scholarly journals Pathophysiology of coagulation during bleeding

2020 ◽  
pp. 294-295
Author(s):  
C. Fenger-Eriksen
Keyword(s):  
Tranexamic Acid ◽  
Blood Clotting ◽  
Blood Clot ◽  
Postoperative Bleeding ◽  
Coagulation Factors ◽  
Acid Group ◽  
Coagulation System ◽  
Colloidal Solutions ◽  
Lethal Triad ◽  
Coagulation Study

Background. Analysis of 99 studies found that the predictor properties of various tests to determine the blood coagulation condition, including the newest ones (thromboelastography, rotational thromboelastometry), regarding the risk of intra- and postoperative bleeding are low. The results of prothrombin time or activated partial thromboplastin time measurements can be very variable depending on the concentration of reagents and the characteristics of the analysis. That is why standard methods of screening to assess the condition of the coagulation system in all patients in the preoperative period are not recommended. Objective. To describe the features of perioperative blood clotting and management of patients. Materials and methods. Analysis of literature data on this topic. Results and discussion. Before performing invasive procedures, a careful history should be taken to determine the presence and severity of previous bleeding and to ask about antithrombotic medications. If the general hemorrhagic history is favorable, further determination of coagulographic parameters is not required. If the history is unfavorable or there is evidence of potential risk factors for bleeding (e. g., liver disease), a comprehensive coagulation study should be performed. Bleeding coagulopathy is a component of the so-called lethal triad, which also includes hypothermia and acidosis. Active administration of infusion solutions can deepen or provoke coagulopathy due to hemodilution. The use of balanced infusion solutions reduces the risk of this complication. According to some authors, the fibrinogen level <2 g/L is the predictor of bleeding probability. The causes of this condition include hyperfibrinolysis, dysfunctional fibrinogen in case of the administration of colloid solutions, increased decomposition of fibrinogen due to acidosis. Colloidal solutions (hydroxyethyl starch) increase the risk of reoperation and the need for transfusions, so their routine use is not currently recommended. Hyperfibrinolysis is a condition in which the rate of blood clot breakdown exceeds the rate of blood clot formation. As a result, hemorrhagic shock worsens and coagulopathy develops. Hyperfibrinolysis develops due to fibrinolytic agents and hypoperfusion. Tranexamic acid is used for heavy bleeding, in particular, postpartum. The WOMAN study involved 20,600 women with postpartum haemorrhage who received 1 g of tranexamic acid or placebo. Mortality due to bleeding in the tranexamic acid group was 1.2 %, and in the placebo group – 1.7 % (p=0.008). Conclusions. 1. Routine use of colloid solutions should be avoided during bleeding. 2. It is necessary to detect and eliminate anemia, hypothermia and acidosis. 3. Detection and elimination of deficiency or dysfunction of coagulation factors, hyperfibrinolysis, thrombocytopenia is an important component of bleeding prevention. 4. Reducing bleeding and improving blood clotting leads to the less need for transfusions and better outcomes for the patient.

scholarly journals Blood coagulation system in chronic benzene poisoning via inhalation

2017 ◽  
Vol 98 (5) ◽  
pp. 758-763
Author(s):  
R A Oruzhov ◽  
R A Zhafarova
Keyword(s):  
Blood Coagulation ◽  
Fibrinolytic Activity ◽  
Blood Clotting ◽  
Blood Clot ◽  
Coagulation System ◽  
Clot Retraction ◽  
Prothrombin Index ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To experimentally study the changes occurring in blood coagulation system in exposure to low-dose benzene. Methods. The experiment was performed on 36 rabbits by chronic exposure of the animals to benzene during 4 months on a daily basis 4 hours a day with 1 non-exposure day a week and a one-month recovery period after the end of exposure. The average poisoning concentration of benzene in the chambers was between 1240±82 mg/m3. The animals were divided into three groups: group 1 was exposed to gradually increasing concentration of benzene, group 2 - to fluctuating (intermittent) concentrations of benzene, group 3 included unexposed to benzene animals and was used as the control group. Overall blood clotting activity, blood clotting time, blood clot retraction, plasma recalcification time, plasma tolerance to heparin, prothrombin index, fibrinogen concentration, blood fibrinolytic activity were determined. Results. In a month after exposure blood clot retraction rates in groups 1 and 2 increased by 79.8 and 23.1% respectively. Plasma tolerance to heparin most significantly changed in animals from group 2 (by 15.4%). Prothrombin time increased by 11.4% in group 1 while in group 3 this parameter decreased by 0.4%. Prothrombin index in group 1 decreased by 4.3%, and in group 2 the changes were not statistically significant. Concentration of fibrinogen in the blood in group 1 had no significant changes and decreased by 4.2% while in group 2 it decreased by 10.4%. Fibrinolytic activity in group 1 and 2 decreased by 47.5 and 5.8% respectively. Conclusion. The studied benzene concentrations impair blood coagulation and anti-coagulation systems including two stages of hemostasis: 1st stage - from factor XII activation, 2nd stage - from prothrombin (factor II) activation.

