Changes In Biologically And Immunochemically Measured Antithrombin III (At III) In Total HIP Replacement With Special Regard To Type Of Thromboembolic Prophylaxis

1981 ◽  
Author(s):  
H O Fredin ◽  
L Tengborn
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Antithrombin Iii ◽  
Screening Method ◽  
Chromogenic Substrate ◽  
Thromboembolic Prophylaxis ◽  
Total Hip ◽  
At Iii ◽  
Lung Scanning

The plasma levels of AT III were studied in 71 patients operated with total hip replacement. AT III was determined with amidolytic assay using the chromogenic substrate Coatest S-2238 (KabiDiagnostica, Sweden) as well as electroimmunochemically. Samples were drawn before the operation and 4-5 times the first week postoperatively. The results were adjusted to the hematocrit (Hcr) for each sample.The patients were randomly allocated to thromboprophylactic prevention with either Macrodex (Pharmacia, Sweden) or heparin with dihydroergotamine (Sandoz, Switzerland). Phlebography of the operated leg and perfusion/ventilation lung scanning was performed on the 10-14th postoperative day.Results. No difference in the AT III levels were seen in patients who developed postoperatively deep venous thrombosis and/or pulmonary embolism (DVT/PE) as compared to those who did not develop DVT/PE.No decrease of AT III was found postoperatively, when adjusted to HcrThe frequency of DVT/PE did not differ significantly between the two types of thromboembolic prophylaxis.Conclusion. Pre-operative determination of AT III, whether biologically or immunochemically, did not seem to be successful as screening method of patients to develop DVT/PE.

Hypercoagulability after Total Hip Replacement

1996 ◽  
Vol 6 (1) ◽  
pp. 1-6 ◽  
Author(s):  
M. A. Mcnally ◽  
A. Kyle ◽  
W.R.G. Macdonald ◽  
E. Mayne ◽  
R.A.B. Mollan
Keyword(s):  
Venous Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Antithrombin Iii ◽  
Perioperative Period ◽  
Total Hip ◽  
Transient Nature ◽  
At Iii ◽  
Thrombin Activation ◽  
Clinically Significant

Changes in blood coagulation are believed to be involved in the aetiology of postoperative thromboembolism. Antithrombin III (AT III) is the most important natural inhibitor of thrombin activation and hence thrombogenesis. This study investigated the nature of a hypercoagulable state in total hip replacement by measurement of AT III in the perioperative period, giving a quantitative assessment of coagulation. Antithrombin III levels fell in all patients after surgery. However, the degree of the fall and the timing of the fall were variable. Eight percent of patients had abnormally low AT III prior to operation, indicating that this proportion of our patients are in a procoagulant state even before surgery. One third of patients had a clinically significant reduction (below 70% of normal) in AT III level after surgery. In this group the fall in AT III was maximal at 2 hours after division of the femoral neck. Careful correction for haemodilution provided new evidence for active consumption of antithrombin III in the perioperative period. By 24 hours after surgery the level of AT III was not significantly different from preoperative levels (p>0.7), even in the group with a clinically important reduction. These findings support only a transient period of hypercoagulability after total hip replacement. The “at-risk” period of venous thrombosis has been shown to be at least several weeks after surgery and the transient nature of the fall in AT III suggests that venous thrombosis is unlikely to be due to hypercoagulability alone.

Pre- and Postoperative Levels of Antithrombin III with Special Reference to Thromboembolism After Total Hip Replacement

1983 ◽  
Vol 49 (03) ◽  
pp. 158-161 ◽  
Author(s):  
H Fredin ◽  
B Nilsson ◽  
B Rosberg ◽  
L Tengborn
Keyword(s):  
Special Reference ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Thromboembolic Prophylaxis ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Dextran 70 ◽  
At Iii ◽  
A Prospective Study ◽  
Deep Vein

SummaryA prospective study of antithrombin HI, determined by electroimmunochemical assay or an amidolytical method, was carried out with special reference to thromboembolism after total hip replacement. Two hundred and seven patients were randomly allocated to thromboembolic prophylaxis with dextran 70 or low dose heparin combined with dihydroergotamine. Deep vein thrombosis determined by phlebography of the operated leg or pulmonary embolism diagnosed with perfusion/ventilation scintigraphy developed in 51% of the total material and did not differ significantly between the two groups of prophylaxis or between patients with a preoperative At III below normal and those with a normal value. The correlation between the two assay methods for At HI was 0.61. An initial, postoperative decrease in At III was noted with a parallel fall in hematocrit and fibrinogen, later followed by an increase of the plasma proteins. It is concluded that the immediate postoperative decrease of At III is mostly due to hemodilution.

Effects on Coagulation and Fibrinolysis of Desmopressin in Patients Undergoing Total Hip Replacement

1991 ◽  
Vol 66 (06) ◽  
pp. 652-656 ◽  
Author(s):  
Per Anders Flordal ◽  
Karl-Gösta Ljungström ◽  
Jan Svensson ◽  
Brenda Ekman ◽  
Gustaf Neander
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Bleeding Time ◽  
Antithrombin Iii ◽  
Postoperative Bleeding ◽  
Double Blind ◽  
Total Hip ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Coagulation And Fibrinolysis

