Journal articles: 'Haemostasis'

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Habal, Petr, Veronika Sívková, and Petr Votava. "Comparison of Efficacy and Safety of Non-Regenerated and Regenerated Oxidized Cellulose Based Fibrous Haemostats." Acta Medica (Hradec Kralove, Czech Republic) 65, no. 2 (2022): 53–58. http://dx.doi.org/10.14712/18059694.2022.18.

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Purpose: Various forms of local haemostats are increasingly used routinely in surgical procedures. Our work is the first comparison of the efficacy and safety of non-regenerated and regenerated oxidized cellulose based fibrous haemostats. Methods: The haemostatic efficacy and safety of fibrous haemostats based on ONRC and ORC were compared in a randomized multicenter study. The primary endpoint was successful haemostasis within 3 minutes of application and no need for surgical revision within 12 hours after the procedure for recurrent bleeding. Results: There was a significant difference in the rate of successful haemostasis in 3 minutes that was achieved in 82% and 55% in the ONRC and ORC groups, respectively (confidence interval 99%; p = 0.009). Mean time to haemostasis was 133.9 ± 53.95 seconds and 178.0 ± 82.33 seconds, in the ONRC, and ORC group, respectively (p = 0.002). Revision surgery for re-bleeding was necessary in 0 (0%), and 1 (2%) of patients in the ONRC, and ORC group, respectively. No adverse events were reported. Conclusion: Fibrous haemostat based on ONRC was non-inferior compared to fibrous haemostat based on ORC when used in accordance with its intended purpose, and was safe and efficient.

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Moldovan, Horațiu, Iulian Antoniac, Daniela Gheorghiță, Maria Sabina Safta, Silvia Preda, Marian Broască, Elisabeta Badilă, et al. "Biomaterials as Haemostatic Agents in Cardiovascular Surgery: Review of Current Situation and Future Trends." Polymers 14, no. 6 (March 16, 2022): 1189. http://dx.doi.org/10.3390/polym14061189.

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Intraoperative haemostasis is of paramount importance in the practice of cardiovascular surgery. Over the past 70 years, topical haemostatic methods have advanced significantly and today we deal with various haemostatic agents with different properties and different mechanisms of action. The particularity of coagulation mechanisms after extracorporeal circulation, has encouraged the introduction of new types of topic agents to achieve haemostasis, where conventional methods prove their limits. These products have an important role in cardiac, as well as in vascular, surgery, mainly in major vascular procedures, like aortic dissections and aortic aneurysms. This article presents those agents used for topical application and the mechanism of haemostasis and offers general recommendations for their use in the operating room.

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Ibrahim, Mostafa, Ahmed El-Mikkawy, Mohamed Abdel Hamid, Haitham Abdalla, Arnaud Lemmers, Ibrahim Mostafa, and Jacques Devière. "Early application of haemostatic powder added to standard management for oesophagogastric variceal bleeding: a randomised trial." Gut 68, no. 5 (May 5, 2018): 844–53. http://dx.doi.org/10.1136/gutjnl-2017-314653.

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BackgroundAcute variceal bleeding (AVB) requires early therapeutic management by experienced endoscopists that often poses logistical challenges for hospitals. We assessed a different management concept with early application of haemostatic powder—which does not require high endoscopic expertise—added to conventional management in a randomised trial.MethodsCirrhotic patients with AVB received standard medical therapy and were randomised to either immediate endoscopy with haemostatic powder application within 2 hours of admission, followed by early elective endoscopy on the next day, that is, within 12–24 hours of admission for definitive treatment (study group) or to early elective endoscopy only (control group). In both groups, failures to achieve clinical haemostasis until the time of early elective endoscopy underwent rescue endoscopy with attempted conventional haemostasis. Primary outcome was endoscopic haemostasis at the elective endoscopy.ResultsOf 86 randomised patients with AVB, 5/43 in the study group required rescue endoscopy for failure of controlling spurting bleeding (n=4) after powder application or for early bleeding recurrence in one patient who died before repeating rescue endoscopy. In the control group, 13/43 patients required rescue endoscopic haemostasis for failure of clinical haemostasis (12%vs30%, p=0.034). In the remaining patients, early elective endoscopic haemostasis was achieved in all 38 patients in the study group, while all remaining 30 patients in the control group had fresh gastric blood or (10%) spurting bleeding at early elective endoscopy with successful haemostasis in all of them. Six-week survival was significantly improved in the study group (7%vs30%, p=0.006).ConclusionThe new concept of immediate powder application improves early clinical and endoscopic haemostasis. This simplified endoscopic approach may have an impact on early and 6-week survival.Trial registration numberNCT03061604.

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Monagle, Paul, and Patricia Massicotte. "Developmental haemostasis: Secondary haemostasis." Seminars in Fetal and Neonatal Medicine 16, no. 6 (December 2011): 294–300. http://dx.doi.org/10.1016/j.siny.2011.07.007.

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Silveira, Angela, Stella Thomassen, Lars-Olof Hansson, Jan Rosing, Anders Hamsten, Katarina Bremme, and Marianne van Rooijen. "Rapid activation of haemostasis after hormonal emergency contraception." Thrombosis and Haemostasis 97, no. 01 (2007): 15–20. http://dx.doi.org/10.1160/th06-09-0540.

