scholarly journals Fibrin clot quality in acutely ill cirrhosis patients: relation with outcome and improvement with coagulation factor concentrates

2021 ◽  
Author(s):  
Annabel Blasi ◽  
Vishal C Patel ◽  
Eva N.H.E. Spanke ◽  
Jelle Adelmeijer ◽  
Marilena Stamouli ◽  
...  
Keyword(s):  
Coagulation Factor ◽  
Fibrin Clot ◽  
Coagulation Factor Concentrates

scholarly journals Normalization of Blood Clotting Characteristics Using Prothrombin Complex Concentrate, Fibrinogen and Fxiii In an Albumin Based Fluid: Experimental Studies In Thromboelastometry.

2020 ◽  
Author(s):  
Tobias Koller ◽  
Nadia Kinast ◽  
Andres Guilarte Castellanos ◽  
Sergio Perez Garcia ◽  
Pilar Paniagua Iglesias ◽  
...  
Keyword(s):  
Whole Blood ◽  
Factor Xiii ◽  
Prothrombin Complex Concentrate ◽  
Massive Transfusion ◽  
Experimental Studies ◽  
Coagulation Factor ◽  
Fibrin Clot ◽  
Fibrinogen Concentrate ◽  
Coagulation Factor Concentrates

Abstract Background: Colloid fluids supplemented with adequate combinations of coagulation factor concentrates with capability to restore coagulation could be a desirable future treatment component in massive transfusion.Methods: Starting from a coagulation factor and blood cell free albumin solution we added Prothrombin Complex Concentrate, Fibrinogen Concentrate and Factor XIII in different combinations and concentrations to analyze their properties to restore thromboelastometry parameters without the use of plasma. Further analysis under presence of platelets was performed for comparability to whole blood conditions.Results: Albumin solutions enriched with Fibrinogen Concentrate, Factor XIII and Prothrombin Complex Concentrate at optimized concentrations show restoring coagulation potential. Prothrombin Complex Concentrate showed sufficient thrombin formation for inducing fibrinogen polymerization. The combination of Prothrombin Complex Concentrate and Fibrinogen Concentrate led to the formation of a stable in vitro fibrin clot. Fibrinogen and Factor XIII showed excellent capacity to improve fibrin clot firmness expressed as Amplitude at 10 minutes and Maximal Clot Firmness. Fibrinogen alone, or in combination with Factor XIII, was able to restore normal Amplitude at 10 minutes and Maximal Clot Firmness values. In the presence of platelets, the thromboelastometry surrogate parameter for thrombin generation (Clotting Time) improves and normalizes when compared to whole blood.Conclusions: Combinations of coagulation factor concentrates suspended in albumin solutions have the capacity to restore thromboelastometry parameters in the absence of plasma. This kind of artificial colloid fluids with coagulation-restoring characteristics might offer new treatment alternatives for massive transfusion.Trial registration: Study registered at the institutional ethic committee “Institut de Recerca, Hospital Santa Creu i Sant Pau, with protocol number IIBSP-CFC-2013-165.

scholarly journals Normalization Of Blood Clotting Characteristics Using Prothrombin Complex Concentrate, Fibrinogen And FXIII In An Albumin Based Fluid: Experimental Studies In Thromboelastometry.

2021 ◽  
Author(s):  
Tobias Koller ◽  
Nadia Kinast ◽  
Andres Guilarte Castellanos ◽  
Sergio Perez Garcia ◽  
Pilar Paniagua Iglesias ◽  
...  
Keyword(s):  
Whole Blood ◽  
Factor Xiii ◽  
Prothrombin Complex Concentrate ◽  
Massive Transfusion ◽  
Experimental Studies ◽  
Coagulation Factor ◽  
Fibrin Clot ◽  
Fibrinogen Concentrate ◽  
Coagulation Factor Concentrates

Abstract Background: Colloid fluids supplemented with adequate combinations of coagulation factor concentrates with the capability to restore coagulation could be a desirable future treatment component in massive transfusion.Methods: Starting from a coagulation factor and blood cell-free albumin solution we added Prothrombin Complex Concentrate, Fibrinogen Concentrate and Factor XIII in different combinations and concentrations to analyze their properties to restore thromboelastometry parameters without the use of plasma. Further analysis under the presence of platelets was performed for comparability to whole blood conditions.Results: Albumin solutions enriched with Fibrinogen Concentrate, Factor XIII and Prothrombin Complex Concentrate at optimized concentrations show restoring coagulation potential. Prothrombin Complex Concentrate showed sufficient thrombin formation for inducing fibrinogen polymerization. The combination of Prothrombin Complex Concentrate and Fibrinogen Concentrate led to the formation of a stable in vitro fibrin clot. Fibrinogen and Factor XIII showed excellent capacity to improve fibrin clot firmness expressed as Amplitude at 10 minutes and Maximal Clot Firmness. Fibrinogen alone, or in combination with Factor XIII, was able to restore normal Amplitude at 10 minutes and Maximal Clot Firmness values. In the presence of platelets, the thromboelastometry surrogate parameter for thrombin generation (Clotting Time) improves and normalizes when compared to whole blood.Conclusions: Combinations of coagulation factor concentrates suspended in albumin solutions can restore thromboelastometry parameters in the absence of plasma. This kind of artificial colloid fluids with coagulation-restoring characteristics might offer new treatment alternatives for massive transfusion.Trial registration: Study registered at the institutional ethic committee “Institut de Recerca, Hospital Santa Creu i Sant Pau, with protocol number IIBSP-CFC-2013-165.