scholarly journals Blood coagulation in the 21st century: existing knowledge, current strategies for treatment and perspective

2020 ◽  
Vol 19 (1) ◽  
pp. 139-157
Author(s):  
N. A. Podoplelova ◽  
V. B. Sulimov ◽  
I. S. Ilin ◽  
A. S. Tashilova ◽  
M. A. Panteleev ◽  
...  
Keyword(s):  
Blood Coagulation ◽  
Blood Clotting ◽  
Coagulation Factors ◽  
New Drugs ◽  
Coagulation System ◽  
Modern World ◽  
Blood Coagulation Factors ◽  
Clotting System ◽  
Normal Hemostasis

Disorders in the blood coagulation system are the leading cause of death and disability in the modern world. So the search for new drugs that can prevent pathological thrombosis, while not affecting normal hemostasis, becomes more relevant than ever. Recent studies has been a revolution in the understanding of the principles of work and the regulation of blood coagulation. In addition, new, more effective approaches to drug development have now appeared. For example computer simulation methods that can significantly reduce the time and resources spent on the search for new candidate molecules. In the review, the blood clotting system, the molekular mechanisms of thrombosis, the role of blood coagulation factors Xa and XIa, and the urgency of developing new inhibitors of these targets are shown, and the most interesting inhibitors of factors Xa and XIa are presented.

Cold Promoted Activation of Factor VII

1972 ◽  
Vol 28 (02) ◽  
pp. 155-168 ◽  
Author(s):  
H Gjønnæs
Keyword(s):  
Coagulation Factors ◽  
Oral Contraception ◽  
Factor Vii ◽  
Coagulation System ◽  
Plasma Coagulation ◽  
Main Effect

SummaryThe cold promoted shortening of the thrombotest-times occuring in the plasmas of the majority of women on oral contraception or in the last trimester of pregnancy when incubated overnight at 0°–4° was investigated.The short thrombotest-times were caused by activation of factor VII in a time consuming reaction. Activation was also revealed in the intrinsic coagulation system, but the changes in the activities of coagulation factors other than factor VII were small.Comparison was made between clot promoting effects of cooling and contact, and it was concluded that while contact apparently exerted its main effect in the intrinsic system, cooling predominately activated the extrinsic plasma coagulation system.The cold promoted activation of factor VII seemed to be brought about by an activator.

The Role of Tranexamic Acid in Controlling Bloodloss During PCNL for Staghorn Calculi

2019 ◽  
Vol 69 (12) ◽  
pp. 3745-3748
Author(s):  
Raluca Costina Barbilian ◽  
Victor Cauni ◽  
Bogdan Mihai ◽  
Ioana Buraga ◽  
Mihai Dragutescu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stones ◽  
Postoperative Bleeding ◽  
Invasive Technique ◽  
Transfusion Rate ◽  
Staghorn Calculi ◽  
Type Of Surgery

The aim of this paper is to assess the efficiency and safety of the tranexamic acid in reducing blood loss and the need for transfusion in patients diagnosed with staghorn calculi treated by percutaneous nephrolithotomy. Percutaneous nephrolithotomy (PCNL) is a minimally invasive technique used for large kidney stones. Hemorrhagic complications and urinary sepsis are serious complications associated with this type of surgery. Tranexamic acid is an antifibrinolytic drug that has the property of reducing intra or postoperative bleeding. The experience with tranexamic acid in preventing blood loss during percutaneous nephrolithotomy for is limited. The use tranexamic acid in percutaneous nephrolithotomy for staghorn type stones is safe and is associated with reduced blood loss and a lower transfusion rate.

The Control of Bloodloss During Percutanerous Nephrolithotomy Using Tranexamic Acid

2018 ◽  
Vol 69 (10) ◽  
pp. 2728-2730
Author(s):  
Raluca Costina Barbilian ◽  
Victor Cauni ◽  
Bogdan Mihai ◽  
Ioana Buraga ◽  
Mihai Dragutescu ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stones ◽  
Postoperative Bleeding ◽  
Invasive Technique ◽  
Transfusion Rate ◽  
Renal Lithiasis ◽  
Percutaneous Approach ◽  
Transfusion Requirements ◽  
Urinary Sepsis

The aim of this study is to assess the efficiency and safety of the tranexamic acid in reducing hemmorrhagic complications and transfusion requirements in patients with renal lithiasis treated by percutaneous approach. Percutaneous nephrolithotomy (PCNL) is a minimally invasive technique used for large kidney stones (]20mm). Urinary sepsis and intra or postoperative bleeding are the very serious complications associated with this type of procedure. Tranexamic acid is used in the treatment of many haemorrhagic conditions. The experience with tranexamic acid in preventing bloodloss during percutaneous nephrolithotomy is very limited. The use tranexamic acid in percutaneous nephrolithotomy is safe and is associated with reduced blood loss and a lower transfusion rate.

