Scholars@Duke
Jerrold Henry Levy

Jerrold Henry Levy

Professor Emeritus of Anesthesiology
Anesthesiology, Cardiothoracic

Scholarly Works

The association of estimated citrate load with frozen plasma versus four-factor prothrombin complex concentrate for coagulopathy after cardiac surgery: a post hoc exploratory analysis of the FARES-II randomised controlled trial.

Journal article BJA Open · September 2026 BACKGROUND: Frozen plasma (FP) is the standard haemostatic therapy after cardiopulmonary bypass, but recent trials indicate that FP is inferior to four-factor prothrombin complex concentrate (PCC). Citrate content may contribute to this difference. We comp ... Full text Link to item Cite

Impact of 25% Albumin on Vasopressor Requirements in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.

Journal article Ann Pharmacother · July 2026 BACKGROUND: Critically ill patients receiving continuous renal replacement therapy (CRRT) commonly experience hypotension necessitating fluids, ultrafiltration (UF) adjustment, or vasopressors. There is limited evidence evaluating 25% albumin on vasopresso ... Full text Link to item Cite

Surgical and procedural bleed risk stratification for anticoagulated patients undergoing planned surgery: guidance from the ISTH SSC Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis.

Journal article J Thromb Haemost · July 2026 Patients often need to interrupt anticoagulation for invasive procedures or surgery. Periprocedural bleeding can contribute to substantial morbidity and mortality. Procedural bleed risk stratification informs whether anticoagulation needs to be interrupted ... Full text Link to item Cite

Management of anticoagulation in patients with heparin-induced thrombocytopenia requiring cardiac surgery with cardiopulmonary bypass: guidance from the ISTH SSC on Perioperative and Critical Care Haemostasis and Thrombosis.

Journal article J Thromb Haemost · June 4, 2026 Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction characterized by thrombocytopenia and a high risk of thrombosis. Patients with HIT and a need for cardiac surgery with cardiopulmonary bypass represent a challenging group, ... Full text Link to item Cite

Development, validation, and user-centric evaluation of an interpretable machine learning decision support tool for the preoperative prediction of mild bleeding disorders (MBD-Check): a prospective diagnostic prediction study.

Journal article Lancet Digit Health · June 4, 2026 BACKGROUND: Mild bleeding disorders are the most common inherited bleeding disorders, often leading to perioperative haemorrhages. Preoperative screening for mild bleeding disorders remains challenging due to the limitations of existing screening tools, re ... Full text Link to item Cite

How to monitor and manage unfractionated heparin in practice (Part 1)? Guidance from the SSC of the ISTH.

Journal article J Thromb Haemost · May 20, 2026 The International Society on Thrombosis and Haemostasis (ISTH) recently published a survey on the management of unfractionated heparin (UFH), which revealed substantial heterogeneity in practice and highlighted the need to develop evidence-based guidance. ... Full text Link to item Cite

Perioperative management of antithrombotic therapy in patients with thrombotic antiphospholipid syndrome.

Journal article Blood Adv · May 12, 2026 Patients with thrombotic antiphospholipid syndrome (APS) frequently require interruption of anticoagulation for invasive procedures; however, data to guide the perioperative management remain limited. We conducted a single-center, retrospective cohort stud ... Full text Link to item Cite

Designing biomarker-selected international trials in sepsis-associated coagulopathy.

Journal article J Thromb Haemost · May 7, 2026 Sepsis-associated coagulopathy represents a dynamic thromboinflammatory continuum ranging from early, compensated sepsis-induced coagulopathy (SIC) to overt disseminated intravascular coagulation (DIC). Divergent international strategies reflect difference ... Full text Link to item Cite

Global practice and challenges in the diagnosis and management of disseminated intravascular coagulation: communication from the ISTH SSC Subcommittee on Disseminated Intravascular Coagulation.

Journal article J Thromb Haemost · May 2026 BACKGROUND: Despite the global burden of disseminated intravascular coagulation (DIC) and decades of scoring system development, no international assessment has evaluated current global practices among clinicians. OBJECTIVES: To describe international diag ... Full text Link to item Cite

Thrombin generation and the pharmacodynamics of parenteral anticoagulants.

Journal article Pharmacol Rev · May 2026 Parenteral anticoagulants are mainstay therapies in critical care and perioperative settings because of their unique pharmacological properties, but they have a narrow therapeutic window. This emphasizes the need to thoroughly understand their pharmacodyna ... Full text Link to item Cite

Regulated cell death in sepsis: reframing NETosis within the spectrum of apoptosis and inflammatory lytic death.

Journal article Inflamm Res · April 28, 2026 BACKGROUND: Sepsis is characterized by dysregulated inflammation leading to organ dysfunction. While immune activation and metabolic stress are central features, accumulating evidence suggests that regulated cell death programs actively influence inflammat ... Full text Link to item Cite

Anaphylaxis and coagulopathy: from rare case reports to mechanistic insights.

Journal article J Thromb Haemost · April 2, 2026 Anaphylaxis is an unpredictable hypersensitivity reaction characterized by acute, life-threatening cardiopulmonary dysfunction, including shock, angioedema, and bronchospasm. Although coagulopathy and disseminated intravascular coagulation (DIC) have been ... Full text Link to item Cite

Management of Direct Oral Anticoagulants in Adult Patients Undergoing Cardiac Surgery: A Joint Consensus Statement by the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons.

Journal article Anesth Analg · April 1, 2026 The Society of Cardiovascular Anesthesiologists (SCA) along with the Society of Thoracic Surgeons (STS) sought to improve the care of adult patients undergoing cardiac surgery who are taking direct oral anticoagulants (DOACs), such as factor Xa and direct ... Full text Link to item Cite

Management of Direct Oral Anticoagulants in Adult Patients Undergoing Cardiac Surgery: A Joint Consensus Statement by the Society of Cardiovascular Anesthesiologists and The Society of Thoracic Surgeons.

Journal article Ann Thorac Surg · April 2026 The Society of Cardiovascular Anesthesiologists (SCA) along with The Society of Thoracic Surgeons (STS) sought to improve the care of adult patients undergoing cardiac surgery who are taking direct oral anticoagulants (DOACs), such as factor Xa and direct ... Full text Link to item Cite

Endotheliopathy within the thromboinflammatory network of sepsis-induced coagulopathy.

Journal article Inflamm Res · March 17, 2026 BACKGROUND: Sepsis represents a life-threatening syndrome driven by dysregulated host responses in which inflammation, coagulation, and endothelial dysfunction intersect. Increasing evidence suggests that endotheliopathy is a dynamically interacting compon ... Full text Link to item Cite

Evolution of Clinical Trials in Anticoagulation for Sepsis: Bridging Past to Future.

Journal article Semin Thromb Hemost · February 2026 Demonstrating the efficacy of new treatments in any condition may be a challenging endeavor, and is particularly the case in sepsis. In the early 21st century, recombinant activated protein C showed a survival benefit in severe sepsis; however, subsequent ... Full text Link to item Cite

Introducing the New Definition and Diagnostic Criteria of Disseminated Intravascular Coagulation Released by the International Society on Thrombosis and Haemostasis in 2025.

