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1
Rathod, Dr Rohit Narendra. "Hemostasis in the Surgical Field". EAS Journal of Medicine and Surgery 4, n. 10 (16 novembre 2022): 211–14. http://dx.doi.org/10.36349/easjms.2022.v04i10.003.
Testo completoAbstract (sommario):
Hemostatic mechanisms are an integral a part of the human physiology. Traditionally divided into intrinsic and extrinsic arms, the coagulation cascade converges, through the interactions of the many various factors, at a standard element—thrombin. As a consequence, variety of various agents is developed to supplement this common, critical step to assist surgical hemostasis. Intraoperative interventions most ordinarily include sutures and heat-generating cautery devices; however, these methods are sometimes insufficient or inappropriate for a selected procedure or anatomic location, resulting in the event of other adjunctive therapies, including topical hemostats. Topical hemostatic agents generally act as active, passive, and combinations therapies, counting on their individual composition and mode of action. We offer a quick review of the traditional coagulation cascade, including critical points, followed by a discussion of surgical strategies and adjuctive therapies want to achieve surgical hemostasis and concluding with a discussion of topical thrombins.
2
Kondratiev, M. V., A. S. Petrova, A. S. Gryzunova, S. N. Lavrentiev, N. I. Zakharova, O. F. Serova, V. A. Krasnova e K. B. Zhybanisheva. "Changes in primary and secondary hemostasis as a predictor of adverse neonatal outcomes in birth asphyxia". Voprosy praktičeskoj pediatrii 18, n. 1 (2023): 103–10. http://dx.doi.org/10.20953/1817-7646-2023-1-103-110.
Testo completoAbstract (sommario):
The hemostatic system is complex and evolves continuously since gestation and well into the adult years, in a process known as “developmental hemostasis”. This article presents information about the functioning of the hemostatic system in normal and pathological conditions (birth asphyxia) in newborns, reflects fundamental differences in hemostatic functioning during the neonatal period and the possibilities in maintaining normal hemostasis in conditions of physiological deficiency of both clotting factors and the anticoagulant system. The article highlights various methods of diagnosing the hemostatic system used in neonatology. The so-called global hemostasis tests are being introduced into neonatal practice. The study of hemostasis using thromboelastography technique allows to correct for the patient's real body temperature and estimate both the interaction of platelets and clotting factors and examine the plasma hemostasis component in isolation. The effects of neonatal asphyxia and therapeutic hypothermia procedures on the hemostatic system are poorly understood. This review article attempts to summarize the data available in the world scientific literature concerning this problem. Key words: newborns, developing hemostasis, asphyxia, hypoxic-ischemic encephalopathy, thromboelastography, coagulation, therapeutic hypothermia
3
B, Nichols, Zbozien R, Nichols A, Hunter J e Hayes PD. "Remedy Publications LLC., | http://surgeryresearchjournal.com World Journal of Surgery and Surgical Research 2023 | Volume 6 | Article 15001 Physical Modification of a Gelatin Sponge Creates a Very Adhesive, Rapidly Absorbable, Blood-Free Hemostat". World Journal of Surgery and Surgical Research 6, n. 1 (30 settembre 2023): 1–6. http://dx.doi.org/10.25107/2637-4625-v6-id1500.
