1.Study on the functional disorder of coagulation in patients with cirrhosis
Journal of Practical Medicine 2000;383(6):25-27
Objectives: Assess some disorder of hemostasis in the patient of cirrhosis; Estimate the correlation between these disorders and the Child-Pugh score. Methods: 30 patients of cirrhosis diagnosed upon the clinical, biological and imaging criteria, in the Department of HepatoGastroEnterology, Hue Central Hospital, from January to October 2000. Results and conclusion: The frequency of the disorder of hemostasis in the patients of cirrhosis is about 92%, the most frequent of these disorders is the prolongation of prothrombine time (83.3%). A diminution of fibrinogen concentration was found in 46.7% the cases. Significant prolongation of the time of Howell and Cephalin - Kaolin time are found respectively in 53.4% and 40%. Thrombocytopenia occurs in only 6.7%. Clinical manifestations don't reflex exactly the disorders of hemostasis, bleeding in the peritoneal cavity was found in 13.3%. There isn't any strict correlation between Child-Pugh score (CPS) and any of the hemostasis disorders. Apart from a medium correlation between CPS and prothrombin time (r=0.56, p<0.05) and concentration of fibrinogen (r=0.62, p<0.05) and minimal correlation between CPS and time of Howell (r=0.32, p<0.05) and Time of Cephalin - Kaolin (r=0.30, p>0.05)
Fibrosis
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Blood Coagulation Disorders
2.Dyscoagulation on the patients with acute leukemia.
Journal of Practical Medicine 2002;435(11):61-8
The study involved 60 patients with acute leukemia at B¹ch Mai Hospital between June and December 2000. Among these, there were 33 males and 27 females. Findings: 65% of patients have hemorrhage; 88.3% have reduction in platelet count. There was the correlation between reduction in platelet count and symptoms of hemorrhage, with the rate of hemorrhage was 84.6% when number of platelet reduced by less than 30G/l. 46% of patients have endogenous dyscoagulation and 23% have exogenous dyscoagulation. DIC was found in 28.3% of patients. Hemorrhage in acute leukemia also related to dyscoagulation.
Leukemia
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Blood Coagulation Disorders
3.Dyscoagulations observed on patients at the Institute of Hematology and Blood Transfusion
Journal of Practical Medicine 2000;383(6):29-31
The study included 401 patients, 159 males and 242 females with age ranged from 7 - 91 years who were treating at Coagulation Unit of the Institute of Hematology and Blood Transfusion between July/1998 and June/1999. Results showed that 118 patients were normal and 283 patients were abnormal coagulation in plasma and platelet. Dyscoagulation can be seen in most of hematological conditions, especially in thrombocytopenia; scattered coagulation syndrome is commonest in patients with sepsis, snake bite, post-operative shock and M3 type acute leukemia
Blood Coagulation Disorders
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therapeutics
4.Study on coagulation disorders in primary polycythemia patients.
Journal of Practical Medicine 2004;474(3):35-36
The relation of some laboratory examinations on blood coagulation and hemostasis with the complications of primitive polycythemia was determined by a study conducted on 20 subjects treated at the clinical department of blood diseases, the Central Institute of Hematology and blood perfusion. Before the treatment, on all patients examination on blood coagulation and hemostasis were performed. Results showed that: in polycythemia, the high quantity of blood plaques was the risk factor of vascular obstruction and closely related with the complications of hemorrhage, thrombocytopenia, ADP. The relation between some disturbances of blood coagulation and clinical features.
Blood Coagulation Disorders
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Hemostasis
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Polycythemia
5.Viscoelastic Coagulation Test Guided Therapy for a Strategy to Reduce Transfusions.
Korean Journal of Blood Transfusion 2018;29(3):240-252
Viscoelastic coagulation tests provide simultaneous measurements of multiple aspects of whole-blood coagulation, including interactions between the plasma components and cellular components of the coagulation cascade. This can be carried out immediately using a point of care technique. Viscoelastic tests could predict the patient's outcome, including mortality, and detect coagulopathy more sensitively, resulted in reduced blood loss. The transfusion strategy based on the viscoelastic parameters rather than a conventional coagulation test has been shown to reduce the transfusion requirements. Although there are concerns about the reliability and accuracy of this method, viscoelastic tests, including ROTEM, would be a useful method to guide patient blood management strategies.
Blood Coagulation Disorders
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Blood Coagulation Tests
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Blood Transfusion
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Humans
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Methods
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Mortality
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Plasma
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Point-of-Care Systems
;
Thrombelastography
6.Trauma-induced coagulopathy: Mechanisms and clinical management.
