scholarly journals Investigation of the Possible Effects of Injectable and Skin Patch Contraceptives on Selected Haemostatic and Haematologic Parameters in Women Attending Primary Healthcare Centre in Eleme, Rivers State

2020 ◽  
pp. 99-108
Author(s):  
Evelyn Mgbeoma Eze ◽  
Fiekumo Igbida Buseri ◽  
Serekara Gideon Christian ◽  
Andrew Temide Olasebiomo ◽  
Baribefe Daniel Koate ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time ◽  
Mean Values ◽  
Skin Patch ◽  
Primary Healthcare Centre ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Depo Provera

The was a case control and comparative study aimed at investigating the possible effects of injectable and skin patch contraceptives on selected haematologic and haemostatic parameters in women attending primary healthcare centre at Eleme, Rivers State The study population consists of seventy-five (75) apparently healthy, non-pregnant, non- smoking women, aged between 25 and 45years; (31 women on DEPO-PROVERA contraceptive, 14 women on Implanon, and 30 apparently healthy non-contraceptive users as control group). Fibrinogen, antithrombin, tissue plasminogen activator was analysed with reagents prepared by Elabscience, Wuhan, China, using an ELISA machine (STAT FAX-2100). Prothrombin time and activated partial thromboplastin time was done manually with reagents prepared by Quimica Clinica Aplicada S.A, Spain. Haematologic parameters were analysed using SYSMEX KX-21-N auto analyser.  Graph-pad Prism 5.0 was used in analysing all data, p < 0.05 was considered statistically significant. For haemostatic parameters, results showed that there was statistically significant increase in mean values of antithrombin (38.48 ± 17.48/ml versus 21.02 ± 15.54ng/ml, p=0.0011) and tissue plasminogen activator (1.34 ± 1.35ng/ml versus 0.28 ± 0.46ng/ml, p=0.0047) in women using the two types of contraceptive, while activated partial thromboplastin time (28.11± 2.37s versus 29.87 ± 2.77s, p=0.0205) was statistically decreased in women on the investigated contraceptives, other haemostatic parameters were not statistically significant. For haematological parameters, the results showed that there was statistically significant increase in mean values of packed cell volume 38.13 ± 2.28% versus 36.21 ± 3.07% (p=0.0126), haemoglobin 12.35 ± 0.79g/dL versus 11.56 ± 0.99g/dL (p=0.0028), white blood cells 6.17 ± 1.22 x109/L versus 5.26 ± 1.18 x109/L (p=0.0143) in women using injectable (DEPO-PROVERA) and skin patch (IMPLANON) contraceptive, other parameters showed no statistically significance. Based on duration of use of contraceptive, there was no statistically significant difference (p>0.05) in women using skin patch; while for injectable, platelet count was high in those who had used it for more than a year. Comparing values obtained from using injectable and skin patch, there was no statistical significant difference in all the parameters. Using analysis of variance to compare values based on parity, there was no statistical significant difference. Conclusively, increase in antithrombin and tissue plasminogen activator, and a decrease in activated partial thromboplastin time in women using IMPLANON (skin patch) and DEPO-PROVERA (injectable) are the haemostatic changes that occurs while using contraceptives and these changes may likely predispose them to bleeding, therefore adequate monitoring of the blood haemostatic processes while taking these contraceptives is critical in order not to expose users to haemorrhage.

scholarly journals Abnormal Changes in Some Haemostatic Parameters in First-ever Stroke Patients in Port Harcourt, Nigeria: A Preliminary Findings

2019 ◽  
pp. 1-9
Author(s):  
Fiekumo Igbida Buseri ◽  
Serekara Gideon Christian ◽  
Evelyn Mgbeoma Eze
Keyword(s):  
Platelet Count ◽  
Prothrombin Time ◽  
Plasminogen Activator ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time ◽  
Stroke Patients ◽  
Mean Values ◽  
Control Subjects ◽  
Port Harcourt ◽  
Tissue Plasminogen

