Scand Suppl · 1993 Perioperative hypertension is primarily due to increased systemic vascular resistance (SVR). Therefore, the major therapeutic approaches are directed at reducing vasoconstriction, using drugs that increase cyclic nucleotides or block calcium entry into vas ... Full text Link to item Cite

Antibody formation after drug administration during cardiac surgery: parameters for aprotinin use.

Journal Article J Heart Lung Transplant · 1993 Patients who require cardiac surgery or heart-lung transplantation may have been previously sensitized to drugs and blood products to which they may be reexposed during their current surgery. Reexposure may produce an anaphylactic reaction, a life-threaten ... Link to item Cite

Effects of vecuronium-induced histamine N-methyltransferase inhibition on cutaneous responses to histamine

Journal Article Agents and Actions · June 1, 1992 All muscle relaxants inhibit histamine N-methyltransferase in vitro, but vecuronium, a steroid-derived muscle relaxant, is the most potent inhibitor. It has been suggested that administration of vecuronium prior to giving a drug that releases histamine may ... Full text Cite

The allergic response

Chapter · 1992 Cite

Anaphylactic reactions during anesthesia.

Journal Article Anesth Analg · January 1992 Full text Link to item Cite

Anaphylactic reactions.

Journal Article Can J Anaesth · January 1992 Full text Link to item Cite

Perioperative experience with amrinone.

Other Eur J Anaesthesiol Suppl · 1992 Amrinone is the only phosphodiesterase fraction III inhibitor currently available in the USA for the treatment of perioperative biventricular failure. Patients with chronic congestive heart failure (CHF) show down-regulation of the beta 1-adrenergic recept ... Link to item Cite

Pharmacokinetic and pharmacodynamic considerations of low cardiac output

Journal Article Journal of Drug Development, Supplement · December 1, 1991 Cite

Pharmacokinetics of amrinone during cardiac surgery.

Journal Article Anesthesiology · December 1991 Amrinone is a nonglycosidic noncatecholamine with both vasodilator and positive inotropic effects that may be administered to patients undergoing cardiac surgery. As an initial step toward elucidating the optimal dosage of amrinone for cardiac surgical pat ... Full text Link to item Cite

Increased anticoagulation during cardiopulmonary bypass by aprotinin.

Journal Article J Thorac Cardiovasc Surg · November 1991 Link to item Cite

Wheal and flare responses to muscle relaxants in humans.

Journal Article Agents Actions · November 1991 Chemically and pharmacologically unrelated molecules release histamine in humans to produce both cutaneous and systemic responses. It has been suggested that molecular changes in the new benzylisoquinoline-derived muscle relaxant, atracurium, make it less ... Full text Link to item Cite

Anaphylaxis during anesthesia.

Journal Article Anesthesiology · October 1991 Full text Link to item Cite

Aprotinin and its heparin-sparing effect

Other The Journal of Thoracic and Cardiovascular Surgery · 1991 Cite

Review article: Anaphylactic reactions during cardiac surgery

Journal Article Perfusion · January 1, 1991 Anaphylactic reactions during cardiac surgery may present as acute cardiopulmonary dysfunction and require prompt and aggressive therapy. Recognition, with appropriate therapeutic intervention, is essential to prevent the life-threatening complications ass ... Full text Cite

Anaphylactic reactions during cardiac surgery

Other Perfusion · 1991 Anaphylactic reactions during cardiac surgery may present as acute cardiopulmonary dysfunction and require prompt and aggressive therapy. Recognition, with appropriate therapeutic intervention, is essential to prevent the life-threatening complications ass ... Cite

Relationship between clinical evaluation of peripheral perfusion and global hemodynamics in adults after cardiac surgery.

Journal Article Crit Care Med · December 1990 The relationship between clinical indicators of peripheral perfusion and global hemodynamics after cardiac surgery was examined in 40 adults. We found no significant relationship between capillary refill, pedal pulses, or extremity (toe or finger) core tem ... Full text Link to item Cite

Allergy and anesthesia

Chapter · 1990 Cite

Pharmacokinetics and pharmacodynamics of phosphodiesterase-III inhibitors

Other Journal of Cardiothoracic Anesthesia · January 1, 1990 Full text Cite

Summary

Journal Article Journal of Cardiothoracic Anesthesia · January 1, 1990 Full text Cite

Management of surgical low cardiac output syndrome

Journal Article Journal of Cardiothoracic Anesthesia · 1990 Cite

Serum protein changes during cardiopulmonary bypass: Implications for host defence

Journal Article Perfusion · January 1, 1990 A reduction in host defence capability, with increased risks of infection, occurs after open-heart surgery to a greater degree than after nonbypass surgery. Our costs for postoperative infections are large, about 15% of the total cost of open-heart surgery ... Full text Cite

Amrinone: pharmacokinetics and pharmacodynamics.

Other J Cardiothorac Anesth · December 1989 Amrinone is a selective inhibitor of phosphodiesterase fraction 3 in both cardiac and smooth muscle. Intravenous administration in humans produces increased contractility and vasodilation of venous capacitance and arterial conductance vessels. The eliminat ... Full text Link to item Cite

Effects of protamine on histamine release from human lung.