SummaryTwelve patients undergoing total hip replacement, with regional anaesthesia and with dextran infusion for plasma expansion and thromboprophylaxis, were given the vasopressin analogue desmopressin (DDAVP) or placebo in a randomized, double-blind prospective study. In controls (n = 6) we found a prolongation of the bleeding time, low factor VIII (FVIII) and von Willebrand factor (vWF) and a decrease in antithrombin III to levels known to be at risk for venous thrombosis. Desmopressin shortened postoperative bleeding time, gave an early FVIII/vWF complex increase, prevented antithrombin III from falling to critically low values and appeared to activate the fibrinolytic system, both by tPA increase and PAI-1 decrease.Thus in the controls we found changes in both coagulation and fibrinolysis indicating a haemorrhagic diathesis as well as a risk for thromboembolism. Desmopressin induced factor changes that possibly reduce both risks.

scholarly journals Hip arthroplasty fatality related to dabigatran induced gastrointestinal haemorrhage

2014 ◽  
Vol 96 (1) ◽  
pp. e01-e03 ◽  
Author(s):  
A Carter ◽  
P Sarda ◽  
M George ◽  
S Corbett
Keyword(s):  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Dabigatran Etexilate ◽  
Gastrointestinal Haemorrhage ◽  
Fatal Complication ◽  
Reversal Agent ◽  
Thromboembolic Prophylaxis ◽  
Total Hip ◽  
Venous Thromboembolic

We report a fatality due to massive gastrointestinal haemorrhage in a patient receiving prophylactic dabigatran etexilate following a total hip replacement. A 79-year-old woman was commenced on dabigatran for venous thromboembolic prophylaxis following a total hip replacement. She presented again four days after surgery with haematemesis and hypotension but her coagulopathy could not be corrected, leading to her death. This case highlights the lack of reversal agent for dabigatran etexilate that resulted in this fatal complication.

Radiographic Determination of the Angle of Version of the Femoral Component in Total Hip Replacement

1988 ◽  
Vol 17 (1) ◽  
pp. 7-9
Author(s):  
Hans Schmotzer ◽  
Ian D Learmonth
Keyword(s):  
Femoral Component ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Film Plane ◽  
Simple Method ◽  
Standard Equipment ◽  
Orthopaedic Practice ◽  
Total Hip

This paper describes a simple method to determine stem orientation after total hip replacement. It is based on standard antero-posterior radiographs and computes the angle between prosthesis and film plane from the shortening of predefined distances in the projection. The error of the method is less than 5 per cent for the stem orientation and less than 10 per cent for the neck orientation. The method allows accurate control of stem orientation by means of standard equipment in orthopaedic practice.

Alterations in Plasma Antithrombin III Following Total Hip Replacement and Elective Cholecystectomy

2009 ◽  
Vol 24 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Kaj Anker Jørgensen ◽  
Erik Stoffersen ◽  
Per J. Sørensen ◽  
Steen Ingeberg ◽  
Mogens Hüttel ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Antithrombin Iii ◽  
Total Hip ◽  
Elective Cholecystectomy

An Attempt at Predicting Postoperative Deep Vein Thrombosis by Preoperative Coagulation Studies in Patients Undergoing Total Hip Replacement

1980 ◽  
Vol 43 (03) ◽  
pp. 194-197 ◽  
Author(s):  
Dennis W T Nilsen ◽  
Miladin Jeremic ◽  
Odd K Weisert
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Antithrombin Iii ◽  
Fibrinogen Level ◽  
Additional Parameter ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Uptake Test ◽  
Deep Vein

SummaryPreoperative levels of fibrinogen, factors V, VII, VIII and antithrombin III were measured in 25 consecutive patients undergoing total hip replacement. Deep vein thrombosis (D.V.T.) was detected by fibrinogen-uptake test in 60% of the patients. The preoperative fibrinogen level was significantly higher (p < 0.05), and serum antithrombin III was markedly lower (p ≦ 0.1) in patients with postoperative D.V.T. The quotient of fibrinogen to serum antithrombin III was significantly higher (p < 0.01) in patients with D.V.T. This quotient may serve as an additional parameter to other clinical and laboratory tests in prediction of postoperative D.V.T. following hip surgery.

Recent Advances in Venous Thromboembolic Prophylaxis During and After Total Hip Replacement

2000 ◽  
Vol 82 (2) ◽  
pp. 251-270 ◽  
Author(s):  
EDUARDO A. SALVATI ◽  
VINCENT D. PELLEGRINI ◽  
NIGEL E. SHARROCK ◽  
PAUL A. LOTKE ◽  
DAVID W. MURRAY ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Thromboembolic Prophylaxis ◽  
Total Hip ◽  
Recent Advances ◽  
Venous Thromboembolic

Determination of the Biological Activity of Heparin by Use of a Chromogenic Substrate

1979 ◽  
Vol 42 (05) ◽  
pp. 1446-1451 ◽  
Author(s):  
Knut Bartl ◽  
Elfriede Dorsch ◽  
Helmut Lill ◽  
Joachim Ziegenhorn
Keyword(s):  
Biological Activity ◽  
Therapeutic Range ◽  
Antithrombin Iii ◽  
Photometric Determination ◽  
Chromogenic Substrate ◽  
Standard Samples ◽  
Spectrum Line ◽  
At Iii ◽  
Specific Determination

SummaryWe describe a new method for determining the biological activity of heparin in plasma with use of thrombin and the substrate Tos-Gly-Pro-Arg-pNA. The procedure is based on the photometric determination of the inactivation of thrombin after incubation with plasma in the presence of endogenous antithrombin III (At III). The method allows the specific determination of heparin concentrations from 0.02 USP to 0.8 USP/ml of plasma in the presence of normal At III levels. It has been carried out manually by use of an Eppendorf spectrum line photometer or automatically by use of a Vitatron Akes analyzer. For evaluation, the results were compared with two standard samples which contained heparin in the low and high therapeutic range, respectively.

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