Background and Purpose: Cellular component and clotting factors are involved in thrombotic events such as stroke, but the type and nature of alteration of those haemostatic parameters remain unclear. Our objective was to identify possible abnormal changes in some haemostatic parameters in established stroke patients. Materials and Methods: This was a prospective case-control study conducted at Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria. Standard operating procedures were adopted to assay fibrinogen, antithrombin, tissue plasminogen activator, prothrombin time and activated partial thromboplastin time as well as the determination of platelet count and platelet indices. The data were analyzed using Statistical Package for Social Science (SPSS) version 17.0 software. Results: A total of 108 individuals comprised of 54 stroke patients aged between 45 and 73 years (mean, 59± 13.04 years), 20 (37.04%) men and 34 (62.96%) women and another 54 age- and sex-matched healthy control subjects were studied. Significantly (p<0.05) higher mean values of mean platelet volume (MPPV), platelet distribution width (PDW), Platelet larger cell ratio (PLCR), antithrombin, tissue plasminogen activator and fibrinogen were observed in the stroke patients when compared to those of the control subjects. Whereas, significantly lower (p<0.05) mean values of platelet count, prothrombin time and activated partial thromboplastin time were observed in the stroke patients than in those of the control subjects. Conclusion: Several haemostatic parameters were found to be altered in stroke patients and have the potential to be risk factors but have not been demonstrated as being causative. Further work is needed to establish where they begin to contribute to stroke prognosis.

Immunoreactivity of Tissue Plasminogen Activator and of Its Inhibitor Complexes

1989 ◽  
Vol 61 (03) ◽  
pp. 409-414 ◽  
Author(s):  
M Rånby ◽  
G Nguyen ◽  
P Y Scarabin ◽  
M Samama
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Degradation Products ◽  
Gel Filtration ◽  
Free Form ◽  
Enzyme Linked Immunosorbent Assay ◽  
Plasma Samples ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Pai 1

SummaryAn enzyme linked immunosorbent assay (ELISA) based on goat polyclonal antibodies against human tissue plasminogen activator (tPA) was evaluated. The relative immunoreactivity of tPA in free form and tPA in complex with inhibitors was estimated by ELISA and found to be 100, 74, 94, 92 and 8l% for free tPA and tPA in complex with PAI-1, PAI-2, α2-antiplasmin and C1-inhibitor, respectively. Addition of tPA to PAI-1 rich plasma resulted in rapid and total loss of tPA activity without detectable loss of ELISA response, indicating an immunoreactivity of tPA in tPA/PAI-1 complex of about l00%. Three different treatments of citrated plasma samples (acidification/reneutralization, addition of 5 mM EDTA or of 0.5 M lysine) prior to determination by ELISA all resulted in increased tPA levels. The fact that the increase was equally large in all three cases along with good analytical recovery of tPA added to plasffi, supported the notion that all tPA antigen present in plasma samples is measured by the ELISA. Analysis by ELISA of fractions obtained by gel filtration of plasma from a patient undergoing tPA treatment identified tPA/inhibitor complexes and free tPA but no low molecular weight degradation products of tPA. Determinations of tPA antigen were made at seven French clinical laboratories on coded and randomized plasma samples with known tPA antigen content. For undiluted samples there was no significant difference between the tPA levels found and those known to be present. The between-assay coefficient of variation was 7 to 10%. In conclusion, the ELISA appeared suited for determination of total tPA antigen in human plasma samples.

Tissue plasminogen activator in chronic subdural hematomas as a predictor of recurrence

2006 ◽  
Vol 104 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Hiroyuki Katano ◽  
Ken Kamiya ◽  
Mitsuhito Mase ◽  
Motoki Tanikawa ◽  
Kazuo Yamada
Keyword(s):  
Growth Factor ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Venous Blood ◽  
Angiogenic Factors ◽  
Subdural Hematomas ◽  
Initial Surgery ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Endothelial Growth Factor

Object Chronic subdural hematomas (CSDHs) recur in 7 to 18% of cases. The present study was conducted to determine whether serum or lesion concentrations of coagulofibrinolytic and angiogenic factors, which have been reported to be potential markers of CSDH development, might predict such recurrences. Methods Sixty consecutive patients (mean age 71.5 years) with CSDHs (74 affected sides) were studied. Samples of serum in preoperative peripheral venous blood and of hematomas (obtained during surgery) were collected and analyzed. The CSDH recurred in six (8.1%) of the 74 affected sides in six patients. None of the values of the coagulative factors or tests in serum showed significant variation between cases with and those without recurrence. Among coagulofibrinolytic factors, tissue plasminogen activator (TPA) in hematomas demonstrated significantly greater levels in recurrent than in nonrecurrent cases; a similar tendency was noted for α2-plasmin inhibitor–plasmin complex in hematomas. Both factors were greater in the lesions than in the serum. Among the angiogenic factors, levels of hepatic growth factor (HGF) and vascular endothelial growth factor (VEGF) in hematomas were significantly greater than in serum, whereas those of basic fibroblast growth factor were rather lower. Note that comparisons between recurrent and nonrecurrent cases revealed no significant difference. Conclusions Patients harboring CSDHs with high TPA concentrations on sampling at the initial surgery have a relatively high probability of recurrence and require follow up with computerized tomography scanning. Angiogenic factors, such as HGF and VEGF, might be candidate markers of CSDH enlargement but are not useful as predictors of recurrence.