Journal article Semin Thromb Hemost · February 2026 In 2025, the International Society on Thrombosis and Haemostasis (ISTH) released updated definitions and diagnostic criteria for disseminated intravascular coagulation (DIC), reflecting advances in understanding its pathophysiology. DIC is now defined as a ... Full text Link to item Cite

Recognizing Coagulation Disorders in Sepsis in the Emergency Room: A Narrative Review.

Journal article J Clin Med · January 8, 2026 Sepsis remains a leading cause of global mortality, and early management in the emergency department (ED) is a key determinant of clinical outcomes. Among the earliest physiological derangements in sepsis are abnormalities in coagulation, which represent n ... Full text Link to item Cite

Endotoxin-induced Ferroptosis-associated Leukocyte Injury and DAMP Release in Sepsis: An in Vitro Study

Journal article Juntendo Medical Journal · January 1, 2026 Background: Sepsis is characterized by dysregulated inflammation and thromboinflammation in which regulated cell death and damage-associated molecular patterns (DAMPs) contribute to organ injury. Ferroptosis has recently emerged as a potential mechanism of ... Full text Cite

Damage-associated Molecular Patterns, Immunothrombosis, and Intravascular Inflammation in Sepsis: A Narrative Integrative Review.

Journal article Semin Thromb Hemost · December 31, 2025 Sepsis is now considered a dysregulated host response in which inflammation, coagulation, and endothelial injury converge to create a self-amplifying network of thromboinflammation. This definition reflects maladaptive immunothrombosis-a defense mechanism ... Full text Link to item Cite

Influence of Direct Oral Anticoagulant Levels and Thrombin Generation on Postoperative Bleeding [SONAR]: A Nested Case-Control Study.

Journal article Thromb Haemost · December 2025 A direct oral anticoagulant (DOAC) concentration threshold above which an impact on surgical hemostasis starts to occur is unknown. Thrombin generation assays (TGAs) provide a measure of the coagulation phenotype. This study aimed to determine whether preo ... Full text Link to item Cite

Disseminated Intravascular Coagulation and Advances in D-Dimer Testing: Progress in Harmonization of Clinical Assays and Innovative Detection Methods.

Journal article Clin Lab Med · December 2025 The measurement of D-dimer, a fibrin degradation product, has become integral to diagnosing and managing thrombotic disorders, particularly disseminated intravascular coagulation. This report synthesizes current knowledge on D-dimer biochemistry, assay met ... Full text Link to item Cite

Perioperative use of factor concentrates and blood products-a survey of clinical practices in the United States: communication from the ISTH Subcommittee on Perioperative and Critical Care.

Journal article J Thromb Haemost · December 2025 BACKGROUND: Educational efforts to improve perioperative physician knowledge on managing bleeding and oral anticoagulants may have influenced clinical practice. This study evaluated management strategies for major bleeding and use of fibrinogen and prothro ... Full text Link to item Cite

Sepsis and heatstroke: overlapping and distinct mechanisms of systemic inflammation.

Journal article Inflamm Res · November 26, 2025 BACKGROUND: Sepsis and heatstroke, although arising from microbial infection or environmental heat exposure, converge upon similar pathophysiological systemic inflammatory responses that include immune dysregulation, mitochondrial dysfunction, endothelial ... Full text Link to item Cite

Heat stress-induced mitochondrial damage and its impact on leukocyte function.

Journal article J Intensive Care · November 4, 2025 Heatstroke is characterized by systemic inflammation, immune dysregulation, and multiorgan failure, in which mitochondrial damage in leukocytes plays a pivotal role. This review examines the mechanisms by which heat stress induces leukocyte mitochondrial d ... Full text Link to item Cite

Factors influencing antithrombin activity following supplementation in sepsis-associated disseminated intravascular coagulation.

Journal article Thromb J · October 6, 2025 BACKGROUND: Antithrombin, a key regulator of the coagulation cascade, is often decreased in patients with sepsis-associated disseminated intravascular coagulation (DIC). Antithrombin is commonly supplemented when activity levels fall to 70% or below in Jap ... Full text Link to item Cite

Handling Hemolytic Blood Samples from High-Risk Clinical Areas: A Call to Action.

Journal article J Appl Lab Med · September 3, 2025 BACKGROUND: Spectrophotometric testing to detect sample hemolysis is available from central laboratory chemistry analyzers. While the cause and preventative measures are known, hemolysis continues to be a common preanalytical error, especially for specimen ... Full text Link to item Cite

Statistical Analysis and Reporting of Cardiac Output Method Comparison Studies (COMPARE) Statement.

Journal article Anesthesiology · September 1, 2025 Cardiac output is a key cardiovascular variable quantifying global blood flow. The measurement performance of cardiac output monitoring methods is investigated in validation studies, which are method comparison studies determining the agreement between car ... Full text Link to item Cite

Mortality, diagnosis, and etiology of disseminated intravascular coagulation-a systematic review and meta-analysis: communication from the ISTH SSC subcommittee on disseminated intravascular coagulation.

Journal article J Thromb Haemost · August 2025 BACKGROUND: Establishing global standards for diagnosis and treatment of disseminated intravascular coagulation (DIC) requires a comprehensive evaluation of its global epidemiology. However, obtaining epidemiologic evidence on DIC from a single cohort stud ... Full text Link to item Cite

Updated definition and scoring of disseminated intravascular coagulation in 2025: communication from the ISTH SSC Subcommittee on Disseminated Intravascular Coagulation.

Journal article J Thromb Haemost · July 2025 Compelling evidence supports the need to update the 2001 definition and diagnosis of disseminated intravascular coagulation (DIC) to reflect our current understanding of disease pathophysiology. DIC has been long considered a critical and untreatable seque ... Full text Link to item Cite

Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery: The FARES-II Multicenter Randomized Clinical Trial.

Journal article JAMA · May 27, 2025 IMPORTANCE: Excessive bleeding is a common and prognostically important complication of cardiac surgery. For bleeding related to coagulation factor deficiency, frozen plasma is the most used therapy. Preliminary trials indicate that 4-factor prothrombin co ... Full text Open Access Link to item Cite

Results of an international survey on the management of therapeutic intensity unfractionated heparin: communication from the SSCs of the ISTH.

Journal article J Thromb Haemost · May 2025 BACKGROUND: Unfractionated heparin (UFH) remains the anticoagulant of choice in critically ill patients. However, its laboratory monitoring and clinical management are particularly challenging. OBJECTIVES: Our objective was to describe current practices an ... Full text Link to item Cite

ECMO-induced coagulopathy: strategic initiatives for research and clinical practice (a workshop report of the NHLBI).

Journal article Blood Vessel Thromb Hemost · May 2025 In May 2024, the Division of Blood Diseases and Resources of the National Heart, Lung, and Blood Institute (NHLBI) hosted a hybrid workshop on "Extracorporeal membrane oxygenation (ECMO)-induced coagulopathy: strategic initiatives for research and clinical ... Full text Link to item Cite

Disseminated intravascular coagulation and cirrhotic coagulopathy: overlap and differences. The current state of knowledge. Communication from the SSC of the ISTH.