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

The Haemocompatibility of Biomaterials In Vitro: Investigations on the Mechanism of the Whole-blood Clot Formation Test

1992 ◽  
Vol 20 (3) ◽  
pp. 390-395 ◽  
Author(s):  
Thomas Groth ◽  
Katrin Derdau ◽  
Frank Strietzel ◽  
Frank Foerster ◽  
Hartmut Wolf
Keyword(s):  
Whole Blood ◽  
Blood Clotting ◽  
Blood Clot ◽  
Formation Rate ◽  
Clot Formation ◽  
Coagulation Cascade ◽  
Contact Activation ◽  
Human Fibrinogen ◽  
Static Conditions

Twenty years ago Imai & Nose introduced a whole-blood clotting test for the estimation of haemocompatibility of biomaterials in vitro In our paper a modification of this assay is described and the mechanism of clot formation further elucidated. It was found that neither the inhibition of platelet function nor the removal of platelets from blood significantly changed the clot formation rate on glass and polyvinyl chloride in comparison to the rate tor whole blood. Scanning electron microscopy demonstrated that platelets were not involved in clot formation near the blood/biomaterial interface. Thus, it was concluded that the system of contact activation of the coagulation cascade dominates during clot formation under static conditions. The latter conclusion was supported by the fact that preadsorption of human serum albumin or human fibrinogen onto the glass plates used, decreased the clot formation rate in the same manner.

Clinical Information From Screening Programs For Coagulation And Fibrinolytic Factors And Inhibitor Deficiencies Using Automated Chromogenic Methods

1981 ◽  
Author(s):  
J W ten Cate ◽  
L H Kahlé ◽  
H R Büller ◽  
M Peters ◽  
G H Weenink
Keyword(s):  
Oral Anticoagulant Therapy ◽  
Venous Blood ◽  
Postoperative Bleeding ◽  
Clinical Information ◽  
Coagulation Factors ◽  
Normal Pregnancy ◽  
Factor X ◽  
Gram Negative ◽  
Screening Programs ◽  
At Iii

The introduction of chromogenic substrates allowed the development of automated spectophotometric assays. After having developed such methods employing an automated kinetic enzyme and substrate analyser for coagulation factors II and X, antithrombin III (AT III), plasminogen (PG) and α2- antiplasmin (α2-AP) , we decided to apply these methods in well defined clinical projects in order to evaluate their future clinical potency. Results obtained thusfar revealed that 1. AT III and PG are predictors of gram negative septicaemia in patients with intraabdominal infection following major abdominal and vascular surgery, 2. The predictive value of AT III for gram negative septicaemia in prospective studies in premature neonates (all assays require only 0.4 ml of venous blood), 3. AT III remains unchanged in normal pregnancy. Decreasing values are observed in toxaemia and isolated deficiencies are observed as an early sign of intravascular coagulation in pre- ecclampsia, 4. Routine screening of AT III in female subjects on oral anticonceptive drugs is of no use, 5. Factor X assays may possibly be used for the control of oral anticoagulant therapy, 6. Screening of patients with postoperative bleeding disorders may disclose congenital factor X deficiency not reflected by routine prothrombin time measurements.

Transient Ischemic Attack in a Hemophilia Patient with Severe Preeclampsia after Preoperative Administration of Tranexamic Acid and Factor VIII Replacement for Cesarean Section

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
D’Onofrio JD ◽  
◽  
Hoffman CR ◽  
Goldberg SF ◽  
◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Transient Ischemic Attack ◽  
Hemophilia A ◽  
Coagulation Factors ◽  
Background Information ◽  
Preoperative Administration ◽  
Increased Risk ◽  
Pharmacologic Prophylaxis ◽  
Ischemic Attack ◽  
Von Willebrand

Hemophilia A in females accounts for few cases due to hemophilia A and B having X-linked recessive inheritance patterns. Hemostatic changes in pregnancy include an increase in coagulation factors and von Willebrand activity, placing hemophilia patients at an increased risk for Postpartum Hemorrhage (PPH). General recommendations include considering pharmacologic prophylaxis, including tranexamic acid and factor replacement when necessary. The ultimate goal is to prevent uncontrolled bleeding during vaginal or operative delivery. Benefits of prophylactic therapies must be weighed with relevant risk profiles of each intervention. We present a case where a parturient with hemophilia prophylactically treated with TXA and FVIII experienced a transient ischemic attack. We discuss the background information known regarding tranexamic acid and factor replacement, and the subsequent recommendations for their use in this patient population. We consider recommendations to expand the multidisciplinary team incorporated in the assessment and planning for the peripartum care of such a patient.

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