Testo completoAbstract (sommario):
Background: An effective hemostat not only needs to stop the bleeding whilst it is held in place but importantly, it must stay there securely during the perioperative recovery phases. As patients move during the recovery period, several forces can act on the hemostat leading to its displacement and possible postoperative hemorrhage. Adhesive hemostats have been developed to prevent this, but many contain human blood components or are prohibitively expensive for widespread use. This study evaluated a physical surface modification of a plain gelatin sponge with no additives (chemical/biologic), designed to securely adhere to bleeding tissue and create a long-lasting hemostatic matrix (TenaTac®, Selentus Science, UK). Methods: Adhesion and hemostasis were tested in a standard leporine hepatic bleeding model against the adhesive hemostats, TachoSil® and Hemopatch®. Absorption was tested in a porcine hepatic implantation model against plain gelatin sponge. Results: TenaTac was very well tolerated in the porcine model and was completely reabsorbed by day 14. TenaTac demonstrated a 69% improvement in adhesion over TachoSil (p<0.001). Hemostasis was also significantly better than TachoSil at the 6- & 9-min endpoints (p=0.016 & p=0.002). With systemic heparinization (300 u/kg) TenaTac’s adhesion score was 42.5% higher than non-heparinized TachoSil (p=0.003). After delivery through a laparoscopic cannula, the hemostasis and adhesive capabilities were not different from Hemopatch (p>0.05 for all). Conclusion: Physical surface modification of a gelatin sponge has resulted in a rapidly absorbable hemostat that demonstrates superior adhesion and hemostasis to other advanced hemostats.
4
Parkhisenko, Yuri A., Alexey K. Vorontsov, Evgeniy F. Cherednikov, Sergey V. Barannikov, Anton V. Korsakov e Vladislav P. Troshin. "Morphological assessment of reparative regeneration of experimental bleeding liver wounds in the treatment of hemostatic agent Surgitamp and granular sorbent Molselect G-50". Journal of Volgograd State Medical University 20, n. 1 (23 aprile 2023): 73–80. http://dx.doi.org/10.19163/1994-9480-2023-20-1-73-80.
Testo completoAbstract (sommario):
The problem of treating intra-abdominal bleeding in abdominal trauma is one of the most serious in urgent surgery. The most common cause of these hemorrhages is liver damage. For surgical hemostasis, local hemostatics and granular sorbents are becoming increasingly common. The aim of the study was to study in vivo the hemostatic properties and morphological features of the reparative regeneration of simulated bleeding liver wounds during treatment with the hemostatic agent Surgitamp and the sorbent Molselect G-50. The experiments were performed on 30 laboratory animals Chinchilla rabbits. After reproducing the model of a bleeding liver wound, bleeding was stopped in the experimental group (n = 15) by applying Molselect G-50 (4.0 g) powdered sorbent into the wound, followed by tamponing with Surgitamp hemostatic gauze (4.0 x 2.0 cm). Hemostasis in the control liver wound was carried out by applying a U-shaped suture with a PGA-3.0 thread until the edges of the wound converged. Morphological studies were performed on the 7th, 14th and 28th days of the experiment. Experimental studies have shown that the time to stop bleeding in the experimental group was 280.0 (264.0308.0) sec, in the control, the time of hemostasis was later 461.0 (420.0501.0) sec. Morphological studies have allowed us to establish differences in both the rate and quality of reparative regeneration of experimental simulated liver wounds compared with the control. Experimental studies using Molselect G-50 in combination with Surgistamp for local hemostasis of bleeding liver wounds in rabbits allowed us to conclude that such a combination makes it possible not only to reliably stop bleeding, but also promotes the stimulation of reparative regeneration.
5
Romantsov, Mikhail N., Eugene F. Cherednikov, Aleksandr Anatolevich Glukhov e Constantine O. Fursov. "New technologies of endoscopic hemostasis in a treatment protocol of patients with gastroduodenal ulcer bleeding". Vestnik of Experimental and Clinical Surgery 11, n. 1 (8 aprile 2018): 16–23. http://dx.doi.org/10.18499/2070-478x-2018-11-1-16-23.
Testo completoAbstract (sommario):
Relevance of research. Acute gastroduodenal bleeding is remaining a difficult and largely unsolved problem up to day. The fundamental importance in treating this category of patients is an endoscopic hemostasis. The decisive point in this problem is the most stable hemostasis and preventing a recurrence of a hemorrhage. In this regard, the search of new solutions and the development of known methods of treatment of the gastroduodenal ulcer bleeding is an important issue.
Aim of research. To evaluate the effectiveness of the treatment protocol of patients with the gastroduodenal ulcer bleeding by applying combined endoscopic insufflations of hemostatic agents and a diovin as an integral part of a complex therapy.