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SummaryHormonal emergency contraception (EC) is a well established contraceptive method, recommended to all women, although the effects on haemostais are not fully evaluated. The aim of this study was to evaluate whether exposure to EC has effects on well established cardiovascular risk factors, and also to examine whether differences exist between two EC treatments. In a prospective randomized cross over design 11 women used two different EC methods, one with estrogen and levonorgestrel (EE-EC) and one with levonorgestrel only (LNG-EC). Plasma concentrations of haemostatic factors (APC resistance, antithrombin, fibrinogen, prothrombin fragment 1+2, free protein S, factor VII and PAI-1), sex-hormone-binding globulin (SHBG), the apolipoprotein (apo)B/apoA1 ratio and C-reactive protein (CRP) were followed frequently during the following 48 h A rapid haemostatic activation was induced with both treatments, although more pronounced with EE-EC. Already two hours after EC, the plasma concentrations of haemostatic parameters and SHBG were significantly different from baseline concentrations. An ETP-based APC-resistance method showed increased APC resistance with EE-EC and decreased APC resistance with LNG-EC. The ApoB/ApoA1 ratio was affected in a favourable direction with EE-EC.CRP increased slightly regardless of treatment. Even a very short exposure to exogenous sex hormones causes prompt effects on hepatic protein synthesis and the coagulation system. This must be taken into consideration whenever exogenous steroid hormones are administered, especially to individuals with a genetic predisposition to thrombosis or transiently disturbed haemostasis.

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Jigar Panchal, Heta, Nigel J. Kent, Andrew J. S. Knox, and Leanne F. Harris. "Microfluidics in Haemostasis: A Review." Molecules 25, no. 4 (February 14, 2020): 833. http://dx.doi.org/10.3390/molecules25040833.

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Haemostatic disorders are both complex and costly in relation to both their treatment and subsequent management. As leading causes of mortality worldwide, there is an ever-increasing drive to improve the diagnosis and prevention of haemostatic disorders. The field of microfluidic and Lab on a Chip (LOC) technologies is rapidly advancing and the important role of miniaturised diagnostics is becoming more evident in the healthcare system, with particular importance in near patient testing (NPT) and point of care (POC) settings. Microfluidic technologies present innovative solutions to diagnostic and clinical challenges which have the knock-on effect of improving health care and quality of life. In this review, both advanced microfluidic devices (R&D) and commercially available devices for the diagnosis and monitoring of haemostasis-related disorders and antithrombotic therapies, respectively, are discussed. Innovative design specifications, fabrication techniques, and modes of detection in addition to the materials used in developing micro-channels are reviewed in the context of application to the field of haemostasis.

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Aird, W. C. "Endothelium and haemostasis." Hämostaseologie 35, no. 01 (2015): 11–16. http://dx.doi.org/10.5482/hamo-14-11-0075.

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SummaryThe endothelium is a widely distributed organ system that plays an important role in health and disease. The endothelium is remarkably heterogeneous in structure and function. One vital function of the endothelium is to maintain blood in its fluid state, and to provide controlled haemostasis at sites of vascular injury. In keeping with the theme of endothelial cell heterogeneity, endothelial cells from different sites of the vascular employ different strategies to mediate local haemostatic balance. These differences are sufficient to explain why systemic imbalances of haemostatic components invariably lead to local thrombotic phenotypes. An important goal for the future is to identify diagnostic markers that reflect phenotypic changes at the level of individual vascular beds, and to develop therapies that target one or another site of the vasculature.

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Austin, Steven K. "Haemostasis." Medicine 49, no. 4 (April 2021): 199–204. http://dx.doi.org/10.1016/j.mpmed.2021.01.004.

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Allford, Sarah L., and Sam Machin. "Haemostasis." Medicine 28, no. 2 (2000): 10–14. http://dx.doi.org/10.1383/medc.28.2.10.28357.

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Allford, Sarah L., and SJ Machin. "Haemostasis." Medicine 32, no. 5 (May 2004): 11–14. http://dx.doi.org/10.1383/medc.32.5.11.33956.

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Allford, Sarah L., and SJ Machin. "Haemostasis." Surgery (Oxford) 22, no. 8 (August 2004): 200a—200d. http://dx.doi.org/10.1383/surg.22.8.200a.43067.

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Allford, Sarah L., and S. J. Machin. "Haemostasis." Surgery (Oxford) 25, no. 6 (June 2007): 241–44. http://dx.doi.org/10.1016/j.mpsur.2007.05.002.

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Batty, Paul, and J. Graham Smith. "Haemostasis." Surgery (Oxford) 28, no. 11 (November 2010): 530–35. http://dx.doi.org/10.1016/j.mpsur.2010.08.008.

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Austin, Steven K. "Haemostasis." Medicine 37, no. 3 (March 2009): 133–36. http://dx.doi.org/10.1016/j.mpmed.2009.01.015.

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Austin, Steven K. "Haemostasis." Medicine 41, no. 4 (April 2013): 208–11. http://dx.doi.org/10.1016/j.mpmed.2013.01.018.

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Austin, Steven K. "Haemostasis." Medicine 45, no. 4 (April 2017): 204–8. http://dx.doi.org/10.1016/j.mpmed.2017.01.013.

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Ludlam, C. A., and C. M. Steel. "HAEMOSTASIS." Lancet 341, no. 8851 (April 1993): 997. http://dx.doi.org/10.1016/0140-6736(93)91080-6.

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Gorovyi, Viktor, Volodymyr Shaprynskyi, Ihor Baralo, Oleh Kapshuk, Andrii Dubovyi, and Volodymyr Mudrytskyi. "Methods of Haemostasis and Restore of Bladder-urethral Segment During Retropubic Prostatectomy in Patients with Benign Prostatic Hyperplasia." Health of Man, no. 2 (June 30, 2021): 38–48. http://dx.doi.org/10.30841/2307-5090.2.2021.237531.