Journal article J Thromb Haemost · March 2025 Patients with disseminated intravascular coagulation (DIC) have decreasing plasma levels of coagulation factors and platelet counts with increased levels of D-dimer. Standard laboratory tests are used clinically to diagnose DIC and quantify the severity of ... Full text Link to item Cite

Management of bleeding and invasive procedures in patients treated with anti-factor XI(a) anticoagulants: proposals from the French Working Group on Perioperative Haemostasis and French Society of Thrombosis and Haemostasis.

Journal article Res Pract Thromb Haemost · March 2025 BACKGROUND: Several anti-FXI(a) agents with distinct mechanisms of action and pharmacological properties are currently under clinical development. While these anticoagulants are not yet available, there is a need to address bleeding risk management for pat ... Full text Link to item Cite

Four-factor Prothrombin Complex Concentrate Use for Bleeding Management in Adult Trauma.

Journal article Anesthesiology · February 1, 2025 The clinical use of four-factor prothrombin complex concentrate in adult trauma patients at risk of bleeding is supported by evidence for urgent reversal of oral anticoagulants but is controversial in acquired traumatic coagulopathy. ... Full text Link to item Cite

Mitochondrial dysfunction is a major cause of thromboinflammation and inflammatory cell death in critical illnesses.

Journal article Inflamm Res · January 13, 2025 BACKGROUND: Mitochondria generate the adenosine triphosphate (ATP) necessary for eukaryotic cells, serving as their primary energy suppliers, and contribute to host defense by producing reactive oxygen species. In many critical illnesses, including sepsis, ... Full text Link to item Cite

Impact of hyper- and hypothermia on cellular and whole-body physiology.

Journal article J Intensive Care · January 13, 2025 The incidence of heat-related illnesses and heatstroke continues to rise amidst global warming. Hyperthermia triggers inflammation, coagulation, and progressive multiorgan dysfunction, and, at levels above 40 °C, can even lead to cell death. Blood cells, p ... Full text Link to item Cite

Viscoelastic haemostatic assays to guide therapy in elective surgery: an updated systematic review and meta-analysis.

Journal article Anaesthesia · January 2025 BACKGROUND: Patients undergoing major surgery frequently experience major uncontrolled bleeding. The aim of this systematic review and meta-analysis was to evaluate the clinical efficacy of using viscoelastic haemostatic assays to manage peri-operative ble ... Full text Link to item Cite

Incorporating the concept of overtransfusion into hemovigilance monitoring: An expert-based definition and criteria from the International HIT-OVER Forum.

Journal article Transfusion · January 2025 BACKGROUND: Liberal or overtransfusion (OT) may be regarded as "inappropriate," but it is not reported as a transfusion-related adverse event. A definition of OT is lacking. OT may include overdosing of components, giving the incorrect component, or unnece ... Full text Link to item Cite

Is Antithrombin Supplementation Effective in Suppressing ECMO Circuit Thrombosis in Sepsis?

Journal article Juntendo Med J · 2025 Extracorporeal membrane oxygenation (ECMO) is increasingly used for the management of severe sepsis-induced cardiopulmonary failure. Despite standard heparin anticoagulation, circuit thrombosis remains a significant complication. Antithrombin (AT), a criti ... Full text Link to item Cite

Troubleshooting heparin resistance.

Journal article Hematology Am Soc Hematol Educ Program · December 6, 2024 The term heparin resistance is likely best defined as the failure of an appropriate dose of unfractionated heparin (UFH) to achieve a predetermined level of anticoagulation. Unfortunately, and despite many prior reports, there is no established consensus a ... Full text Link to item Cite

Navigating Hemolysis and the Renal Implications of Hemoglobin Toxicity in Cardiac Surgery.

Journal article Anesthesiology · December 1, 2024 Acute kidney injury (AKI) affects 20% to 30% of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). This review synthesizes clinical evidence indicating that CPB-induced hemolysis plays a pivotal role in the development of AKI. The patho ... Full text Link to item Cite

Perioperative considerations in the paediatric patient with congenital and acquired coagulopathy.

Journal article BJA Open · December 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 Link to item Cite

Transfusions in Lung Transplantation: Reply.

Journal article Anesthesiology · December 1, 2024 Full text Link to item Cite

Human Plasma Derived Antithrombin (Atenativ) in Heparin-Resistant Cardiac Surgery Patients: Protocol Update for an Ongoing Phase 3, Double-Blind, Placebo-Controlled, Multicenter Study

Conference Blood · November 5, 2024 Background and Significance: Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) require anticoagulation to prevent hemostatic activation and circuit thrombosis. Unfract ... Full text Cite

Prothrombin complex concentrate for direct factor Xa inhibitor-associated bleeding or before urgent surgery.

Journal article Thromb Res · November 2024 INTRODUCTION: Factor Xa inhibitor (FXaI)-associated bleeding events are common and associated with substantial morbidity. Systematic evaluation of widely available, effective, and affordable FXaI bleed management strategies is needed. MATERIALS AND METHODS ... Full text Link to item Cite

Autophagy and autophagic cell death in sepsis: friend or foe?

Journal article J Intensive Care · October 25, 2024 In sepsis, inflammation, and nutrient deficiencies endanger cellular homeostasis and survival. Autophagy is primarily a mechanism of cellular survival under fasting conditions. However, autophagy-dependent cell death, known as autophagic cell death, is pro ... Full text Link to item 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

Placental Origins of Preeclampsia: Insights from Multi-Omic Studies.

Journal article Int J Mol Sci · August 28, 2024 Preeclampsia (PE) is a major cause of maternal and neonatal morbidity and mortality worldwide, with the placenta playing a central role in disease pathophysiology. This review synthesizes recent advancements in understanding the molecular mechanisms underl ... 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

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

Journal article Med Klin Intensivmed Notfmed · July 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

The role of accelerometer-derived sleep traits on glycated haemoglobin and glucose levels: a Mendelian randomization study.

Journal article Sci Rep · June 28, 2024 Self-reported shorter/longer sleep duration, insomnia, and evening preference are associated with hyperglycaemia in observational analyses, with similar observations in small studies using accelerometer-derived sleep traits. Mendelian randomization (MR) st ... Full text Link to item Cite

Determining prognostic indicator for anticoagulant therapy in sepsis-induced disseminated intravascular coagulation.

Journal article J Intensive Care · June 24, 2024 BACKGROUND: There is no reliable indicator that can assess the treatment effect of anticoagulant therapy for sepsis-associated disseminated intravascular coagulation (DIC) in the short term. The aim of this study is to develop and validate a prognostic ind ... 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

Nightmares share genetic risk factors with sleep and psychiatric traits.

Journal article Transl Psychiatry · February 27, 2024 Nightmares are vivid, extended, and emotionally negative or negative dreams that awaken the dreamer. While sporadic nightmares and bad dreams are common and generally harmless, frequent nightmares often reflect underlying pathologies of emotional regulatio ... 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

Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study.