Materials and methods. The research is based on results of treatment of the patients with the gastroduodenal ulcer bleeding being in a medical setting at the departments of surgery at Voronezh city clinical emergency hospital №1. During the treatment of the main group (59 patients) there was used an integrated approach with the usage of powdered hemostatic agents of gelplastan and lyophilisate NovoSeven in combination with diovin in the endoscopic treatment of gastroduodenal ulcer bleeding. There were used the traditional well-known methods of the endoscopic hemostasis without the usage of hemostatic agents and absorbent grains in treatment of the control group (56 patients).
Results and discussion. The evaluation of results of patients’ treatment with gastroduodenal ulcer bleeding was performed according to the figures of the final hemostasis, the frequency of recurrent bleeding, the prevention of emergency operations, the rates of mortality, the duration of hospitalization. The developed protocol of the patients’ treatment with gastroduodenal ulcer bleeding with the usage of combined the endoscopic insufflation of two hemostatics and diovin makes it possible to achieve the maximum persistent hemostasis at 94.9% of patients, to reduce the risk of recurrent hemorrhages by 2.5 times, to prevent emergency operations and, as a result, to reduce the lethality.
Conclusion. The usage of new technologies of endoscopic hemostasis by the hemostatic pneumoinsufflation gelplastan and lyophilisate NovoSeven in combination with diovin in the treatment of patients with gastroduodenal ulcer bleeding allows to reduce the risk of recurrent hemorrhage from 12,5% to 5,01% (by 2,5 times), to prevent emergency operations, to reduce the lethality from 3,65% to 1,7% (by 2,1 times) and to reduce the period of staying in the hospital from 10,2 to 7,4 bed days (p<0.05).
6
Misumi, Yoshitsugu, Kouichi Nonaka e Maiko Kishino. "Endoscopic Image 2 Hours after PuraStat® Application: A Case of Achieving Hemostasis Using PuraStat® for Postgastric Lesion Biopsy Bleeding after Hemostatic Clips Failed". Case Reports in Gastrointestinal Medicine 2023 (26 luglio 2023): 1–3. http://dx.doi.org/10.1155/2023/5620348.
Testo completoAbstract (sommario):
PuraStat® (3D Matrix, Tokyo, Japan) is a novel, self-assembling peptide hemostatic hydrogel that can be used endoscopically. Hemostasis can be physically obtained by covering bleeding points; however, there are no reports of how long PuraStat remains in the upper gastrointestinal tract. Herein, we report a case wherein esophagogastroduodenoscopy (EGD) was performed 2 hours after PuraStat application. A 73-year-old man underwent EGD for evaluation of lesions in the posterior wall of the stomach. A biopsy was then performed on the gastric lesions; however, massive bleeding occurred. A hemostatic clip was used to stop bleeding but failed; primary hemostasis was obtained by applying PuraStat. EGD performed 2 hours later to determine whether the patient could be discharged revealed that the white-turning PuraStat gel remained firmly in the applied area, confirming complete hemostasis. PuraStat is a hemostatic agent capable of physical hemostasis that reliably remains in the stomach even after a few hours of use and, thus, may replace some conventional hemostasis methods.
7
Budko, E. V., L. M. Yampolsky, D. A. Chernikova e A. A. Khabarov. "Comparative evaluation of the effectiveness of a local hemostatic agent modified with a bio-organic composition". CARDIOMETRY, n. 18 (18 maggio 2021): 100–112. http://dx.doi.org/10.18137/cardiometry.2021.18.100112.