scholarly journals Normalization of blood clotting characteristics using prothrombin complex concentrate, fibrinogen and FXIII in an albumin based fluid: experimental studies in thromboelastometry

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Tobias Koller ◽  
Nadia Kinast ◽  
Andres Guilarte Castellanos ◽  
Sergio Perez Garcia ◽  
Pilar Paniagua Iglesias ◽  
...  
Keyword(s):  
Whole Blood ◽  
Factor Xiii ◽  
Prothrombin Complex Concentrate ◽  
Massive Transfusion ◽  
Experimental Studies ◽  
Coagulation Factor ◽  
Fibrin Clot ◽  
Fibrinogen Concentrate ◽  
Coagulation Factor Concentrates

Abstract Background Colloid fluids supplemented with adequate combinations of coagulation factor concentrates with the capability to restore coagulation could be a desirable future treatment component in massive transfusion. Methods Starting from a coagulation factor and blood cell-free albumin solution we added Prothrombin Complex Concentrate, Fibrinogen Concentrate and Factor XIII in different combinations and concentrations to analyze their properties to restore thromboelastometry parameters without the use of plasma. Further analysis under the presence of platelets was performed for comparability to whole blood conditions. Results Albumin solutions enriched with Fibrinogen Concentrate, Factor XIII and Prothrombin Complex Concentrate at optimized concentrations show restoring coagulation potential. Prothrombin Complex Concentrate showed sufficient thrombin formation for inducing fibrinogen polymerization. The combination of Prothrombin Complex Concentrate and Fibrinogen Concentrate led to the formation of a stable in vitro fibrin clot. Fibrinogen and Factor XIII showed excellent capacity to improve fibrin clot firmness expressed as Amplitude at 10 min and Maximal Clot Firmness. Fibrinogen alone, or in combination with Factor XIII, was able to restore normal Amplitude at 10 min and Maximal Clot Firmness values. In the presence of platelets, the thromboelastometry surrogate parameter for thrombin generation (Clotting Time) improves and normalizes when compared to whole blood. Conclusions Combinations of coagulation factor concentrates suspended in albumin solutions can restore thromboelastometry parameters in the absence of plasma. This kind of artificial colloid fluids with coagulation-restoring characteristics might offer new treatment alternatives for massive transfusion. Trial registration Study registered at the institutional ethic committee “Institut de Recerca, Hospital Santa Creu i Sant Pau, with protocol number IIBSP-CFC-2013-165.

The Year 2020 in Review: Noteworthy Literature for Thoracic Transplant Anesthesiologists

2021 ◽  
pp. 108925322110076
Author(s):  
Benjamin A. Abrams ◽  
Barbara Wilkey
Keyword(s):  
Lung Transplantation ◽  
Adult Congenital Heart Disease ◽  
Coagulation Factor ◽  
Preoperative Assessment ◽  
Total Artificial Heart ◽  
Donor Pool ◽  
Transplant Patients ◽  
Adult Congenital ◽  
Coagulation Factor Concentrates ◽  
Made In

The year 2020 was a monumental year in medicine, and this review focuses on selected articles for cardiothoracic anesthesiologists and perioperative physicians involved in the care of heart and lung transplant patients. In the field of lung transplantation, significant strides were made in our knowledge of risk stratification during the preoperative assessment of potential recipients, perioperative transfusion medicine, and the administration of coagulation factor concentrates. In addition, variations in perioperative management and outcomes between institutions were studied across an assortment of metrics regarding lung transplantation, including case volumes and anesthetic practices. Transitioning to topics in the field of heart transplantation, consideration was given to recipients with adult congenital heart disease, and separately, approaches to expanding the donor pool through donation after circulatory death. With regard to preoperative support, outcomes for the total artificial heart as well as the MitraClip as bridges to transplantation were published.

scholarly journals Factor XIII and Fibrin Clot Properties in Acute Venous Thromboembolism

2021 ◽  
Vol 22 (4) ◽  
pp. 1607
Author(s):  
Michał Ząbczyk ◽  
Joanna Natorska ◽  
Anetta Undas
Keyword(s):  
Venous Thromboembolism ◽  
Factor Xiii ◽  
Active Form ◽  
Coagulation Factor ◽  
Proteome Analysis ◽  
Fibrin Clot ◽  
Subsequent Increase ◽  
Vein Thrombosis ◽  
Acute Pe ◽  
Fxiii Activity