scholarly journals Analisis pengaruh pemberian virgin coconut oil (VCO) terhadap adhesi intraperitoneal

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Erwin . ◽  
Jimmy Panelewen ◽  
Ishak Lahunduitan
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Rattus Norvegicus ◽  
Adhesion Formation ◽  
Coconut Oil ◽  
Virgin Coconut Oil ◽  
Chi Square ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Anti Inflammation

Abstract: Intraperitoneal adhesion is an attachment between intraperitoneal tissue and organ in the form of fibrosis. The occurences of intraperitoneal adhesion are 67-93% after laparotomy and 97% after gynecological operation. Adhesion between wound and omentum occurs in 80% of patients; 50% involve the intestines. Prevention and inhibition of adhesion formation can be done by decreasing post traumatic inflammation. There are several substances that can be used for that purpose, inter alia: anti-inflammation, anti-histamine, anti-coagulant (heparin), anti-oxidant, proteolytic enzymes, and tissue plasminogen activator. It is already known that virgin coconut oil (VCO) has several important roles, such as: anti-inflammation, antithrombosis, mechanical barrier, and antioxidant due to its tocopherol content. This study aimed to obtain the influence of several doses of intraperitoneal VCO on intraperitoneal adhesion macroscopically and microscopically after laparotomy. This was an analytical interventional study using control. Samples were male Wistar rats (Rattus norvegicus) with an average body weight of 175-200 g. The results of Kruskal-Wallis chi-square tests were 16.381, df = 4, and Asymp sig = 0.003 (P < 0.05) for macroscopical grading (Zühlke) meanwhile 15.160, df = 4, and Asymp sig = 0.004 (P < 0.01) for microscopical grading (Yilmaz). Conclusion: There was a statistically significant difference in macroscopical grades according to Zühlke and in microscopical grades according to Yalmiz among the five groups concerning the occurence of intraperitoneal adhesion in Rattus norvegicus.Keywords: intraperitoneal adhesion, virgin coconut oil (VCO).Abstract: Adhesi intraperitonial adalah timbulnya perlengketan berupa fibrosis antara jaringan dan organ di dalam rongga abdomen. Kejadian adhesi intraperitoneal sekitar 67-93% setelah operasi laparotomi bedah dan mencapai 97% pada operasi ginekologi. Adhesi antara luka dan omentum terjadi pada 80% pasien dan sekitar 50% melibatkan usus. Untuk mencegah atau mengurangi pembentukan adhesi dapat dilakukan dengan menurunkan inflamasi pasca trauma melalui bahan atau obat anti-inflamasi, anti-histamin, anti-koagulan (heparin), anti-oksidan, enzim proteolitik, dan tissue plasminogen activator. Virgin Coconut Oil (VCO) telah diketahui berperan sebagai antiinflamasi, antitrombotik, barier mekanik, dan antioksidan dengan bahan aktif utama tokoferol. Penelitian ini bertujuan untuk mengetahui pengaruh VCO secara makroskopik dan mikroskopik terhadap adhesi intraperitoneal dengan menganalisis perbandingan dosis VCO yang diberikan intraperitoneal pada hewan coba tikus Wistar. Jenis penelitian ini analitik intervensional dengan kontrol. Hewan coba ialah tikus Wistar (Rattus norvegicus) yang diseragamkan berat badan 175-200 g, jenis kelamin jantan, dan variannya. Hasil uji Kruskal-Wallis chi-square ialah 16,381 dengan df = 4 dan Asymp sig = 0,003 (P < 0,05) untuk penilaian makroskopik (Zühlke) sedangkan nilai 15,160, dengan df = 4 dan Asymp sig = 0,004 (P < 0,01) untuk penilaian mikroskopik (Yilmaz). Simpulan: Terdapat perbedaan bermakna dalam derajat makroskopik menurut Zühlke dan derajat mikroskopik menurut Yilmaz pada ke-5 perlakuan dalam kejadian adhesi intraperitoneal pada Rattus norvegicus.Kata kunci: adhesi intraperitoneal, VCO