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The objective: to estimate methods of haemostasis and restore of bladder-urethral segment during retropubic prostatectomy in patients with benign prostatic hyperplasia. Materials and methods. Analysis of methods of haemostasis and restore of bladder-urethral segment during retropubic prostatectomy in patients with benign prostatic hyperplasia was performed. Results. Open retropubic prostatectomy (like transbladder prostatectomy) was recommended by European Association of Urology (EAU, 2020) as operation of first choice for surgical treatment big size prostatic hyperplasias. The authors gave such prevalences of retropubic prostatectomy over trans-bladder: operation is performed under visual control that gives haemostatic control of prostatic cavity and removing all parts of nodules; the bladder is not drainaged that avoids disuria in postoperative period, decreases postoperative bed-time and increases comfort for patients; urethra is cut by scissor in apical part of prostate that is prophylaxis tearing of urethra, trauma of exernal sphincter, stricture of memranaceas urethra and urine incontinence after operation; reconstruction of bladder-urethral segment is performed that is prophylaxis of stricture of bladder neck; surgeon can performed simultaneous hernioplasty and retropubic prostatectomy in case of inquinal hernia and benign prostatic hyperplasia. Arterial and venous blood supplying of bladder and enlarged prostate were wrote. Places of arterial and venous bleeding after cutting of prostatic capsule and removing nodules, prophylaxis suturing of arterial and venous bleeding places were noted. Original own methods of restoring of bladder-urethral segment and haemostasis of prostatic cavity by using two or three П-like catgut sutures were shown. For simplifying operation and decreasing time of performing operation and increasing haemostasis of prostatic cavity authors recommended performing passing haemostatic sutures throught prostatic capsule only once and linking of sutures on muscle peaces from rectus muscle (or pyramidal muscle). In case of absent bleeding from prostatic cavity the simplify method of bladder neck trigonisation by using two П-like catgut sutures or two V-like catgut sutures on bladder neck for prophylaxis of bladder neck stenosis was recommended (proximal trigonisation of bladder neck in prostatic cavity). Review of haemostatic merhods of prostatic cavity during retropubic prostatectomy was shown. Conclusion. Analysis of methods of haemostasis and restore of bladder-urethral segment and own original methods during retropubic prostatectomy in patients with benign prostatic hyperplasia allow improve haemostasis of prostatic cavity, prophylaxis of bladder neck and urethra stenosis, decrease intraoperative bleeding and period of operation.

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Kontorinis, G., and B. Schwab. "Significance of advanced haemostasis investigation in recurrent, severe post-tonsillectomy bleeding." Journal of Laryngology & Otology 125, no. 9 (May 12, 2011): 952–57. http://dx.doi.org/10.1017/s0022215111000879.

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AbstractObjective:To evaluate the significance of advanced post-operative haemostasis investigation in cases of recurrent, severe post-tonsillectomy bleeding.Materials and methods:Of the 120 patients treated at our tertiary centre between 2006 and 2010 due to post-tonsillectomy haemorrhage, 22 with recurrent, severe episodes of bleeding underwent further, advanced haemostasis investigation.Results:Underlying haemorrhagic disease was not diagnosed in any case. Isolated abnormal clotting factor levels were identified in two patients. Decreased fibrinogen concentration due to dilutional coagulopathy was found in nine cases (40.9 per cent).Conclusion:Recurrent, severe post-tonsillectomy haemorrhage is rarely related to undiagnosed haemostatic disorders. Thus, advanced haemostasis studies have little therapeutic relevance. However, repetitive post-tonsillectomy bleeding may be related to decreased fibrinogen levels due to dilutional coagulopathy. Therefore, fibrinogen concentration should be tested, and dilutional coagulopathy treated promptly.

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Segal, Jonathan, Keith Siau, Cynthia Kanagasundaram, Alan Askari, Paul Dunckley, and Allan John Morris. "Training in endotherapy for acute upper gastrointestinal bleeding: a UK-wide gastroenterology trainee survey." Frontline Gastroenterology 11, no. 6 (January 30, 2020): 430–35. http://dx.doi.org/10.1136/flgastro-2019-101345.

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IntroductionCompetence in endoscopic haemostasis for acute upper gastrointestinal bleeding (AUGIB) is typically expected upon completion of gastroenterology training. However, training in haemostasis is currently variable without a structured training pathway. We conducted a national gastroenterology trainee survey on haemostasis exposure and on attitudes and barriers to training.MethodsA 24-item electronic survey was distributed to UK gastroenterology trainees covering the following domains: demographics, training setup, attitudes and barriers, confidence in managing AUGIB independently and exposure to individual haemostatic modalities (supervised and independent). Responses were analysed by region and training grade to assess potential variation in training.ResultsA total of 181 trainees completed the questionnaire (response rate 33.5%). There was significant variation in AUGIB training setup across the UK (p<0.001), with 22.7% of trainees declaring no access to structured or ad hoc training. 31.5% expressed confidence in managing AUGIB independently; this varied by trainee grade (0% of first-year specialty trainees (ST3s) to 60.7% of final-years (ST7s)) and by training setup (p=0.001). ST7 trainees reported lack of experience with independently applying glue (86%), Hemospray (54%), heater probe (36%) and variceal banding (36%). Overall, 88% of trainees desired additional haemostasis training and 89% indicated support for a national certification process to ensure competence in AUGIB.ConclusionAUGIB training in the UK is variable. The majority of gastroenterology trainees lacked confidence in haemostasis management and desired additional training. Training provision should be urgently reviewed to ensure that trainees receive adequate haemostasis exposure and are competent by completion of training.

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Bruckner, Brian A., and Matthias Loebe. "The Use of an Absorbable Microporous Polysaccharide Hemosphere Haemostat (AristaAH®) in Ventricular Assist Device Implant and Cardiac Transplantation Procedures." European Cardiology Review 8, no. 2 (2012): 125. http://dx.doi.org/10.15420/ecr.2012.8.2.125.

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Topical haemostatic agents are useful adjuncts for the overall approach to haemostasis during mechanical support and cardiac transplant surgical procedures. Increasing numbers of cardiac surgical patients are presenting with pharmacologically induced impairment of the clotting cascade. Additionally, there continues to be an increase in the numbers of ventricular assist device implantations worldwide and these patients have haemostasis challenges both at the time of implantation and at subsequent transplantation. Patients undergoing assist device placement or cardiac transplantation usually have severe, refractory heart failure and varying degrees of multi-organ dysfunction, which make them susceptible to bleeding during the surgical procedure. Despite routine blood conservation measures and the use of intravenous agents, local surgical field haemostasis still remains a challenge. Topical agents are increasingly used in cardiac surgical procedures, especially in assist device or transplant cases. Herein, we report our institutional approach to topical haemostasis in a high-risk group of patients undergoing assist device or cardiac transplant. AristaAH®, a novel polysaccharide topical haemostat, provides effective and safe control of challenging bleeding situations.