Journal Article Agents Actions · August 1989 Animal mast cell models demonstrate direct histamine release by protamine. Investigators have proposed that protamine also releases histamine in man. We studied the effects of protamine alone and heparin-protamine mixtures on minced lung tissue for evidenc ... Full text Link to item Cite

Evaluation of patients at risk for protamine reactions.

Journal Article J Thorac Cardiovasc Surg · August 1989 Patients with neutral protamine Hagedorn and protamine-zinc insulin-dependent diabetes, a history of fish allergy, or prior vasectomy have been reported to be at an increased risk for protamine reactions after cardiopulmonary bypass because of prior sensit ... Link to item Cite

Wheal and flare responses to opioids in humans.

Journal Article Anesthesiology · May 1989 Certain opioids release histamine from cutaneous mast cells to produce local wheal and flare responses and adverse hemodynamic effects. In vivo responses to opioids suggest that cutaneous responses result from the interaction of opioids with opioid recepto ... Full text Link to item Cite

The allergic response

Chapter · 1989 Cite

Allergy and anesthesia

Chapter · 1989 Cite

Cardiovascular changes during anaphylactic/anaphylactoid reactions in man

Journal Article Journal of Clinical Anesthesia · 1989 Cite

Anaphylactic/anaphylactoid reactions during cardiac surgery.

Journal Article J Clin Anesth · 1989 Over a 12-month period, 1,743 patients were retrospectively evaluated for anaphylactic/anaphylactoid reactions during cardiac surgery. Reactions to protamine, vancomycin, blood, and metocurine were observed in eight patients (0.46%). Baseline to reaction m ... Full text Link to item Cite

Contamination reduction during central venous catheterization.

Journal Article Crit Care Med · February 1988 This study examined a simple technique for reducing contamination during catheterization of the internal jugular vein. Sixty patients were assigned randomly to receive either a traditional iodophor skin cleansing or an alcohol cleansing, followed by applic ... Full text Link to item Cite

Allergy and anesthesia

Chapter · 1988 Cite

Allergic reactions during anesthesia.

Other J Clin Anesth · 1988 Any drug or blood product administered in the perioperative period has the potential to produce a life-threatening allergic (immune reaction) called anaphylaxis. Anaphylactic reactions represent adverse reactions mediated by immunospecific antibodies (IgE ... Full text Link to item Cite

Use of cardiopulmonary bypass in studies of the circulation.

Journal Article Br J Anaesth · 1988 In summary, CPB provides a complex set of physiological circumstances during which the patient is subjected to severe physiological alterations with surprisingly few adverse sequelae. Our ultimate goal in performing medical research is to provide scientifi ... Full text Link to item Cite

Transfusion reactions

Chapter · 1987 Cite

Prospective evaluation of risk of protamine reactions in patients with NPH insulin-dependent diabetes.

Journal Article Anesth Analg · July 1986 Patients with NPH (neutral protamine Hagedorn) insulin-dependent diabetes may have an increased risk for protamine reactions because of prior sensitization. During one year, we prospectively evaluated 50 at-risk cardiac surgery patients for clinical reacti ... Link to item Cite

Anaphylactic and anaphylactoid reactions. A review.

Other Spine (Phila Pa 1976) · April 1986 Anaphylaxis is a life-threatening, immunologically mediated reaction. "Anaphylactoid" reactions produce the same clinical syndrome but are not immunologically mediated. Vasoactive mediators of these reactions include histamine, eosinophilic chemotactic fac ... Full text Link to item Cite

Shock

Chapter · 1986 Cite

Myocardial Ischemia

Chapter · 1986 Cite

Transfusion principles

Chapter · 1986 Cite

A retrospective study of the incidence and causes of failed spinal anesthetics in a university hospital.

Journal Article Anesth Analg · July 1985 One hundred sequential spinal anesthetic procedures were reviewed retrospectively to study specifically the incidence and causes of spinal anesthesia. Variables examined included the patient population, the technical aspects of performing subarachnoid tap ... Link to item Cite

A case report of a potentially fatal complication associated with ischia's transaortic method of celiac plexus block

Journal Article Regional Anesthesia · January 1, 1985 A case is described of severe diarrhea following a transaortic neurolytic celiac plexus block. A brief review of incidence and severity of this complication associated with the newer methods of celiac plexus block is presented, and the possible cause of di ... Cite

Inadvertent transbronchial insertion of narrow-bore feeding tubes into the pleural space.

Other JAMA · May 11, 1984 Four patients had soft, narrow-bore feeding tubes passed transbronchially into the pleural space. Guide wires were used to aid passage and may have contributed to this complication. The errant positioning of the tube was first noted roentgenographically in ... Link to item Cite

Case Records of the Massachusetts General Hospital

Other The New England journal of medicine · 1983 Discussant in case 19-1983 ... Cite

Intravenous epinephrine therapy in anaphylaxis

Other Journal of the American Medical Association · 1983 Full text Cite

Anaphylaxis to meperidine.

Other Anesth Analg · March 1982 Link to item Cite

Controlled circulation

Chapter · 1982 Cite