A Comparison of Thromboelastography with Heparinase or Protamine Sulfate Added In Vitro during Heparinized Cardiopulmonary Bypass

1997 ◽  
Vol 78 (02) ◽  
pp. 820-826 ◽  
Author(s):  
Bruce D Spiess ◽  
Michael H Wall ◽  
Bruce S Gillies ◽  
Jane C K Fitch ◽  
Louise O Soltow ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Postoperative Hemorrhage ◽  
Sensitive Indicator ◽  
Blood Samples ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Heparin Neutralization

SummaryThromboelastography (TEG) has been used after cardiopulmonary bypass (CPB) to diagnose excessive postoperative hemorrhage. Conventional TEG during CPB is not possible due to the sensitivity of the TEG to even small amounts of heparin, which produces a nondiagnostic tracing. The purpose of this study was to compare heparin neutralization using heparinase or protamine in TEG blood samples obtained during CPB. TEG testing was performed on 48 patients before, during and after CPB. Tissue plasminogen activator activity and antigen were measured on a subset of 32 patients. We found: 1) heparinase neutralized at least 10 IU/ml heparin while 1.6 ug/ml protamine neutralized up to 7 IU/ml heparin, 2) in samples with complete heparin neutralization by both methods, there was no significant difference in the R values, 3) while there was good correlation for other TEG parameters between heparinase and protamine treated samples, heparinase treatment produced shorter K values and higher angle, MA and A60, 4) while fibrinolysis was detected using both methods, heparinase treatment suppressed fibrinolysis in the TEG in both samples from patients and after in vitro addition of tissue plasminogen activator, 5) TEG was not a sensitive indicator of t-PA activity, detecting only 21% of samples with increased t-PA activity during bypass, and 5) heparinase was at least 100 times more expensive than protamine. We conclude that while both heparinase and protamine can be used to neutralize heparin in TEG samples obtained during CPB, protamine neutralization is more sensitive to fibrinolysis and less expensive, but the protamine dose must be carefully selected to match the heparin level used at individual institutions.

scholarly journals Biological effect of tissue plasminogen activator (t-PA) and DNase intrapleural delivery in pleural infection patients

2019 ◽  
Vol 6 (1) ◽  
pp. e000440 ◽  
Author(s):  
Nikolaos I Kanellakis ◽  
John M Wrightson ◽  
Rob Hallifax ◽  
Eihab O Bedawi ◽  
Rachel Mercer ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Treatment Period ◽  
Tissue Plasminogen Activator ◽  
Statistical Significance ◽  
Significant Rise ◽  
Monocyte Chemoattractant Protein 1 ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Pleural Infection ◽  
Intrapleural Administration

BackgroundPleural infection (PI) is a major global disease with an increasing incidence, and pleural fluid (PF) drainage is essential for the successful treatment. The MIST2 study demonstrated that intrapleural administration of tissue plasminogen activator (t-PA) and DNase, or t-PA alone increased the volume of drained PF. Mouse model studies have suggested that the volume increase is due to the interaction of the pleura with the t-PA via the monocyte chemoattractant protein 1 (MCP-1) pathway. We designed a study to determine the time frame of drained PF volume induction on intrapleural delivery of t-PA±DNase in humans, and to test the hypothesis that the induction is mediated by the MCP-1 pathway.MethodsData and samples from the MIST2 study were used (210 PI patients randomised to receive for 3 days either: t-PA and DNase, t-PA and placebo, DNase and placebo or double placebo). PF MCP-1 levels were measured by ELISA. One-way and two-way analysis of variance (ANOVA) with Tukey’s post hoc tests were used to estimate statistical significance. Pearson’s correlation coefficient was used to assess linear correlation.ResultsIntrapleural administration of t-PA±DNase stimulated a statistically significant rise in the volume of drained PF during the treatment period (days 1–3). No significant difference was detected between any groups during the post-treatment period (days 5–7). Intrapleural administration of t-PA increased MCP-1 PF levels during treatment; however, no statistically significant difference was detected between patients who received t-PA and those who did not. PF MCP-1 expression was not correlated to the drug given nor the volume of drained PF.ConclusionsWe conclude that the PF volume drainage increment seen with the administration of t-PA does not appear to act solely via activation of the MCP-1 pathway.