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Kornev, V. I., and D. A. Shelukhin. "Haemostasis and minimally invasive extracorporeal circulation." Patologiya krovoobrashcheniya i kardiokhirurgiya 23, no. 3 (November 27, 2019): 84. http://dx.doi.org/10.21688/1681-3472-2019-3-84-97.

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Advances in extracorporeal circulation using a minimally invasive circuit have rapidly emerged, and the components and biocoatings of the minimally invasive extracorporeal circuit (MiECC) have improved. The application range of minimally invasive cardiopulmonary bypass has expanded, however the main indications for the use of MiECCs during cardiac surgery have not yet been systematized. To the best of our knowledge, no guidelines for anticoagulant therapy regimens during minimally invasive cardiopulmonary bypass exist, and its effect on blood loss and the activation of coagulation in the perioperative period remain unclear. The present review highlighted the components of the circuit and the practical aspects of using MiECC. We formulated indications for the use of minimally invasive circuits and classified biocompatible coatings used to reduce the contact activation of haemostasis. According to the literature, when performing cardiopulmonary bypass with MiECC, the physiological haemostatic balance is disturbed. The detected changes in plasma haemostasis do not allow drawing conclusions regarding the advantages of MiECC, despite its clinical benefits. Multicentre randomized trials that comply with the rules of the pre-analytical stage of haemostasis and use global tests (thrombin generation test, thrombodynamics test, etc.) are required. The available studies on the haemostatic system using MiECC are not adequate for determining whether MiECCs on a haemostatic system are recommendable. However, MiECCs allow physicians to get closer to the fast track cardiac surgery ideal.Received 7 October 2019. Revised 14 November 2019. Accepted 18 November 2019.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

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Haverkate, F., S. G. Thompson, and F. Duckert. "Haemostasis Factors in Angina Pectoris; Relation to Gender, Age and Acute-phase Reaction." Thrombosis and Haemostasis 73, no. 04 (1995): 561–67. http://dx.doi.org/10.1055/s-0038-1653821.

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SummaryThe ECAT Angina Pectoris Study is a European multicentre study with the aim of investigating the pathogenetic and predictive role of haemostatic factors in the progression of coronary heart disease. It is the largest study performed up to now with regard to both the number of patients with angina pectoris (n = 3043) and the number of haemostasis assays (n = 23) included.The present paper presents baseline cross-sectional data with particular reference to the relationship of haemostatic factors with each other and with the coronary risk factors age, gender and acute-phase reaction (1). Two clusters of haemostatic factors could be distinguished in which each variable was correlated (P < 0.001) to every other variable: (a) Eight fibrinolysis assays including t-PA, PAI-1 and euglo- bulin clot lysis time (ECLT), for which PAI-1 appeared to be the dominating factor; (b) antithrombin III, protein C, α2-antiplasmin and plasminogen, the interdependence of which has no obvious explanation. (2). Twelve out of the 23 haemostasis assays were associated (P < 0.01) with age. Except for α2-antiplasmin, these relationships indicated an increased tendency to thrombosis with increasing age. (3). Gender differences found in 14 haemostasis parameters do not indicate a consistent difference in the tendency to thrombosis between men and women. Eight haemostasis parameters were on average higher in female than in male patients in the age group over 50 years. (4). C-reactive protein, an acute-phase reactant, was positively correlated (P < 0.001) with fibrinogen, factor VIIIc, von Willebrand factor, the fibrinolysis assays t-PA, PAI-1, ECLT and plasminogen. These parameters are therefore potential markers of an ongoing, low-grade inflammatory response in patients with atherosclerosis and, as most of them have been reported as cardiovascular risk markers, they may be involved in the pathogenesis of the disease as a link in the relation between inflammation and arterial thrombosis.

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Furie, Bruce, Lola Bellido-Martin, Vivien Chen, Reema Jasuja, and Barbara Furie. "Imaging fibrin formation and platelet and endothelial cell activation in vivo." Thrombosis and Haemostasis 105, no. 05 (2011): 776–82. http://dx.doi.org/10.1160/th10-12-0771.

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SummaryOver the past six decades research employing in vitro assays has identified enzymes, cofactors, cell receptors and associated ligands important to the haemostatic process and its regulation. These studies have greatly advanced our understanding of the molecular and cellular bases of haemostasis and thrombosis. However, in vitro assays cannot simultaneously reproduce the interactions of all of the components of the haemostatic process that occur in vivo nor do they reflect the importance of haemodynamic factors resulting from blood flow. To overcome these limitations investigators have increasingly turned to animal models of haemostasis and thrombosis. In this article we describe some advances in the visualisation of platelet and endothelial cell activation and blood coagulation in vivo and review what we have learned from our intravital microscopy experiments using primarily the laser-induced injury model for thrombosis.

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Tran, Huong D. N., Shehzahdi Shebbrin Moonshi, Zhi Ping Xu, and Hang Thu Ta. "Influence of nanoparticles on the haemostatic balance: between thrombosis and haemorrhage." Biomaterials Science 10, no. 1 (2022): 10–50. http://dx.doi.org/10.1039/d1bm01351c.

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A first review discussing the influence of nanoparticles on the whole haemostatic balance through their interaction with the coagulation, anticoagulation, fibrinolytic and/or the innate immune system, which is potentially linked to haemostasis.

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Vorster, H. H., J. H. Cummings, and F. J. Veldman. "Diet and haemostasis: time for nutrition science to get more involved." British Journal of Nutrition 77, no. 5 (May 1997): 671–84. http://dx.doi.org/10.1079/bjn19970067.