Journal article Sleep · January 11, 2024 Abnormally short and long sleep are associated with premature mortality, and achieving optimal sleep duration has been the focus of sleep health guidelines. Emerging research demonstrates that sleep regularity, the day-to-day consistency of sleep-wake timi ... Full text Link to item Cite

The Role of Circadian Rhythms and Sleep in Anorexia Nervosa.

Journal article JAMA Netw Open · January 2, 2024 IMPORTANCE: Observational studies have associated anorexia nervosa with circadian rhythms and sleep traits. However, the direction of causality and the extent of confounding by psychosocial comorbidities in these associations are unknown. OBJECTIVES: To in ... 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 Iji Zasshi · 2024 The glycocalyx serves as the covering layer of the luminal surface of vascular endothelial cells, comprising proteoglycans, glycosaminoglycans, and adherent plasma proteins. This intricate structure is crucial in promoting antithrombogenicity, controlling ... Full text Link to item Cite

Why is DIC a Rare Diagnosis in the 21st Century?

Journal article Juntendo Iji Zasshi · 2024 Disseminated Intravascular Coagulation (DIC) has been a common diagnosis made by health care givers since the dawn of the 20th century. However, currently, this diagnosis is entertained rarely in clinical settings that can predispose to this complication. ... Full text Link to item Cite

Pharmacologic Approaches to Bleeding

Book section · January 1, 2024 Pharmacologic approaches are an important part of bleeding management beyond the use of transfusional therapies. In addition to antifibrinolytic agents, that have an increasing role in managing traumatic, surgical, and medical bleeding, procoagulant factor ... Full text Cite

Fibrinolytic Changes in Critical Illnesses: Is Fibrinolysis Shutdown a Specific Concept?

Journal article Juntendo Iji Zasshi · 2024 Trauma-induced coagulopathy (TIC) is characterized by dynamic changes in fibrinolysis, which can significantly impact patient outcomes. These changes typically manifest in two phases: hyperfibrinolysis followed by fibrinolysis suppression. In the early sta ... Full text Link to item 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 Journal of thrombosis and haemostasis : JTH · 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 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

Multi-ancestry genome-wide analysis identifies shared genetic effects and common genetic variants for self-reported sleep duration.

Journal article Hum Mol Genet · September 5, 2023 Both short (≤6 h per night) and long sleep duration (≥9 h per night) are associated with increased risk of chronic diseases. Despite evidence linking habitual sleep duration and risk of disease, the genetic determinants of sleep duration in the general pop ... 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

Anticoagulation in the intensive care unit

Book section · January 1, 2023 Intensive care unit (ICU) patients are often anticoagulated for indications that include thromboprophylaxis, ischemic and other cardiovascular thrombotic states, and extracorporeal circulation. The non-vitamin K direct oral anticoagulation agents (DOACs) i ... Full text Cite

Postoperative Cardiovascular Management

Book section · January 1, 2023 Postoperative cardiovascular dysfunction is increasingly common as older and increasingly more critically ill patients undergo cardiac surgery. Biventricular dysfunction and circulatory changes occur after cardiopulmonary bypass (CPB) and in patients under ... Full text Cite

Blood Conservation, Transfusion, and Conservation

Book section · January 1, 2023 Cardiac surgical patients are at significant risk for bleeding. Certain patients are at a greater risk for bleeding and a need for transfusions. Variables that are important risk factors include (1) advanced age, (2) low preoperative red blood cell volume ... Full text 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

Genetic evidence for a potential causal relationship between insomnia symptoms and suicidal behavior: a Mendelian randomization study.

Journal article Neuropsychopharmacology · August 2022 Insomnia and restless leg syndrome (RLS) are associated with increased risk for suicidal behavior (SB), which is often comorbid with mood or thought disorders; however, it is unclear whether these relationships are causal. We performed a two-sample Mendeli ... 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

Association of Poor Sleep Burden in Middle Age and Older Adults With Risk for Delirium During Hospitalization.

Journal article J Gerontol A Biol Sci Med Sci · March 3, 2022 BACKGROUND: Delirium is a distressing neurocognitive disorder recently linked to sleep disturbances. However, the longitudinal relationship between sleep and delirium remains unclear. This study assessed the associations of poor sleep burden, and its traje ... 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

Selection into shift work is influenced by educational attainment and body mass index: a Mendelian randomization study in the UK Biobank.

Journal article Int J Epidemiol · August 30, 2021 BACKGROUND: Shift work is associated with increased cardiometabolic disease risk. This observation may be partly explained by cardiometabolic risk factors having a role in the selection of individuals into or out of shift work. We performed Mendelian rando ... Full text Link to item Cite

Whole-genome association analyses of sleep-disordered breathing phenotypes in the NHLBI TOPMed program.

Journal article Genome Med · August 26, 2021 BACKGROUND: Sleep-disordered breathing is a common disorder associated with significant morbidity. The genetic architecture of sleep-disordered breathing remains poorly understood. Through the NHLBI Trans-Omics for Precision Medicine (TOPMed) program, we p ... 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

Genetically Proxied Diurnal Preference, Sleep Timing, and Risk of Major Depressive Disorder.

Journal article JAMA Psychiatry · August 1, 2021 IMPORTANCE: Morning diurnal preference is associated with reduced risk of major depressive disorder (MDD); however, causality in this association is uncertain. OBJECTIVE: To examine the association of genetically proxied morning diurnal preference with dep ... Full text Link to item Cite

Is disrupted sleep a risk factor for Alzheimer's disease? Evidence from a two-sample Mendelian randomization analysis.

Journal article Int J Epidemiol · July 9, 2021 BACKGROUND: It is established that Alzheimer's disease (AD) patients experience sleep disruption. However, it remains unknown whether disruption in the quantity, quality or timing of sleep is a risk factor for the onset of AD. METHODS: We used the largest ... 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

Variant curation expert panel recommendations for RYR1 pathogenicity classifications in malignant hyperthermia susceptibility.

Journal article Genet Med · July 2021 PURPOSE: As a ClinGen Expert Panel (EP) we set out to adapt the American College of Medical Genetics and Genomics (ACMG)/Association for Molecular Pathology (AMP) pathogenicity criteria for classification of RYR1 variants as related to autosomal dominantly ... Full text 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

The trans-ancestral genomic architecture of glycemic traits.

Journal article Nat Genet · June 2021 Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up ... Full text Link to item Cite

C-reactive Protein and Risk of OSA in Four US Cohorts.

Journal article Chest · June 2021 BACKGROUND: Individuals with OSA have elevated levels of inflammatory markers, but no prospective study has examined the role of inflammation in the development of OSA. RESEARCH QUESTION: Is C-reactive protein (CRP) prospectively associated with risk of de ... 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

Inhaled Selective Pulmonary Vasodilators for Adult Lung Transplantation

Conference JOURNAL OF HEART AND LUNG TRANSPLANTATION · April 2021 Link to item Cite

Inhaled Selective Pulmonary Vasodilators for Advanced Heart Failure Therapies

Conference JOURNAL OF HEART AND LUNG TRANSPLANTATION · April 2021 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

Associations of self-reported obstructive sleep apnea with total and site-specific cancer risk in older women: a prospective study.