scholarly journals Dose optimization study for recombinant tissue plasminogen activator in acute ischemic stroke: A study from Middle-East

2021 ◽  
Vol 26 (3) ◽  
pp. 465-469
Author(s):  
Helia Hemasian ◽  
Erfan Sheikhbahaei ◽  
Arvin Shahzamani ◽  
Faribourz Khorvash ◽  
Mohammad Saadatnia ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Middle East ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Intracranial Hemorrhage ◽  
Recombinant Tissue Plasminogen Activator ◽  
Effective Dosage ◽  
Significant Difference ◽  
Tissue Plasminogen

Background: Variable intravenous recombinant tissue-plasminogen activator (rt-PA) dosages are used for ischemic stroke. We aimed to report our experience from administering different rt-PA doses in a tertiary referral center in Middle-East. Method: Medical documents of ischemic stroke patients who received rt-PA were retrospectively reviewed and analyzed. Patients were grouped into three categories based on the received total amount of rt-PA and their body weight: 0.6 mg/kg (low-dose), 0.75 mg/kg (intermediate-dose), and 0.9 mg/kg (high-dose). During the hospitalization period, patients were under full surveillance for rt-PA complications. The validated format of the National Institutes of Health stroke scale (NIHSS) and the modified Rankin scale (mRS) were used at the baseline, at the time of being discharged, and after 3 months. Chi-square, ANOVA, and ANCOVA were used for statistical analysis. Results: 602 patients were evaluated and grouped as follow: 187 (31.06%) in 0.6 mg/kg group (61% male) with mean age of 68±15 years, 217 (36.04%) in 0.75 mg/kg group (59% male) with mean age of 67±13 years, and 198 (32.89%) in 0.9 mg/kg group (50% male) with mean age of 69±17 years. There was no significant difference between the three groups regarding their demographics, comorbidities, and the distribution of stroke risk factors. No significant difference was seen between the three groups regarding in-hospital death and intracranial hemorrhage (p=0.07 and 0.09, respectively). In terms of NIHSS, no significant difference was observed between the three groups at the time of admission, discharge, and follow-up (p=0.98, 0.85, and 0.47, respectively). At the time of discharge, the mRS of 0.6 mg/kg group was significantly higher than the other two groups (p=0.04), which decreased in the 3-month follow-up and did not make significant differences (p=0.38). Conclusions: According to the in-hospital mortality, intracranial hemorrhage, mRS, and NIHSS scores, we recommend 0.75 mg/kg as our safe, beneficial, and cost-effective dosage.

Abstract T MP119: Recombinant Tissue Plasminogen Activator Does Not Impact Mortality in Acute Ischemic Stroke: A Meta-analysis of Randomized Controlled Trials

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Drew Uhrig ◽  
Gyanendra Kumar ◽  
Susan Fowler ◽  
Andrei Alexandrov
Keyword(s):  
Sensitivity Analysis ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Meta Analysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Controlled Trials ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Mortality Estimates ◽  
Time Point

Background: Currently there is still some reluctance among emergency physicians and even neurologists to prescribe recombinant tissue plasminogen activator (rt-PA) for acute stroke. The majority of those unlikely to use it are concerned about causing harm to their patient. The object of this meta-analysis was to pool the mortality estimates at various time points following rt-PA administration. We hypothesized that there was a significant difference in mortality of patients treated with rt-PA and those treated with placebo. Methods: The databases PUBMED, EMBASE, SCOPUS, CENTRAL, and clinicaltrials.gov were searched for English-language randomized double blinded, placebo controlled trials of rt-PA. Mortality estimates were pooled and reported separately for days 7, 30, 90, and 180. Pooled relative risk (RR) and 95% confidence intervals were calculated using Dersimonian and Laird Random effects model. A priori designed sensitivity analyses included exclusion sensitivity analysis, and subgroup analysis into studies that included and excluded patients presenting within 3 hours of onset. Results: Eleven trials (N =6905) met the inclusion criteria. Total variance attributable to heterogeneity was not significant (I2 <50%) for any time point except at 30 days (I2, 53%). Publication bias was not significant on Begg’s and Egger’s tests. Mortality was not significantly different between the two groups at any time point. Exclusion sensitivity analysis revealed that exclusion of the NINDS trial rendered the 7 day and 30 day difference significant. Trials that randomized patients beyond 3 hours did not drive the mortality difference seen at any time point. Conclusion: In conclusion, compared with placebo, rt-PA does not impact mortality at any time point after administration through 6 months.