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Abnormal haemostasis, and specifically a pre-thrombotic state characterized by hypercoagulability, increased platelet aggregation and impaired fibrinolysis, is associated with increased atheroma and thrombosis. The recent literature clearlyindicates that diet may prevent or be used to treat some abnormal haemostatic stats. There are reports on effects of energy intake and expenditure, alcohol consumption, intakes of total fat, different fatty acids, fish oil, NSP and vitamins on markers of coagulation, platelet function and fibrinolysis. Some of the confusion and controversy in this field has arisen because the wrong markers of haemostasis have been measured in dietary trials. Moreover, many of the studies have lacked good dietary control. It is suggested that more sensitive, functional markers of the balance between the different facets of the haemostatic system should be measured. It is also important to test hypotheses developed from known observations and to propose mechanisms of action of the various dietary factors, based on our improved understanding of the haemostatic system.

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Welch, M., J. Barratt, S. Martin, and C. Wright. "A model for testing topical haemostatic dressings for peripheral extremity haemorrhage following amputation." Journal of The Royal Naval Medical Service 104, no. 3 (2018): 169–72. http://dx.doi.org/10.1136/jrnms-104-169.

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AbstractAimsTo assess the viability of a peripheral extremity amputation and haemorrhage model for testing topical haemostatic dressings, and secondarily to test whether a topical haemostatic dressing would arrest bleeding and maintain haemostasis without a tourniquet in this model.MethodsAn animal model was used during proof of principle model development. Bilateral through-elbow amputations were performed on a single swine under anaesthetic and treated with application of Celox Rapid topical haemostatic dressing (Celox gauze) to the stump after 30 seconds of free bleeding. Following initial haemostasis, the wound sites were bandaged using standard trauma dressings. Vital signs were monitored throughout the study.ResultsThe animal survived and, in both amputations, haemorrhage was successfully controlled. There was no evidence of re-bleeding during the 30 minutes post-injury or following removal of the packed Celox gauze from the wound sites.ConclusionTopical haemostatic dressings could be considered alongside tourniquets for use as a primary treatment of peripheral extremity haemorrhage due to traumatic amputation. It may be useful in prolonged field care where evacuation is delayed or where tourniquet alone does not provide adequate haemorrhage control.

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McCormick, Neal J., Undrell J. Moore, John G. Meechan, and Mohsen Norouzi. "Haemostasis part 2: medications that affect haemostasis." Dental Update 41, no. 5 (June 2, 2014): 395–405. http://dx.doi.org/10.12968/denu.2014.41.5.395.

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RECK, J., M. BERGER, F. S. MARKS, R. B. ZINGALI, C. W. CANAL, C. A. S. FERREIRA, J. A. GUIMARÃES, and C. TERMIGNONI. "Pharmacological action of tick saliva upon haemostasis and the neutralization ability of sera from repeatedly infested hosts." Parasitology 136, no. 11 (July 23, 2009): 1339–49. http://dx.doi.org/10.1017/s0031182009990618.

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SUMMARYTicks are blood-feeding arthropods widely distributed in the world and vectors of several diseases. As haematophagy demands evasion strategies and repeatedly infested hosts develop protective immune responses, we investigated the mechanisms of theRhipicephalus (Boophilus) microplussaliva anti-haemostatic activity and the possible relationship between the acquired natural anti-tick host resistance and anti-haemostatic action. For this purpose, we studied the effects ofR. microplussaliva on different pathways of haemostasis and tested whether repeated infested bovine sera (RIBS) are able to abolish salivary anti-haemostatic activities.R. microplussaliva (i) displays inhibitory activity upon collagen-induced platelet aggregation; (ii) inhibits the induction of endothelial pro-coagulant state; and (iii) reduces thrombogenesisin vivo. RIBS were shown to be able to partially block the delay of coagulation and the anti-thrombotic effect of saliva, and to totally abolish the modulation of endothelium activation. Conversely, RIBS has no effect on the inhibition of platelet aggregation. These results show, for the first time, the neutralization ability of sera from acquired resistance hosts against tick anti-haemostatics. Moreover, this is the first report of a haematophagous parasite able to modulate endothelial cell pro-coagulant state, and addresses the presence of anti-platelet and anti-thrombotic activity inR. microplussaliva.

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Schiffer, Thorsten, Heiko K. Struder, Hans-Georg Predel, and Wildor Hollmann. "Effects of Mild Leg Exercise in a Seated Position on Haemostatic Parameters Under Normobaric Hypoxic Conditions." Canadian Journal of Applied Physiology 30, no. 6 (December 1, 2005): 708–22. http://dx.doi.org/10.1139/h05-150.

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This study tested the hypothesis that in humans mild leg exercise affects haemostasis in normobaric hypoxia and thus avoids the development of a deep venous thrombosis (DVT). Eight young men breathed in a 15.4% oxygen in nitrogen gas mixture for 2 hrs while seated at rest (R) or seated and performing a 3-min mild leg exercise program (Ex) at 15-min intervals to assess the impact of mild leg exercise on haemostatic parameters related to the risk of developing DVT, as has been discussed for hypobaric hypoxic conditions during commercial airline travel. Capillary blood gases were analysed every 30 min. Heart rate was monitored continuously. Haemostatic parameters were analysed from venous blood at the beginning, after 1 and 2 hrs, and after a 30-min resting period in normoxic conditions. Plasminogen-activator-inhibitor-1 diminished in both tests in hypoxia, but not after the resting period. Antithrombin-III decreased in R in the hypoxic period. Platelet count, international normalized ratio, partial thromboplastin time remained unchanged, as did highly sensitive parameters like tissue-plasminogen-activator, α2-antiplasmin, d-dimers, thrombin-antithrombin-III-complexes, and prothrombin-fragments 1 and 2. The haematocrit decreased significantly in R. The mild leg execise prevented the decrease of antithrombin-III and caused an increase in haematocrit after an initial drop in the first hour. The present study revealed that normobaric hypoxia did not have clinically relevant effects on haemostasis in humans. Mild leg exercise carried out under those conditions did not lead, via alterations in haemostasis, to a reduced risk of DVT. Key words: local aerobic exercise, haemostasis, hypoxia, thrombosis

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Dutta, Anupam, Taniya Sarkar Dutta, Anup Kumar Das, and Pranoy Dey. "Haemostatic action of a topical foam-based patch (VELSEAL-T) in haemophiliac patients with external bleeding." Journal of Haemophilia Practice 7, no. 1 (June 17, 2020): 78–84. http://dx.doi.org/10.17225/jhp00160.