Journal article Sleep · March 12, 2021 BACKGROUND AND OBJECTIVES: Chronic intermittent hypoxia resulting from obstructive sleep apnea (OSA) may activate multiple carcinogenic pathways and lead to cancer development. METHODS: We prospectively examined the association between OSA and cancer risk ... Full text Link to item Cite

Sleep health, diseases, and pain syndromes: findings from an electronic health record biobank.

Journal article Sleep · March 12, 2021 STUDY OBJECTIVES: Implementation of electronic health record biobanks has facilitated linkage between clinical and questionnaire data and enabled assessments of relationships between sleep health and diseases in phenome-wide association studies (PheWAS). I ... Full text 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

Habitual Sleep Duration, Daytime Napping, and Dietary Intake: A Mendelian Randomization Study.

Journal article Curr Dev Nutr · March 2021 BACKGROUND: Chronic inadequate sleep and frequent daytime napping may inflict deleterious health effects including weight gain, cardiometabolic and psychiatric diseases, and cancer. It is plausible that these relations may be partly influenced by the consu ... 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

Coagulopathy and Bleeding Management for Aortic Dissection Surgery

Book section · 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

Night shift work is associated with an increased risk of asthma.

Journal article Thorax · January 2021 INTRODUCTION: Shift work causes misalignment between internal circadian time and the external light/dark cycle and is associated with metabolic disorders and cancer. Approximately 20% of the working population in industrialised countries work permanent or ... Full text Link to item 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

Habitual sleep disturbances and migraine: a Mendelian randomization study.

Journal article Ann Clin Transl Neurol · December 2020 OBJECTIVE: Sleep disturbances are associated with increased risk of migraine, however the extent of shared underlying biology and the direction of causal relationships between these traits is unclear. Delineating causality between sleep patterns and migrai ... Full text Link to item Cite

Operating characteristics of the rank-based inverse normal transformation for quantitative trait analysis in genome-wide association studies.

Journal article Biometrics · December 2020 Quantitative traits analyzed in Genome-Wide Association Studies (GWAS) are often nonnormally distributed. For such traits, association tests based on standard linear regression are subject to reduced power and inflated type I error in finite samples. Apply ... 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

Book section · 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 Anesthesia and analgesia · April 2020 BackgroundCoagulopathy 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 seve ... Full text 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

Melatonin Effects on Glucose Metabolism: Time To Unlock the Controversy.

Journal article Trends Endocrinol Metab · March 2020 The past decade has witnessed a revival of interest in the hormone melatonin, partly attributable to the discovery that genetic variation in MTNR1B - the melatonin receptor gene - is a risk factor for impaired fasting glucose and type 2 diabetes (T2D). Des ... 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 Frontiers in immunology · January 2020 BackgroundThe 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 ... Full text Cite

Sleep Duration and Myocardial Infarction.

Journal article J Am Coll Cardiol · September 10, 2019 BACKGROUND: Observational studies suggest associations between extremes of sleep duration and myocardial infarction (MI), but the causal contribution of sleep to MI and its potential to mitigate genetic predisposition to coronary disease is unclear. OBJECT ... Full text 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

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

Journal article Critical care (London, England) · August 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 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

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

Journal article Journal of clinical medicine · May 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 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

Chronotype Genetic Variant in PER2 is Associated with Intrinsic Circadian Period in Humans.

Journal article Sci Rep · March 29, 2019 The PERIOD2 (PER2) gene is a core molecular component of the circadian clock and plays an important role in the generation and maintenance of daily rhythms. Rs35333999, a missense variant of PER2 common in European populations, has been shown to associate ... 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

Genome-wide association study identifies genetic loci for self-reported habitual sleep duration supported by accelerometer-derived estimates.

Journal article Nat Commun · March 7, 2019 Sleep is an essential state of decreased activity and alertness but molecular factors regulating sleep duration remain unknown. Through genome-wide association analysis in 446,118 adults of European ancestry from the UK Biobank, we identify 78 loci for sel ... Full text Link to item Cite

Biological and clinical insights from genetics of insomnia symptoms.

Journal article Nat Genet · March 2019 Insomnia is a common disorder linked with adverse long-term medical and psychiatric outcomes. The underlying pathophysiological processes and causal relationships of insomnia with disease are poorly understood. Here we identified 57 loci for self-reported ... Full text Link to item Cite

Polygenic risk score identifies associations between sleep duration and diseases determined from an electronic medical record biobank.

Journal article Sleep · March 1, 2019 STUDY OBJECTIVES: We aimed to detect cross-sectional phenotype and polygenic risk score (PRS) associations between sleep duration and prevalent diseases using the Partners Biobank, a hospital-based cohort study linking electronic medical records (EMR) with ... Full text Link to item Cite

Admixture mapping identifies novel loci for obstructive sleep apnea in Hispanic/Latino Americans.

Journal article Hum Mol Genet · February 15, 2019 Obstructive sleep apnea (OSA) is a common disorder associated with increased risk of cardiovascular disease and mortality. Its prevalence and severity vary across ancestral background. Although OSA traits are heritable, few genetic associations have been i ... Full text Link to item Cite

Renal Angina Is a Sensitive, but Nonspecific Identifier of Postcardiac Surgery Acute Kidney Injury.

Journal article J Cardiothorac Vasc Anesth · February 2019 OBJECTIVES: Acute kidney injury (AKI) is a common complication of cardiac surgery, and early detection is difficult. This study was performed to determine the sensitivity, specificity, positive predictive value, negative predictive value, and statistical p ... 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

Genome-wide association analyses of chronotype in 697,828 individuals provides insights into circadian rhythms.

Journal article Nat Commun · January 29, 2019 Being a morning person is a behavioural indicator of a person's underlying circadian rhythm. Using genome-wide data from 697,828 UK Biobank and 23andMe participants we increase the number of genetic loci associated with being a morning person from 24 to 35 ... Full text Link to item Cite

Shared heritability and functional enrichment across six solid cancers.

Journal article Nat Commun · January 25, 2019 Quantifying the genetic correlation between cancers can provide important insights into the mechanisms driving cancer etiology. Using genome-wide association study summary statistics across six cancer types based on a total of 296,215 cases and 301,319 con ... 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

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

Anticoagulation, Preoperative

Book section · January 1, 2017 Full text Cite

Allergy

Book section · January 1, 2017 Full text 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

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

Impact of Common Diabetes Risk Variant in MTNR1B on Sleep, Circadian, and Melatonin Physiology.

Journal article Diabetes · June 2016 The risk of type 2 diabetes (T2D) is increased by abnormalities in sleep quantity and quality, circadian alignment, and melatonin regulation. A common genetic variant in a receptor for the circadian-regulated hormone melatonin (MTNR1B) is associated with i ... Full text Link to item Cite

CSF1R mosaicism in a family with hereditary diffuse leukoencephalopathy with spheroids.

Journal article Brain · June 2016 Mutations in the colony stimulating factor 1 receptor (CSF1R) have recently been discovered as causal for hereditary diffuse leukoencephalopathy with axonal spheroids. We identified a novel, heterozygous missense mutation in CSF1R [c.1990G > A p.(E664K)] b ... Full text Link to item Cite

Prothrombin Complex Concentrates for Bleeding in the Perioperative Setting.