THE RESPONSE OF PROTEIN S, TISSUE PLASMINOGEN ACTIVATOR AND TISSUE PLASMINOGEN ACTIVATOR INHIBITOR TO DESMOPRESSIN (DDAVP) INFUSION

1987 ◽  
Author(s):  
N K Wadhwa ◽  
S Kim ◽  
P Glas-Greenwalt ◽  
K S Kant ◽  
V E Pollak
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Activated Protein C ◽  
Plasminogen Activator Inhibitor ◽  
Protein S ◽  
Venous Occlusion ◽  
Mean Values ◽  
Tissue Plasminogen ◽  
Baseline Values ◽  
Activator Inhibitor

Protein S (PS) is a cofactor for activated protein C (PC) in the neutralization of tissue plasminogen activator inhibitor (PA-I) and in its profibrinolytic effect (Blood 69:231, 1987). Increased fibrinolytic activity and tissue plasminogen activator (t-PA) antigen in response to venous occlusion are dissociated because of t-PA and PA-I complex formation (Br. J. Haematol. 61:169, 1985). We hypothesized that DDAVP infusion stimulates t-PA and PS release from endothelium, thereby decreasing PA-I. These responses to intravenous DDAVP infusion (0.4 μg/kg) were studied in 1.0 healthy volunteers. t-PA activity and PA-I were measured by standard fibrin plates. t-PA antigen was assayed by ELISA. PS and PC were measured by electroimmunodiffusion. The baseline values were expressed as 100%. Mean values expressed as percent of baseline at 10, 30, 60 min after DDAVP infusion were:These data support that both t-PA and PS were released, during DDAVP infusion, thereby resulting in decreased PA-I.

Use of Tissue Plasminogen Activator in Abdominal Abscesses in Children—A Single-Center Randomized Control Trial

2020 ◽  
pp. 084653712091426
Author(s):  
Craig R. Gibson ◽  
Afsaneh Amirabadi ◽  
Simal Goman ◽  
Nicholas C. Armstrong ◽  
Jacob C. Langer ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Primary Outcome ◽  
Treated Group ◽  
Single Center ◽  
Abdominal Abscesses ◽  
Number Of Patients ◽  
Significant Difference ◽  
Tissue Plasminogen ◽  
Secondary Outcomes

Purpose: To establish the efficacy of once-per-day intracavitary tissue plasminogen activator (tPA) in the treatment of pediatric intra-abdominal abscesses. Methods: A single-center prospective, double-blinded, randomized controlled trial of the use of intracavitary tPA in abdominal abscesses in children. Patients were randomized to either tPA-treatment or saline-treatment groups. Primary outcome was drainage catheter dwell (hours). Secondary outcomes were length of hospital stay, times to discharge, clinical and sonographic resolution, and adverse events (AEs). Results: Twenty-eight children were randomized to either group (n = 14 each). Demographics between groups were not significantly different (age P = .28; weight P = .40; gender P = .44). There were significantly more abscesses in the tPA-treated group ( P = .03). Abscesses were secondary to perforated appendicitis (n = 25) or postappendectomy (n = 3). Thirty-four abscesses were drained, 4 aspirated, 3 neither drained/aspirated. There was no significant difference in number of drains ( P = .14), drain size ( P = .19), primary outcome ( P = .077), or secondary outcomes found. No procedural or intervention drug-related AEs occurred. No patient in the saline-treated group required to be switched/treated with tPA. Conclusion: No significant difference in the length of catheter dwell time, procedure time to discharge, or time to resolution was found. Intracavitary tPA was not associated with morbidity or mortality. The results neither support nor negate routine use of tPA in the drainage of intra-abdominal abscess in children. It is possible that a multicentre study with a larger number of patients may answer this question more definitively.

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