Testo completoAbstract (sommario):
Constant attention to the study of the experience of using hemostatic products proposed for local bleeding arrest encourages new developments in this field. Modern hemostatics are porous multilayer systems with an inclusion of active coagulants. The results of the assessment of hemostatic activity obtained with the help of clinical and laboratory methods often do not lend themselves to cross-checking and statistical processing, and do not allow us to study objects with different physical and chemical properties. Methods of chemometrics, namely planimetry, allow you to visualize the parameters of sorption and hemocoagulation activity. A comparative planimetric study of commercial local hemostatic agents like Celox powder, sponges and napkins of various companies, zeolite powder, as well as new hemostatic compositions, which were given provisionally label A52 and A58, was carried out. It is shown that the hemostatic composition labeled as A52 leads to the activation of absorbent materials, the formation of a stable volumetric primary and secondary thrombus. A comparative evaluation of the effectiveness of a new hemostatic agent in an acute experiment shows a high expression of hemostasis (the time of primary hemostasis is 15-20 seconds) and no recurrence of bleeding for the studied samples compared to the reference.
8
Wu, Baofeng, Ruixin Zhang, Chendi Liang, Chengjie Zhang e Gang Qin. "Study on the Safety of the New Radial Artery Hemostasis Device". Journal of Interventional Cardiology 2022 (5 aprile 2022): 1–8. http://dx.doi.org/10.1155/2022/2345584.
Testo completoAbstract (sommario):
Objective. At present, the use of particular radial hemostatic devices after coronary angiography (CAG) or percutaneous coronary intervention (PCI) has become the primary method of hemostasis. Most control studies are based on the products already on the market, while only a few studies are on the new hemostatic devices. The aim of this study is to compare a new radial artery hemostasis device which is transformed based on the invention patent (Application number: CN201510275446) with TR Band (Terumo Medical) to evaluate its clinical effects. Methods. In a prospective randomized clinical trial, 60 patients after CAG or PCI were randomly divided into two groups, patients in the trial group (CD group) using a new radial artery hemostasis device to stop bleeding and the control group (TR group) using the TR Band. The method is to collect relevant data of the two groups and compare the differences in hemostasis, local complications, and patient discomfort between the two groups. Results. The hemostatic devices in both groups achieved adequate hemostasis, and there was no failure to stop bleeding. The new radial artery hemostasis device was better than the TR band in pain and swelling ( P < 0.05 ). There were no significant differences in bleeding, hematoma, ecchymosis, skin damage, and local infection between the two groups ( P > 0.05 ). Conclusions. The sample of the new radial artery hemostasis device can stop bleeding effectively at the puncture site after CAG or PCI and is not inferior to the TR Band balloon hemostatic device in safety and is better in comfort.
9
Du, Jian, Jingzhong Wang, Tao Xu, Hai Yao, Lili Yu e Da Huang. "Hemostasis Strategies and Recent Advances in Nanomaterials for Hemostasis". Molecules 28, n. 13 (7 luglio 2023): 5264. http://dx.doi.org/10.3390/molecules28135264.
Testo completoAbstract (sommario):
The development of materials that effectively stop bleeding and prevent wound adhesion is essential in both military and medical fields. However, traditional hemostasis methods, such as cautery, tourniquets, and gauze, have limitations. In recent years, new nanomaterials have gained popularity in medical and health fields due to their unique microstructural advantages. Compared to traditional materials, nanomaterials offer better adhesion, versatility, and improved bioavailability of traditional medicines. Nanomaterials also possess advantages such as a high degree and stability, self-degradation, fewer side effects, and improved wound healing, which make them ideal for the development of new hemostatic materials. Our review provides an overview of the currently used hemostatic strategies and materials, followed by a review of the cutting-edge nanomaterials for hemostasis, including nanoparticles and nanocomposite hydrogels. The paper also briefly describes the challenges faced by the application of nanomaterials for hemostasis and the prospects for their future development.
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Han, Wenli, e Shige Wang. "Advances in Hemostatic Hydrogels That Can Adhere to Wet Surfaces". Gels 9, n. 1 (22 dicembre 2022): 2. http://dx.doi.org/10.3390/gels9010002.