Vui Kian HO ; Jolin WONG ; Angelly MARTINEZ ; James WINEARLS
Annals of the Academy of Medicine, Singapore 2022;51(1):40-48
INTRODUCTION:
Trauma-induced coagulopathy (TIC) is a form of coagulopathy unique to trauma patients and is associated with increased mortality. The complexity and incomplete understanding of TIC have resulted in controversies regarding optimum management. This review aims to summarise the pathophysiology of TIC and appraise established and emerging advances in the management of TIC.
METHODS:
This narrative review is based on a literature search (MEDLINE database) completed in October 2020. Search terms used were "trauma induced coagulopathy", "coagulopathy of trauma", "trauma induced coagulopathy pathophysiology", "massive transfusion trauma induced coagulopathy", "viscoelastic assay trauma induced coagulopathy", "goal directed trauma induced coagulopathy and "fibrinogen trauma induced coagulopathy'.
RESULTS:
TIC is not a uniform phenotype but a spectrum ranging from thrombotic to bleeding phenotypes. Evidence for the management of TIC with tranexamic acid, massive transfusion protocols, viscoelastic haemostatic assays (VHAs), and coagulation factor and fibrinogen concentrates were evaluated. Although most trauma centres utilise fixed-ratio massive transfusion protocols, the "ideal" transfusion ratio of blood to blood products is still debated. While more centres are using VHAs to guide blood product replacement, there is no agreed VHA-based transfusion strategy. The use of VHA to quantify the functional contributions of individual components of coagulation may permit targeted treatment of TIC but remains controversial.
CONCLUSION
A greater understanding of TIC, advances in point-of-care coagulation testing, and availability of coagulation factors and fibrinogen concentrates allows clinicians to employ a more goal-directed approach. Still, hospitals need to tailor their approaches according to available resources, provide training and establish local guidelines.
Blood Coagulation Disorders/therapy*
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Blood Transfusion
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Hemorrhage
;
Hemostasis
;
Hemostatics
;
Humans
8.Performance of HemosIL ReadiPlasTin, a Liquid Reagent for Prothrombin Time Measurement
Saeam SHIN ; Yunjung JUNG ; Wonkeun SONG ; Min Jeong PARK
Journal of Laboratory Medicine and Quality Assurance 2019;41(1):9-12
BACKGROUND: Prothrombin time (PT) measurement is an important test for screening blood coagulation disorders and monitoring anticoagulant therapy. In this study, we evaluated the analytical performance of HemosIL ReadiPlasTin (Instrumentation Laboratory, USA), a liquid reagent for PT measurement. METHODS: The precision of HemosIL ReadiPlasTin was evaluated according to the Clinical and Laboratory Standards Institute (CLSI) EP5-A3 guidelines. Further, comparison with HemosIL RecombiPlasTin 2G (Instrumentation Laboratory, USA) was made according to the CLSI EP9-A3 guidelines. The reference intervals were established according to the CLSI C28-A3 guidelines. RESULTS: The coefficient of variation values for repeatability and total imprecision at two levels of control materials were lower than 1.1% and 3.4%, respectively. The performance of HemosIL ReadiPlasTin was comparable to that of HemosIL RecombiPlasTin 2G, with a high correlation (r=0.996). The reference interval for normal subjects was 10.4–13.3 seconds. CONCLUSIONS: HemosIL ReadiPlasTin showed an acceptable degree of imprecision and its performance showed high correlation with that of a conventional reagent. Therefore, it is expected to be useful for PT measurement in clinical laboratories.
Blood Coagulation Disorders
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Blood Coagulation Tests
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Mass Screening
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Prothrombin Time
;
Prothrombin
;
Thromboplastin
10.Advances in the effect of inhibiting complement activation in the treatment of sepsis-associated coagulopathy.
Xin LU ; Xin WEI ; Zhibin WANG
Chinese Critical Care Medicine 2023;35(4):438-441
Sepsis-associated coagulopathy refers to extensive coagulation activation accompanied by a high risk of bleeding and organ failure. In severe cases, it is manifested as disseminated intravascular coagulation (DIC) and leads to multiple organ dysfunction syndrome (MODS). Complement is an important component of the innate immune system and plays an important role in defending against invasion of pathogenic microorganisms. The early pathological process of sepsis involves excessive activation of the complement system, which forms an extremely complex network through interactions with the coagulation, kinin and fibrinolytic system, amplifying and exacerbating the systemic inflammatory response. In recent years, it has been suggested that uncontrolled complement activation system can exacerbate sepsis-associated coagulation dysfunction or even DIC, indicating the potential value of intervening in the complement system in the treatment of septic DIC, and related research progress is reviewed in this article in order to provide new ideas for the discovery of sepsis-associated coagulopathy therapy drugs.
Humans
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Blood Coagulation Disorders
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Complement Activation
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Blood Coagulation
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Multiple Organ Failure
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Sepsis