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AbstractIntroductionHaemophilia is an X-linked congenital bleeding disorder due to deficiency of coagulation factor VIII (in haemophilia A) or factor IX (in haemophilia B) caused by mutations of the respective clotting factor genes. Treatment involves the administration of an appropriate dose of factor concentrate, as soon as possible, in the event of any bleeding episode. In low-resource settings, such as Northeast India, where factor concentrates are not widely available, people with haemophilia (PwH) may bleed profusely even from trivial external injuries, warranting transfusion of blood or blood products. We previously reported on the use of a low cost, foam-based haemostatic patch to treat an external bleed in a single patient. In this study, we investigated its use to treat a range of external injuries in PwH presenting at Assam Medical College and Hospital.MethodOver 24 months, eligible PwH with external injuries attending our haemophilia clinic were treated with a topical haemostatic patch (VELSEAL-T) at the target bleeding site. The time to cessation of bleeding was recorded and the wound sites evaluated after haemostasis to monitor efficacy and safety.ResultsOut of 72 individuals with bleeding disorders who volunteered to participate, 59 cases of external bleeding in 48 PwH were eligible for inclusion in the study. Nine (15.3%) had aberration wounds, 24 (40.7%) cut wounds, 21 (35.6%) tooth and/or gum bleeding and five (8.4%) bleeding from puncture wounds. The average time required for achievement of haemostasis was 9.9 (±4.7) minutes. Aberration wounds required the least amount of time for haemostasis at 7.3 (±4.4) minutes. Cut wounds required a mean time of 8.5 (±2.9) minutes; puncture wounds required 9.0 (±3.1) minutes; gum bleeding required the longest time to achieve haemostasis with a mean of 12.7 (±5.6) minutes.ConclusionThe use of this topical haemostatic patch has been shown to be beneficial in the treatment of external injuries in PwH, and provides a good treatment option in resource-constrained areas. A larger controlled study would be helpful to further investigate its efficacy and safety.

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Magnusson, Maria, Vera Ignjatovic, Winita Hardikar, and Paul Monagle. "A conceptual and practical approach to haemostasis in paediatric liver disease." Archives of Disease in Childhood 101, no. 9 (March 24, 2016): 854–59. http://dx.doi.org/10.1136/archdischild-2015-309535.

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Children with liver disease can develop severe bleeding episodes and thrombosis. Liver failure usually results in decreased levels of procoagulant and anticoagulant factors. Additional risk factors, including changes in vascular flow and endothelial function, are of importance for the development of bleeding or thrombosis in individual vascular beds. Detailed studies of haemostatic disturbances in the setting of paediatric liver disease are sparse and extrapolation from adult studies is common. The spectrum of liver diseases and the haemostatic system differs between children and adults. Specific paediatric liver diseases are reported to have more distinctive effects on haemostasis and the risk of bleeding and/or thrombosis. Conclusion: we propose a model regarding haemostasis in paediatric liver disease, taking into account a number of specific variables and mechanisms, as well as the type of liver disease, which will provide a framework for clinical decision-making in these complex patients.

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Duraj, Lukas, J. Stasko, M. Hasko, M. Fedor, P. Chudy, J. Sokol, R. Limonova, I. Skornova, J. Danko, and P. Kubisz. "Thrombelastography and Thrombelastometry." Acta Medica Martiniana 13, no. 1 (March 1, 2013): 14–20. http://dx.doi.org/10.2478/acm-2013-0007.

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Abstract The term thrombelastography / thrombelastometry was used to describe the trace produced from measurement of the viscoelastic changes associated with fibrin polymerization. The result of measurement is a compact mapping of the various stages of haemostasis. One of the first real clinical applications of this method was the haemostatic monitoring of liver transplantation and cardiac surgery using extracorporeal circulation. In trauma patients the thrombelastography /thrombelastometry was proved to predict early transfusion requirements. Another authors suggest thrombelastography /thrombelastometry as a possible tool for early identification of pregnant women at increased risk of fetal loss. This article provides overview on the development of thrombelastography / trombelastometry and its possible use in laboratory of haemostasis.

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Obradovic, Slobodan, Slavka Mandic-Radic, Dragan Dincic, Vesna Subota, and Branko Gligic. "Haemostasis in acute myocardial infarction." Jugoslovenska medicinska biohemija 22, no. 2 (2003): 109–18. http://dx.doi.org/10.2298/jmh0302109o.

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Acute myocardial infarction (AMI) is caused by a localized arterial thrombosis, which resulted with myocardial ischemia and necrosis. This event causes the reaction of heart muscle (akinesis and dyskinesis of the ischemic parts of myocardial wall, arrhythmias, and haemodinamic disturbances) and severe systemic reaction (activation of neuroendocrine axis and inflammatory response). Haemostatis disturbances, which can be detected during the AMI and partly caused by the local coronary thrombosis, and partly by the mentioned heart and systemic reaction. A number of therapeutic procedures like venepuncture and almost all drugs commonly used, also influence the measurement of haemostatic parameters. Premorbid state, like smoking diabetes, hyperchlosterolemia, hypertension and obesity and also strong modulators of haemostatis disturbances in AMI and to light on the main factors which modulate that complicated process.

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Revel-Vilk, Shoshana. "Neonatal haemostasis." Hämostaseologie 36, no. 04 (2016): 261–64. http://dx.doi.org/10.5482/hamo-15-11-0032.