Testo completoAbstract (sommario):
Currently, uncontrolled bleeding remains a serious problem in emergency, surgical and battlefield environments. Despite the specific properties of available hemostatic agents, sealants, and adhesives, effective hemostasis under wet and dynamic conditions remains a challenge. In recent years, polymeric hydrogels with excellent hemostatic properties have received much attention because of their adjustable mechanical properties, high porosity, and biocompatibility. In this review, to investigate the role of hydrogels in hemostasis, the mechanisms of hydrogel hemostasis and adhesion are firstly elucidated, the adhesion design strategies of hemostatic hydrogels in wet environments are briefly introduced, and then, based on a comprehensive literature review, the studies and in vivo applications of wet-adhesive hemostatic hydrogels in different environments are summarized, and the improvement directions of such hydrogels in future studies are proposed.
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Zhuk, S., e V. Vorobey-Vykhivska. "Dynamics of indicators of hemostatic system as prognostic criteria consequences of ART programs". HEALTH OF WOMAN, n. 5(111) (20 giugno 2016): 165–70. http://dx.doi.org/10.15574/hw.2016.111.165.
Testo completoAbstract (sommario):
The article deals with the insurense of haemostatic system on the ART result. The objective: of the study was to establish the relationships between the state of hemostasis in dynamics during the ART program and its results. Patients and methods. The study involved 130 women who underwent infertility treatment through IVF. The dynamics of hemostasis indicators for ART programs is investigated. Results. The trend to a hypercoagulable state in women with failed attempts of IVF is fined. Risk factors ART failure due to hemostasis disorders is established. Conclusions. The evolution of the hemostatic system is an important prognostic criteria on the outcome of ART programs. The lack of signs of a hypercoagulable state can be considered a prerequisite for pregnancy. Dynamic monitoring of hemostasis within ART programs will take timely measures on correction of the hemostatic system and to some extent influence the effects of treatment. Key words: infertility, hemostasis, assisted reproductive technology.
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Jin, Huiyang, e Zhengke Wang. "Advances in Alkylated Chitosan and Its Applications for Hemostasis". Macromol 2, n. 3 (27 luglio 2022): 346–60. http://dx.doi.org/10.3390/macromol2030022.
Testo completoAbstract (sommario):
Chitosan, a natural polysaccharide, has been widely used as a biomaterial, especially for hemostasis. However, hemostatic materials processed from pure chitosan have limited hemostatic effect and are extremely unstable in some cases; chemical modification is therefore needed to improve the hemostatic properties of chitosan. Through chemical reactions with hydroxyl and amino groups in chitosan macromolecules, such as alkylation, carboxylation, quaternization, etc., different groups can be introduced into the repeating units. Moreover, the introduction of different substituents can endow chitosan with more functions. For example, the introduction of long alkyl chains can improve its hydrophobic property, and greatly improve its hemostatic property. However, there is still no review of alkylated chitosan for hemostasis. Therefore, we introduce in detail several methods (direct alkylation, reductive alkylation and acylation reaction) for preparing alkylated chitosan and its applications for hemostasis.
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Park, Jin-Seok, Byung Wook Bang, Su Jin Hong, Eunhye Lee, Kye Sook Kwon, Hyung Kil Kim, Yong Woon Shin e Don Haeng Lee. "Efficacy of a novel hemostatic adhesive powder in patients with refractory upper gastrointestinal bleeding: a pilot study". Endoscopy 51, n. 05 (10 gennaio 2019): 458–62. http://dx.doi.org/10.1055/a-0809-5276.
Testo completoAbstract (sommario):
Abstract Background A new hemostatic adhesive powder (UI-EWD) has been developed to reduce the high re-bleeding rates associated with the currently available hemostatic powders. The current study aimed to assess the efficacy of UI-EWD as a salvage therapy for the treatment of refractory upper gastrointestinal bleeding (UGIB). Methods A total of 17 consecutive patients who had failed to achieve hemostasis with conventional endoscopic procedures and had undergone treatment with UI-EWD for endoscopic hemostasis in refractory UGIB were prospectively enrolled in the study. We evaluated the success rate of initial hemostasis and rate of re-bleeding within 30 days. Results All patients underwent successful UI-EWD application at the bleeding site. Initial hemostasis occurred in 16/17 patients (94 %). Re-bleeding within 30 days occurred in 3/16 patients (19 %) who had achieved initial hemostasis. In the second-look endoscopy after 24 hours, hydrogel from UI-EWD was found attached at the bleeding site in 11/16 patients (69 %). Conclusion UI-EWD has a high success rate for initial hemostasis in refractory UGIB and shows promising results in the prevention of re-bleeding.