Journal article 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

Comparison of Heritability Estimation and Linkage Analysis for Multiple Traits Using Principal Component Analyses.

Journal article Genet Epidemiol · April 2016 A disease trait often can be characterized by multiple phenotypic measurements that can provide complementary information on disease etiology, physiology, or clinical manifestations. Given that multiple phenotypes may be correlated and reflect common under ... Full text Link to item Cite

Genome-wide association study of 25(OH) Vitamin D concentrations in Punjabi Sikhs: Results of the Asian Indian diabetic heart study.

Journal article J Steroid Biochem Mol Biol · April 2016 Vitamin D deficiency is implicated in multiple disease conditions and accumulating evidence supports that the variation in serum vitamin D (25(OH)D) levels, including deficiency, is under strong genetic control. However, the underlying genetic mechanism as ... Full text Link to item Cite

Genome-wide association analysis identifies novel loci for chronotype in 100,420 individuals from the UK Biobank.

Journal article Nat Commun · March 9, 2016 Our sleep timing preference, or chronotype, is a manifestation of our internal biological clock. Variation in chronotype has been linked to sleep disorders, cognitive and physical performance, and chronic disease. Here we perform a genome-wide association ... 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

Genome-wide association studies in the Japanese population identify seven novel loci for type 2 diabetes.

Journal article Nat Commun · January 28, 2016 Genome-wide association studies (GWAS) have identified more than 80 susceptibility loci for type 2 diabetes (T2D), but most of its heritability still remains to be elucidated. In this study, we conducted a meta-analysis of GWAS for T2D in the Japanese popu ... Full text Link to item Cite

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

Journal article 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

Book section · 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

Investigation of Genetic Variation Underlying Central Obesity amongst South Asians.

Journal article PLoS One · 2016 South Asians are 1/4 of the world's population and have increased susceptibility to central obesity and related cardiometabolic disease. Knowledge of genetic variants affecting risk of central obesity is largely based on genome-wide association studies of ... Full text Link to item Cite

Genetic Risk Score for Essential Hypertension and Risk of Preeclampsia.

Journal article Am J Hypertens · January 2016 BACKGROUND: Preeclampsia is a hypertensive complication of pregnancy characterized by novel onset of hypertension after 20 weeks gestation, accompanied by proteinuria. Epidemiological evidence suggests that genetic susceptibility exists for preeclampsia; h ... Full text Link to item Cite

Circadian gene variants influence sleep and the sleep electroencephalogram in humans.

Journal article Chronobiol Int · 2016 The sleep electroencephalogram (EEG) is highly heritable in humans and yet little is known about the genetic basis of inter-individual differences in sleep architecture. The aim of this study was to identify associations between candidate circadian gene va ... Full text Link to item Cite

Common variants in DRD2 are associated with sleep duration: the CARe consortium.

Journal article Hum Mol Genet · January 1, 2016 Sleep duration is implicated in the etiologies of chronic diseases and premature mortality. However, the genetic basis for sleep duration is poorly defined. We sought to identify novel genetic components influencing sleep duration in a multi-ethnic sample. ... Full text Link to item Cite

Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions.

Journal article Sleep · December 1, 2015 A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in thi ... Full text Link to item Cite

Common type 2 diabetes risk variant in MTNR1B worsens the deleterious effect of melatonin on glucose tolerance in humans.

Journal article Metabolism · December 2015 AIMS: The common MTNR1B genetic variant rs10830963 is associated with an increased risk of type 2 diabetes (T2D). To date, no experimental study has tested the effect of the MTNR1B variant on glucose metabolism in humans during exposure of the melatonin re ... Full text Link to item Cite

Trans-ancestry genome-wide association study identifies 12 genetic loci influencing blood pressure and implicates a role for DNA methylation.

Journal article Nat Genet · November 2015 We carried out a trans-ancestry genome-wide association and replication study of blood pressure phenotypes among up to 320,251 individuals of East Asian, European and South Asian ancestry. We find genetic variants at 12 new loci to be associated with blood ... Full text Link to item 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

A comprehensive 1,000 Genomes-based genome-wide association meta-analysis of coronary artery disease.

Journal article Nat Genet · October 2015 Existing knowledge of genetic variants affecting risk of coronary artery disease (CAD) is largely based on genome-wide association study (GWAS) analysis of common SNPs. Leveraging phased haplotypes from the 1000 Genomes Project, we report a GWAS meta-analy ... 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

Abstract 4589: Association of genes, pathways, and haplogroups of the mitochondrial genome with the risk of colorectal cancer: The Multiethnic Cohort

Conference Cancer Research · August 1, 2015 AbstractThe mitochondrial genome encodes for the synthesis of 13 proteins that are essential for the oxidative phosphorylation (OXPHOS) system. Inherited variation in mitochondrial genes may influence cancer ... Full text Cite

Han Chinese Polycystic Ovary Syndrome Risk Variants in Women of European Ancestry

Journal article Obstetrical & Gynecological Survey · August 2015 Full text Cite

Directional dominance on stature and cognition in diverse human populations.

Journal article Nature · July 23, 2015 Homozygosity has long been associated with rare, often devastating, Mendelian disorders, and Darwin was one of the first to recognize that inbreeding reduces evolutionary fitness. However, the effect of the more distant parental relatedness that is common ... 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

Han Chinese polycystic ovary syndrome risk variants in women of European ancestry: relationship to FSH levels and glucose tolerance.

Journal article Hum Reprod · June 2015 STUDY QUESTION: Are PCOS risk variants identified in women of Han Chinese ethnicity also associated with risk of PCOS or the phenotypic features of PCOS in European women? SUMMARY ANSWER: One variant, rs2268361-T, in the intron of FSHR was associated with ... 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

Book section · March 23, 2015 Cite

Blood products and blood components

Book section · March 23, 2015 Cite

Procoagulants

Book section · 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

Book section · 2015 Cite

Predictors of Postoperative Bleeding

Book section · January 1, 2015 Full text 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

Book section · 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

Book section · 2014 Cite

Integration of sequence data from a Consanguineous family with genetic data from an outbred population identifies PLB1 as a candidate rheumatoid arthritis risk gene.

Journal article PLoS One · 2014 Integrating genetic data from families with highly penetrant forms of disease together with genetic data from outbred populations represents a promising strategy to uncover the complete frequency spectrum of risk alleles for complex traits such as rheumato ... Full text Link to item 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

IBC CARe microarray allelic population prevalences in an American Indian population.

Journal article PLoS One · 2013 BACKGROUND: The prevalence of variant alleles among single nucleotide polymorphisms (SNPs) is not well known for many minority populations. These population allele frequencies (PAFs) are necessary to guide genetic epidemiology studies and to understand the ... Full text Link to item 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

Identification and functional characterization of candidate topographic guidance molecules in the chick tectum

Conference International Journal of Developmental Neuroscience · December 2012 Full text 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

Large-scale gene-centric meta-analysis across 32 studies identifies multiple lipid loci.