Coagulation factor XIII (FXIII) is converted by thrombin into its active form, FXIIIa, which crosslinks fibrin fibers, rendering clots more stable and resistant to degradation. FXIII affects fibrin clot structure and function leading to a more prothrombotic phenotype with denser networks, characterizing patients at risk of venous thromboembolism (VTE). Mechanisms regulating FXIII activation and its impact on fibrin structure in patients with acute VTE encompassing pulmonary embolism (PE) or deep vein thrombosis (DVT) are poorly elucidated. Reduced circulating FXIII levels in acute PE were reported over 20 years ago. Similar observations indicating decreased FXIII plasma activity and antigen levels have been made in acute PE and DVT with their subsequent increase after several weeks since the index event. Plasma fibrin clot proteome analysis confirms that clot-bound FXIII amounts associated with plasma FXIII activity are decreased in acute VTE. Reduced FXIII activity has been associated with impaired clot permeability and hypofibrinolysis in acute PE. The current review presents available studies on the role of FXIII in the modulation of fibrin clot properties during acute PE or DVT and following these events. Better understanding of FXIII’s involvement in the pathophysiology of acute VTE might help to improve current therapeutic strategies in patients with acute VTE.

HIV-Antibody Seroconversions in Dutch Haemophiliacs Using Heat-Treated and Non Heat-Treated Coagulation Factor Concentrates

1988 ◽  
Vol 59 (03) ◽  
pp. 396-399 ◽  
Author(s):  
Tom F W Wolfs ◽  
Cees Breederveld ◽  
Willy J A Krone ◽  
Lia v d Hoek ◽  
Margreet Bakker ◽  
...  
Keyword(s):  
High Risk ◽  
Multicentre Study ◽  
Blood Donors ◽  
Seroconversion Rate ◽  
Coagulation Factor ◽  
Donor Screening ◽  
Heat Treated ◽  
Hiv Antibodies ◽  
Coagulation Factor Concentrates

SummaryA national multicentre study was performed to investigate the effects of donorselection and the use of heat-treated plasma products on seroconversion to HIV in 157 Dutch haemophiliacs. All patients included in the study were seronegative for HIV antibodies in 1983.Thirteen percent (20/157) seroconverted between 1983 and 1986. Nineteen of 20 seroconversions could be related to the use of non heat-treated products in the year preceding HIV antibody seroconversion. One seroconversion occurred in a person using heat-treated non donor screened product.Seroconversion rate decreased as a result of the policy to discourage high risk blood donors and no seroconversions were observed following the introduction of donor screening in 1985.

The use of coagulation factor concentrates for perioperative bleeding management – a global perspective

Transfusion ◽  
2020 ◽  
Vol 60 (4) ◽  
pp. 663-666
Author(s):  
Oliver Grottke ◽  
Jeannie Callum ◽  
Melissa M. Cushing ◽  
Thorsten Haas
Keyword(s):  
Coagulation Factor ◽  
Global Perspective ◽  
Bleeding Management ◽  
Perioperative Bleeding ◽  
Coagulation Factor Concentrates

scholarly journals Dynamics of Platelet Counts in Major Trauma: The Impact of Haemostatic Resuscitation and Effects of Platelet Transfusion—A Sub-Study of the Randomized Controlled RETIC Trial

2020 ◽  
Vol 9 (8) ◽  
pp. 2420
Author(s):  
Helmuth Tauber ◽  
Nicole Innerhofer ◽  
Daniel von Langen ◽  
Mathias Ströhle ◽  
Dietmar Fries ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Platelet Transfusion ◽  
Major Trauma ◽  
Coagulation Factor ◽  
Trauma Patients ◽  
First Line ◽  
Platelet Counts ◽  
Randomized Controlled ◽  
Coagulation Factor Concentrates ◽  
Haemostatic Resuscitation

Although platelets play a central role in haemostasis, the dynamics of platelet counts during haemostatic resuscitation, the response to platelet transfusion, and effects on clinical outcome are poorly described for trauma patients. As a sub-study of the already published randomized controlled RETIC Study “Reversal of Trauma-induced Coagulopathy using First-line Coagulation Factor Concentrates or Fresh-Frozen Plasma” trial, we here analysed whether the type of first-line haemostatic resuscitation influences the frequency of platelet transfusion and determined the effects of platelet transfusion in coagulopathic patients with major trauma. Patients randomly received first-line plasma (FFP) or coagulation factor concentrates (CFC), mainly fibrinogen concentrate. In both groups, platelets were transfused to maintain platelet counts between 50 and 100 × 109/L. Transfusion rates were significantly higher in the FFP (n = 44) vs. CFC (n = 50) group (FFP 47.7% vs. CFC 26%); p = 0.0335. Logistic regression analysis adjusted for the stratification variables injury severity score (ISS) and brain injury confirmed that first-line FFP therapy increases the odds for platelet transfusion (odds ratio (OR) 5.79 (1.89 to 20.62), p = 0.0036) and this effect was larger than a 16-point increase in ISS (OR 4.33 (2.17 to 9.74), p = 0.0001). In conclusion, early fibrinogen supplementation exerted a platelet-saving effect while platelet transfusions did not substantially improve platelet count and might contribute to poor clinical outcome.

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