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Dambayev, G. Ts, A. N. Baikov, Ye V. Semichev, M. N. Shpisman, A. N. Aleinik, O. I. Deneko e P. S. Bushlanov. "The intraoperative methods of hemostasis during liver surgeries". Bulletin of Siberian Medicine 10, n. 4 (28 agosto 2011): 89–92. http://dx.doi.org/10.20538/1682-0363-2011-4-89-92.
Testo completoAbstract (sommario):
This article deals with a short analysis of intraoperative hemostasis in parenchymatous organs by the example of liver. A brief historical survey is given. The hemostatic sutures developed by different formers and the defects of hemostatic sutures are considered. There are some features of instrumental hemostasis, its advantages and disadvantages. The description of the new developed devices on basis of cold plasma, the hemostatic and antiseptic properties of the devices are presented.
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Ravn, Hanne. "Hemostasis in Pediatric Cardiac Surgery". Seminars in Thrombosis and Hemostasis 43, n. 07 (8 giugno 2017): 682–90. http://dx.doi.org/10.1055/s-0037-1603365.
Testo completoAbstract (sommario):
AbstractThe majority of children undergoing pediatric cardiac surgery with cardiopulmonary bypass require transfusion of blood products. The management of hemostasis in the pediatric population is challenging, partly due to pronounced alterations in several hemostatic parameters following cardiopulmonary bypass. Despite these marked changes being seen quite often, they are not necessarily an indication for hemostatic interventions. This review summarizes and discusses the available monitoring tests of hemostatic impairment during and following pediatric cardiac surgery. It covers standard laboratory tests, viscoelastic test, evaluation of platelet function, fibrinolysis, and the management of anticoagulation including its reversal. Interpretation of hemostatic measurements is done with due respect to the concept of developmental hemostasis, but also cyanotic heart disease, which are considered by some to be associated with an increased risk of bleeding.
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Kamamoto, Dai, Tokunori Kanazawa, Eriko Ishihara, Kaoru Yanagisawa, Hideyuki Tomita, Ryo Ueda, Masahiro Jinzaki, Kazunari Yoshida e Masahiro Toda. "Efficacy of a topical gelatin-thrombin hemostatic matrix, FLOSEAL®, in intracranial tumor resection". Surgical Neurology International 11 (7 febbraio 2020): 16. http://dx.doi.org/10.25259/sni_272_2019.
Testo completoAbstract (sommario):
Background: Hemostasis plays an important role in safe brain tumor resection and also reduces the risk for surgical complications. This study aimed to evaluate the efficacy of FLOSEAL®, a topical hemostatic agent that contains thrombin and gelatin granules, in brain tumor resections. Methods: We evaluated the hemostatic effect of FLOSEAL by scoring the intensity of bleeding from 1 (mild) to 4 (life threatening). We assessed the rate of success of hemostasis with 100 patients who underwent intracranial tumor resection. We also investigated the duration of the operation, the amount of intra- and postoperative bleeding, the number of hospital stays, and adverse events in patients who used FLOSEAL compared with those who did not use FLOSEAL. Results: FLOSEAL was applied to a total of 109 bleeding areas in 100 patients. A total of 95 bleeding areas had a score of 1 and 91 (96%) showed successful hemostasis. Thirteen bleeding areas scored 2 and 8 (62%) showed hemostasis with the first application of FLOSEAL. The second application was attempted with five bleeding areas and four showed hemostasis. About 94% (103/109 areas) of bleeding points successfully achieved hemostasis by FLOSEAL. Moreover, FLOSEAL significantly decreased the amount of intraoperative bleeding and postoperative bleeding as assessed with computed tomography on 1 day postoperatively compared with no use of FLOSEAL. There were no adverse events related to FLOSEAL use. Conclusion: Our results indicate that FLOSEAL is a reliable, convenient, and safe topical hemostatic agent for intracranial tumor resection.