Journal article Am J Hum Genet · November 2, 2012 Genome-wide association studies (GWASs) have identified many SNPs underlying variations in plasma-lipid levels. We explore whether additional loci associated with plasma-lipid phenotypes, such as high-density lipoprotein cholesterol (HDL-C), low-density li ... 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

Variants in DENND1A are associated with polycystic ovary syndrome in women of European ancestry.

Journal article J Clin Endocrinol Metab · July 2012 CONTEXT: A genome-wide association study has identified three loci (five independent signals) that confer risk for polycystic ovary syndrome (PCOS) in Han Chinese women. Replication is necessary to determine whether the same variants confer risk for PCOS i ... Full text Link to item Cite

A genome-wide approach accounting for body mass index identifies genetic variants influencing fasting glycemic traits and insulin resistance.

Journal article Nat Genet · May 13, 2012 Recent genome-wide association studies have described many loci implicated in type 2 diabetes (T2D) pathophysiology and β-cell dysfunction but have contributed little to the understanding of the genetic basis of insulin resistance. We hypothesized that gen ... 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

Large-Scale Gene-Centric Meta-Analysis across 39 Studies Identifies Type 2 Diabetes Loci

Journal article The American Journal of Human Genetics · April 2012 Full text 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

Large-scale gene-centric meta-analysis across 39 studies identifies type 2 diabetes loci.

Journal article Am J Hum Genet · March 9, 2012 To identify genetic factors contributing to type 2 diabetes (T2D), we performed large-scale meta-analyses by using a custom ∼50,000 SNP genotyping array (the ITMAT-Broad-CARe array) with ∼2000 candidate genes in 39 multiethnic population-based studies, cas ... 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

Alternatives to heparin for anticoagulation

Book section · January 5, 2012 Cite

Blood conservation strategies

Book section · 2012 Cite

Cardiac surgical pharmacology

Book section · 2012 Cite

Gene-centric meta-analysis of lipid traits in African, East Asian and Hispanic populations.

Journal article PLoS One · 2012 Meta-analyses of European populations has successfully identified genetic variants in over 100 loci associated with lipid levels, but our knowledge in other ethnicities remains limited. To address this, we performed dense genotyping of ∼2,000 candidate gen ... Full text Link to item Cite

Population genetic structure and origins of Native Hawaiians in the multiethnic cohort study.

Journal article PLoS One · 2012 The population genetic structure of Native Hawaiians has yet to be comprehensively studied, and the ancestral origins of Polynesians remain in question. In this study, we utilized high-resolution genome-wide SNP data and mitochondrial genomes of 148 and 16 ... Full text Link to item Cite

Environmental and genetic factors influence age at menarche in women with polycystic ovary syndrome.

Journal article J Pediatr Endocrinol Metab · 2012 OBJECTIVE: We hypothesized that body mass index (BMI) and DNA variants would predict age at menarche in polycystic ovarian syndrome (PCOS). SUBJECTS: Subjects aged 18-45 years with PCOS defined by the National Institutes of Health criteria (n=522) and cont ... Full text Link to item Cite

The metabochip, a custom genotyping array for genetic studies of metabolic, cardiovascular, and anthropometric traits.

Journal article PLoS Genet · 2012 Genome-wide association studies have identified hundreds of loci for type 2 diabetes, coronary artery disease and myocardial infarction, as well as for related traits such as body mass index, glucose and insulin levels, lipid levels, and blood pressure. Th ... 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

Pleiotropic effects of GIP on islet function involve osteopontin.

Journal article Diabetes · September 2011 OBJECTIVE: The incretin hormone GIP (glucose-dependent insulinotropic polypeptide) promotes pancreatic β-cell function by potentiating insulin secretion and β-cell proliferation. Recently, a combined analysis of several genome-wide association studies (Met ... 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

Triglyceride response to an intensive lifestyle intervention is enhanced in carriers of the GCKR Pro446Leu polymorphism.

Journal article J Clin Endocrinol Metab · July 2011 CONTEXT: Glucokinase regulatory protein (GCKR) regulates the trafficking and enzymatic activity of hepatic glucokinase, the rate-limiting enzyme in glycogen synthesis and glycolysis. The intronic single-nucleotide polymorphism (SNP) rs780094 (intron 16) an ... 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

DASH: a method for identical-by-descent haplotype mapping uncovers association with recent variation.

Journal article Am J Hum Genet · June 10, 2011 Rare variants affecting phenotype pose a unique challenge for human genetics. Although genome-wide association studies have successfully detected many common causal variants, they are underpowered in identifying disease variants that are too rare or popula ... Full text Link to item Cite

Updated genetic score based on 34 confirmed type 2 diabetes Loci is associated with diabetes incidence and regression to normoglycemia in the diabetes prevention program.

Journal article Diabetes · April 2011 OBJECTIVE: Over 30 loci have been associated with risk of type 2 diabetes at genome-wide statistical significance. Genetic risk scores (GRSs) developed from these loci predict diabetes in the general population. We tested if a GRS based on an updated list ... Full text Link to item Cite

Common mitochondrial sequence variants in ischemic stroke.

Journal article Ann Neurol · March 2011 OBJECTIVE: Rare mitochondrial mutations cause neurologic disease, including ischemic stroke and MRI white matter changes. We investigated whether common mitochondrial genetic variants influence risk of sporadic ischemic stroke and, in patients with stroke, ... Full text Link to item Cite

Safety of Recombinant Activated Factor VII in Randomized Clinical Trials REPLY

Journal article NEW ENGLAND JOURNAL OF MEDICINE · February 10, 2011 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

Book section · 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

Common variants at 10 genomic loci influence hemoglobin A₁(C) levels via glycemic and nonglycemic pathways.

Journal article Diabetes · December 2010 OBJECTIVE: Glycated hemoglobin (HbA₁(c)), used to monitor and diagnose diabetes, is influenced by average glycemia over a 2- to 3-month period. Genetic factors affecting expression, turnover, and abnormal glycation of hemoglobin could also be associated wi ... 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

Expression analysis of loci associated with type 2 diabetes in human tissues.

Journal article Diabetologia · November 2010 AIMS/HYPOTHESIS: Genetic mapping has identified over 20 loci contributing to genetic risk of type 2 diabetes. The next step is to identify the genes and mechanisms regulating the contributions of genetic risk to disease. The goal of this study was to evalu ... 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

Cardiac Surgical Pharmacology

Book section · 2010 Cite

Anticoagulation, Preoperative

Book section · January 1, 2010 Full text Cite

Protamine inhibits conversion of prothrombin to thrombin

Conference SWISS MEDICAL WEEKLY · October 17, 2009 Link to item Cite

Circulating beta-carotene levels and type 2 diabetes-cause or effect?

Journal article Diabetologia · October 2009 AIMS/HYPOTHESIS: Circulating beta-carotene levels are inversely associated with risk of type 2 diabetes, but the causal direction of this association is not certain. In this study we used a Mendelian randomisation approach to provide evidence for or agains ... Full text Link to item 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

Strong association of socioeconomic status with genetic ancestry in Latinos: implications for admixture studies of type 2 diabetes.