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SummaryThe maturation and postnatal development of the human coagulation system results in significant and important differences in the coagulation and fibrinolysis of neonates and young children compared to older children and adults. Importantly, these differences, which mostly reflect the immaturity of the neonatal haemostasis system, are functionally balanced. Healthy neonates show no signs of easy bruising or other bleeding diathesis and no increased tendency to thrombosis for any given stimulus compared to adults.Systemic diseases may affect haemostasis, thus predisposing ill neonates to increased risk for haemorrhagic or thrombotic complications. In hospitalized children, neonates have increased risk of developing thrombosis compared to infants and children, mostly associated with the presence of central venous catheter. For diagnosis of haemostasis disorders, diagnostic laboratories processing pediatric samples should use age, analyzer and reagent appropriate reference ranges. Age specific guidelines should be followed for the management of neonates with hemostatic disorders.

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Montgomery, Robert R., Richard A. Marlar, and Joan C. Gill. "Newborn Haemostasis." Clinics in Haematology 14, no. 2 (June 1985): 443–60. http://dx.doi.org/10.1016/s0308-2261(21)00483-5.

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Gibson, B. "Neonatal haemostasis." Archives of Disease in Childhood 64, no. 4 Spec No (April 1, 1989): 503–6. http://dx.doi.org/10.1136/adc.64.4_spec_no.503.

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Niles, Jacqui. "Surgical haemostasis." In Practice 21, no. 4 (April 1999): 196–204. http://dx.doi.org/10.1136/inpract.21.4.196.

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English, Christopher A., Leon Chen, and Michael R. Migden. "Traction haemostasis." Australasian Journal of Dermatology 59, no. 2 (December 15, 2017): 156–57. http://dx.doi.org/10.1111/ajd.12748.

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Mathias, Mary, and R. Liesner. "Understanding haemostasis." Paediatrics and Child Health 17, no. 8 (August 2007): 317–21. http://dx.doi.org/10.1016/j.paed.2007.06.002.

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KEY, N. S., A. DE PAEPE, F. MALFAIT, and C. L. SHOVLIN. "Vascular haemostasis." Haemophilia 16 (June 22, 2010): 146–51. http://dx.doi.org/10.1111/j.1365-2516.2010.02313.x.

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Moore, Gary W., and Savita Rangarajan. "Haemostasis screening." British Journal of Hospital Medicine 70, Sup8 (August 2009): M116—M118. http://dx.doi.org/10.12968/hmed.2009.70.sup8.43551.

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Barnes, Chris, Vera Ignjatovic, Janine Furmedge, Fiona Newall, Anthony Chan, Lidia De Rosa, Simone Hamilton, et al. "Developmental haemostasis." Thrombosis and Haemostasis 95, no. 02 (2006): 362–72. http://dx.doi.org/10.1160/th05-01-0047.

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SummaryDevelopmental haemostasis is a concept, now universally accepted, introduced by Andrew et al. in the late 1980’s. However, coagulation analysers and reagents have changed significantly over the past 15 years. Coagulation testing is known to be sensitive to changes in individual reagents and analysers. We hypothesised that the reference ranges developed by Andrew et al. may not be appropriate for use in a modern coagulation laboratory. Our study was designed to determine whethera current day coagulation testing system (STA Compact analyser and Diagnostica Stago reagent system) was sensitive to agerelated changes in coagulation assays. This is the first large scale study since Andrew et al. to determine the age associated numerical changes in coagulation proteins. Our results confirm the concepts of developmental haemostasis elucidated by Andrew et al. However, our results clearly demonstrate that the absolute values of reference ranges for coagulation assays in neonates and children vary with analyser and reagent systems. The results confirm the need for coagulation laboratories to develop age-related reference ranges specific to their own testing systems. Without this, accurate diagnosis and management of neonates and children with suspected bleeding or clotting disorders is not possible. Finally we present age related reference ranges for D-dimers, TFPI, and endogenous thrombin potential, previously not described.

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Aabakken, Lars. "Endoscopic haemostasis." Best Practice & Research Clinical Gastroenterology 22, no. 5 (October 2008): 899–927. http://dx.doi.org/10.1016/j.bpg.2008.05.002.

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Holmes, V. A., and J. M. W. Wallace. "Haemostasis in normal pregnancy: a balancing act?" Biochemical Society Transactions 33, no. 2 (April 1, 2005): 428–32. http://dx.doi.org/10.1042/bst0330428.

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Pregnancy is a risk factor for venous thrombosis and the incidence of venous thromboembolism during normal pregnancy is 6-fold higher during pregnancy than in the general female population of child-bearing age. This incidence is, however, remarkably low given the increases in markers of haemostatic activation observed during normal pregnancy. During normal healthy pregnancy there are substantial changes in the haemostatic system, many of which are procoagulant and supposed to be in preparation for the haemostatic challenge of delivery. Normal haemostasis requires a balance between coagulation and fibrinolysis to maintain the integrity of the vasculature, and complex physiological changes are evident during pregnancy which appear to ensure a constant coagulation/fibrinolysis balance. This balance is maintained, at least partly, by an increase in fibrinolytic activity, but decreases in other factors such as factor XI and monocyte tissue factor expression may also serve to counterbalance procoagulant changes.

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Bos, Sarah, Bente van den Boom, Pieter Kamphuisen, Jelle Adelmeijer, Hans Blokzijl, Tim Schreuder, and Ton Lisman. "Haemostatic Profiles are Similar across All Aetiologies of Cirrhosis." Thrombosis and Haemostasis 119, no. 02 (January 4, 2019): 246–53. http://dx.doi.org/10.1055/s-0038-1676954.