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Uba, Yuki, Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Akira Miyano, Yoshitaro Yamamoto et al. "Comparison of Endoscopic Hemostasis for Endoscopic Sphincterotomy Bleeding between a Novel Self-Assembling Peptide and Conventional Technique". Journal of Clinical Medicine 12, n. 1 (22 dicembre 2022): 79. http://dx.doi.org/10.3390/jcm12010079.
Testo completoAbstract (sommario):
Introduction: Recently, a novel self-assembling peptide hemostatic gel has become available in Japan. However, the safety and efficacy of this novel self-assembling peptide hemostatic gel remain unclear for bleeding after EST. The aim of this study was to evaluate the safety and efficacy of a novel self-assembling peptide hemostatic gel for bleeding after EST, and to perform a comparison to a conventional endoscopic hemostasis technique. Method: This retrospective study was carried out between January 2019 and October 2022. Patients who developed bleeding associated with EST were enrolled. The patients were divided into two groups based on the hemostasis technique used: a conventional hemostasis technique (Group A) or a novel self-assembling peptide hemostatic gel hemostasis technique (Group B). Result: A total of 62 patients (Group A, n = 36; Group B, n = 26) were included. Endoscopic hemostasis was initially obtained in 72.2% (26/32) of patients in Group A and in 88.4% (23/26) of patients in Group B, which was not significantly different (p = 0.1320). However, the procedure time was significantly shorter in Group B (mean, 9.38 min) compared with Group A (mean, 15.4 min) (p = 0.0103). There were no significant differences in the severity of bleeding between the two groups (p = 0.4530). Post-EST bleeding was observed in six patients (Group A, n = 4; Group B, n = 2). Adverse events were more frequently observed in Group A (n = 12) than in Group B (n = 1) (p = 0.0457). Conclusions: PuraStat application for EST bleeding might be safe and effective, and is comparable to the conventional endoscopic hemostasis technique, although further prospective randomized trials are needed.
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Cherednikov, Evgeniy, Igor Yuzefovich, Yuri Maleev, Sergey V. Barannikov Barannikov, Tatyana Litovkina, Galina Polubkova e Evgeniy Ovsyannikov. "The Use of the Hemostatic Agent Zhelplastan in Combination with a Granulated Sorbent in the Treatment of Patients with Mallory-Weiss Syndrome". International Journal of Biomedicine 11, n. 2 (5 giugno 2021): 160–63. http://dx.doi.org/10.21103/article11(2)_oa7.