Journal article Diabetologia · August 2009 AIMS/HYPOTHESIS: Type 2 diabetes is more prevalent in US American minority populations of African or Native American descent than it is in European Americans. However, the proportion of this epidemiological difference that can be ascribed to genetic or env ... 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

Transfusion and hemostasis in cardiac surgery

Journal article TRANSFUSION · March 2008 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

Evaluation of the REG1 Anticoagulant System Using Thrombelastography and Thrombin Generation Assay.

Conference Blood · November 16, 2007 AbstractBackground: The REG1 system (Regado Biosciences, Inc. Durham, NC) is a novel anticoagulant system which comprises RB006 (drug) and RB007 (antidote). The aptamer, RB006 selectively binds to FIXa and b ... Full text 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

TXNIP regulates peripheral glucose metabolism in humans.

Journal article PLoS Med · May 2007 BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by defects in insulin secretion and action. Impaired glucose uptake in skeletal muscle is believed to be one of the earliest features in the natural history of T2DM, although underlying mechanism ... Full text Link to item 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

Cardiac Surgical Pharmacology

Book section · 2007 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

Book section · 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

The Krüppel-like factor 11 (KLF11) Q62R polymorphism is not associated with type 2 diabetes in 8,676 people.

Journal article Diabetes · December 2006 Krüppel-like factor 11 is a pancreatic transcription factor whose activity induces the insulin gene. A common glutamine-to-arginine change at codon 62 (Q62R) in its gene KLF11 has been recently associated with type 2 diabetes in two independent samples. Q6 ... Full text Link to item Cite

Common variants in the ENPP1 gene are not reproducibly associated with diabetes or obesity.

Journal article Diabetes · November 2006 The common missense single nucleotide polymorphism (SNP) K121Q in the ectoenzyme nucleotide pyrophosphate phosphodiesterase (ENPP1) gene has recently been associated with type 2 diabetes in Italian, U.S., and South-Asian populations. A three-SNP haplotype, ... Full text Link to item 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

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

Aprotinin in cardiac surgery

Journal article NEW ENGLAND JOURNAL OF MEDICINE · May 4, 2006 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

Activated recombinant factor VII in cardiac surgery.

Other Curr Opin Anaesthesiol · February 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 Link to item Cite

Symposium on the Definition and Management of Anaphylaxis: Summary report

Journal article Journal of Allergy and Clinical Immunology · 2005 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

Effects of tirofiban on haemostatic activation in vitro.

Journal article Br J Anaesth · August 2004 BACKGROUND: Thrombin plays a critical role in normal haemostasis and pathological thrombosis. Heparin has long been a mainstay choice of antithrombotic regimen in cardiac patients, but persistent thrombin generation seems to occur during heparin therapy. B ... 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

Journal article ORTHOPEDICS · June 2004 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

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

Blood conservation strategies

Book section · 2004 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

Cardiac Surgical Pharmacology

Book section · 2003 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

Novel pharmacologic approaches to reduce bleeding

Journal article CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE · 2003 Link to item 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

Immunological complications

Book section · 2001 Cite

Heart failure

Book section · 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

Plasma Tryptase in Nonimmunologic Reactions

Journal article Anesthesiology · January 1, 2001 Full text 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

Group recommendations

Journal article ANNALS OF THORACIC SURGERY · August 2000 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 Journal of Cardiothoracic and Vascular Anesthesia · June 2000 Full text 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

Alpha-adrenergic effect of fenoldpam on human umbilical artery

Conference ANESTHESIA AND ANALGESIA · February 2000 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

Management strategies for high-risk cardiac surgery: improving outcomes in patients with heart failure.

Other Heart Surg Forum · 2000 BACKGROUND: Surgical heart failure management is the fastest growing aspect of cardio-vascular surgery. Advances in cardiac surgical techniques have changed the number and types of operations permitted physicians and thus broadened the complexity of patien ... Link to item Cite

Skin testing with newer neuromuscular blocking agents in humans

Journal article BJA: British Journal of Anaesthesia · 2000 Cite

Intraoperative coronary thrombosis in association with low-dose aprotinin therapy (vol 13, pg 623, 1999)

Journal article JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA · December 1999 Link to item 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

Conference JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA · August 1999 Link to item Cite

Questions and answers: A roundtable discussion

Journal article JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA · August 1999 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

Incidence of hypersensitivity reactions - Discussion

Journal article ANNALS OF THORACIC SURGERY · June 1998 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

Perioperative hypertension

Book section · 1998 Cite

Protamine reactions

Book section · 1998 Cite

Monitoring coagulation

Book section · 1998 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

Cardiac surgical pharmacology

Book section · 1997 Cite

The allergic response

Book section · 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

Can we alter heparin dose-responses with antithrombin III?

Conference ANESTHESIA AND ANALGESIA · April 1996 Link to item Cite

Allergy and anesthesia

Book section · 1996 Cite

Placental transfer of milrinone in the nonhuman primate (baboon)

Journal article American Journal of Obstetrics & Gynecology · 1996 Cite

Effects of drugs on the vascular system

Conference ANESTHESIOLOGY AND THE CARDIOVASCULAR PATIENT · 1996 Link to item Cite

Phosphodiesterase inhibitors

Conference ANESTHESIOLOGY AND THE CARDIOVASCULAR PATIENT · 1996 Link to item 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

New cardiac drugs

Book section · 1995 Cite

Allergy and anesthesia

Book section · 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

Identification of a new variant CYP2D6 allele with a single base deletion in exon 3 and its association with the poor metabolizer phenotype.

Journal article Hum Mol Genet · June 1994 The human CYP2D6 gene codes for the enzyme, debrisoquine 4-hydroxylase, which metabolizes over 25 therapeutically important drugs. The inability to metabolize these drugs, which results in a 'poor metabolizer' (PM) phenotype, can be attributed, in some cas ... 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

Book section · 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

PHARMACOKINETICS OF MILRINONE DURING CARDIAC-SURGERY

Conference ANESTHESIOLOGY · September 1993 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

In Reply

Journal article Anesthesiology · July 1, 1992 Full text 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

Immunological complications

Book section · 1992 Cite

The allergic response

Book section · 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

Book section · 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

Dr. Levy replies

Journal article Critical Care Medicine · July 1989 Full text 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

Book section · 1989 Cite

Allergy and anesthesia

Book section · 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

The lack of importance of Lanwei point in the diagnosis of acute appendicitis.

Journal article Pain · April 1988 Fifty patients with a presumptive diagnosis of acute appendicitis based on usual Western medicine criteria (e.g., McBurney point tenderness, increase WBC, history of nausea, etc.) were examined prospectively for tenderness of the Lanwei acupoint, just prio ... 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

Book section · 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

A Laboratory Test to Detect Antibodies to Protamine

Journal article Anesthesiology · August 1, 1987 Full text Cite

Transfusion reactions

Book section · 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

Book section · 1986 Cite

Myocardial Ischemia

Book section · 1986 Cite

Transfusion principles

Book section · 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

Book section · 1982 Cite