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Background and Aim Patients with cirrhosis may acquire profound changes in haemostasis. Although haemostatic changes in cirrhosis have been extensively studied, most studies were performed in groups of patients with mixed aetiology. As thrombotic events appear more common in some aetiologies of disease, notably non-alcoholic steatohepatitis (NASH) and cholestatic disease, we hypothesized that haemostatic changes might be different across aetiologies. Patients and Methods We studied 109 patients with cirrhosis (31 cholestatic liver disease, 23 NASH, 37 alcoholic liver disease [ALD], 18 viral hepatitis) and 44 healthy controls. Patients with malignancy were excluded. Routine diagnostic tests of haemostasis, thrombin generation assays, fibrin permeability assays and a plasma-based fibrinolytic assay were performed. Results All patients had comparable severity of disease according to their Model for End-Stage Liver Disease score (9 [7–11]). Plasma levels of von Willebrand factor were substantially elevated across all aetiologies, with a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 levels comparable to controls. Thrombin generation capacity was elevated in all aetiologies, most profoundly in ALD. Fibrin permeability was decreased in all aetiologies, which was accompanied by elevated fibrinogen levels. Clot lysis times were prolonged in NASH and cholestatic disease. Plasma levels of individual proteins were similarly altered in all aetiologies. Conclusion Our in-depth haemostatic profiling of primary, secondary and tertiary haemostasis in a group of patients with Childs–Turcotte–Pugh A/B cirrhosis showed no large differences between aetiologies, and was consistent with a general hypercoagulable profile in patients with mild cirrhosis. These results suggest that patients with cirrhosis have an increased risk of thrombosis, irrespective of their aetiology.

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Kander, Thomas, and Ulf Schött. "Effect of hypothermia on haemostasis and bleeding risk: a narrative review." Journal of International Medical Research 47, no. 8 (August 2019): 3559–68. http://dx.doi.org/10.1177/0300060519861469.

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It must be remembered that clinically important haemostasis occurs in vivo and not in a tube, and that variables such as the number of bleeding events and bleeding volume are more robust measures of bleeding risk than the results of analyses. In this narrative review, we highlight trauma, surgery, and mild induced hypothermia as three clinically important situations in which the effects of hypothermia on haemostasis are important. In observational studies of trauma, hypothermia (body temperature <35°C) has demonstrated an association with mortality and morbidity, perhaps owing to its effect on haemostatic functions. Randomised trials have shown that hypothermia causes increased bleeding during surgery. Although causality between hypothermia and bleeding risk has not been well established, there is a clear association between hypothermia and negative outcomes in connection with trauma, surgery, and accidental hypothermia; thus, it is crucial to rewarm patients in these clinical situations without delay. Mild induced hypothermia to ≥33°C for 24 hours does not seem to be associated with either decreased total haemostasis or increased bleeding risk.

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Lisman, Ton, Stephen H. Caldwell, and Nicolas M. Intagliata. "Haemostatic alterations and management of haemostasis in patients with cirrhosis." Journal of Hepatology 76, no. 6 (June 2022): 1291–305. http://dx.doi.org/10.1016/j.jhep.2021.11.004.

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MISCHKE, R. "Laboratory evaluation and interpretation of haemostasis in small animals." Journal of the Hellenic Veterinary Medical Society 65, no. 3 (December 21, 2017): 165. http://dx.doi.org/10.12681/jhvms.15533.

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This review deals with indications for performing haemostasis tests, methodical aspects of blood sampling and handling of sample material, selection of appropriate tests and basic principles of test interpretation. Indications for laboratory evaluation of haemostasis in small animals include spontaneous bleeding or bleeding disproportionate to the degree of trauma, bleeding from multiple sites and diseases which are frequently associated with haemostatic disorders. Patient history and clinical findings can deliver clues for the type of haemorrhagic diathesis. Important preanalytical issues include prevention of prolonged venous stasis, order of drawing and appropriate filling of the collection tubes and careful mixing of blood with anticoagulant. Initial screening can be performed by global tests of haemostasis including viscoelastic testing using thrombelastography and rotation thrombelastometry and/or a “basic examination profile” including platelet count, capillary bleeding time (optional in cases of suspected functional platelet disorders) and group tests prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin (clotting) time (optionally in cases of prolonged PT and aPTT). This procedure allows a rational evaluation of the haemostatic system and a specific use of further tests including individual coagulation factor activities, inhibitor activities, activation markers, examination of von Willebrand factor, and platelet function analyses. It is important (1) to use species- and method specific reference values for interpretation and (2) to consider the limitations of tests when performed according to the standard test procedure optimised for human sample material (e.g., low sensitivity of PT test for canine and feline samples).

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Boddu, Siva Rama Krishna, Monish Ram S.D, and Suresh Hanagavadi. "Surgical management in a classical haemophilia patient – A rare case report." IP Archives of Cytology and Histopathology Research 7, no. 3 (September 15, 2022): 186–88. http://dx.doi.org/10.18231/j.achr.2022.040.

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A young man presented with complaints of right upper quadrant pain for 6 months, past history revealed he is a known case of Haemophilia A, which is a challenge for surgeons and anaesthetist to manage intraoperative and postoperative bleeding, henceforth referred to Haematology, department of pathology. Soon after taking clinical history patient was subjected for haemostatic screening tests such as PT, APTT, mixing studies, inhibitors screening and factor VIII assay revealed patient is a case of several haemophilic with negative for inhibitors and elevated APTT values. Patient is prepared for surgery only after giving Anti haemophilic factor replacement and preoperatively achieving 100% haemostasis by raising Factor VIII assay to 100%. Intra and post operatively patient is constantly monitored for bleeding. Post operatively every 12hrs patient was infused with anti-haemophilic factor variable levels and tapering doses to maintain constant haemostasis as the factor VIII half-life is less than 12 hours. Patient was haemodynamically stable when discharged that is 7 day post-surgery. Thus, we presenting a case how to manage haemophiliacs in a simple way for any kind of surgery with availability of antihemophilic factors and expertise in maintaining the haemostasis as build up confidence among surgeons.

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Journal articles on the topic 'Haemostasis'

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