Testo completoAbstract (sommario):
Background: Mallory-Weiss syndrome (MWS) is one of the common causes of acute upper gastrointestinal bleeding. The aim of our research was to develop a method for the treatment of MWS, which would improve the efficiency of local hemostasis, reduce the risk of re-bleeding and shorten the treatment time. Methods and Results: The study involved 102 patients with MWS. All patients were divided by random sampling into two groups: the main group (MG) and control group (CG). Patients of both groups were comparable in age, gender, concomitant diseases, type of bleeding, size of bleeding defect, and duration of observations. The MG included 52 patients, who were given the developed method of MWS treatment. Patients with ongoing bleeding were treated with a combined method of endoscopic hemostasis: active bleeding was initially stopped by infiltration or coagulation (argon-plasma coagulation was preferred), and then to increase the reliability of hemostasis and prevent the resumption of bleeding, powdered Zhelplastan 0.2g was applied to the rupture area with an insufflator, followed by Sephadex G-25 0.3g (Patent RF №2633925). In patients with signs of unstable hemostasis, the developed method of cytoprotective action on a clot or thrombosed vessel was used by applying a local hemostatic, Zhelplastan 0.2g, to the defect area in combination with a granular sorbent, Sephadex G-25 0.3g, during therapeutic endoscopy to prevent the resumption of bleeding. In patients with stable stopped bleeding, a hemostatic powdered Zhelplastan was applied to the defect area using an endoscope in combination with Sephadex G-25, according to the developed method. In the CG (n=50), well-known methods of arresting endoscopic bleeding (pricking with aminocaproic acid, vasoconstrictors, argon-plasma coagulation, etc.) were used without local hemostatics and granular sorbents. Summing up the results of patients with Mallory-Weiss syndrome in the compared groups, in the MG final hemostasis was performed in 51(98.1%) patients. In the MG, bleeding resumed in 1(1.9%) patient. There were no emergency operations or deaths. In the CG, the bleeding was finally stopped in 43(86%) patients, and it resumed in 7(14%) patients. Emergency surgery was required for 1(2%) patient. In the CG, the mortality rate was 4%. Conclusion: In MWS, the use of the developed method of endoscopic treatment, including pneumoinsufflation of a powdered hemostatic agent in combination with a granular sorbent, against the background of conservative therapy, improved the results of treatment, increased the reliability of local hemostasis, reduced the number of recurrent bleedings, and excluded emergency operations.
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Chen, Ran, Fanglin Du e Qipeng Yuan. "Multifunctional Sodium Hyaluronate/Chitosan Foam Used as an Absorbable Hemostatic Material". Bioengineering 10, n. 7 (21 luglio 2023): 868. http://dx.doi.org/10.3390/bioengineering10070868.
Testo completoAbstract (sommario):
Absorbable hemostatic materials have great potential in clinical hemostasis. However, their single coagulation mechanism, long degradation cycles, and limited functionality mean that they have restricted applications. Here, we prepared a sodium hyaluronate/carboxymethyl chitosan absorbable hemostatic foam (SHCF) by combining high-molecular-weight polysaccharide sodium hyaluronate with carboxymethyl chitosan via hydrogen bonding. SHCFs have rapid liquid absorption performance and can enrich blood cells. They transform into a gel when it they come into contact with blood, and are more easily degraded in this state. Meanwhile, SHCFs have multiple coagulation effects and promote hemostasis. In a rabbit liver bleeding model, SHCFs reduced the hemostatic time by 85% and blood loss by 80%. In three severe and complex bleeding models of porcine liver injury, uterine wall injury, and bone injury, bleeding was well-controlled and anti-tissue adhesion effects were observed. In addition, degradation metabolism studies show that SHCFs are 93% degraded within one day and almost completely metabolized within three weeks. The absorbable hemostatic foam developed in this study is multifunctional; with rapid hemostasis, anti-adhesion, and rapid degradation properties, it has great clinical potential for in vivo hemostasis.
20
Hussein, Mohamed, Durayd Alzoubaidi, Miguel-Fraile Lopez, Michael Weaver, Jacobo Ortiz-Fernandez-Sordo, Paul Bassett, Johannes W. Rey et al. "Hemostatic spray powder TC-325 in the primary endoscopic treatment of peptic ulcer-related bleeding: multicenter international registry". Endoscopy 53, n. 01 (26 maggio 2020): 36–43. http://dx.doi.org/10.1055/a-1186-5360.
Testo completoAbstract (sommario):
Abstract Background Upper gastrointestinal bleeding (UGIB) is a leading cause of morbidity and is associated with a 2 % – 17 % mortality rate in the UK and USA. Bleeding peptic ulcers account for 50 % of UGIB cases. Endoscopic intervention in a timely manner can improve outcomes. Hemostatic spray is an endoscopic hemostatic powder for GI bleeding. This multicenter registry was created to collect data prospectively on the immediate endoscopic hemostasis of GI bleeding in patients with peptic ulcer disease when hemostatic spray is applied as endoscopic monotherapy, dual therapy, or rescue therapy. Methods Data were collected prospectively (January 2016 – March 2019) from 14 centers in the UK, France, Germany, and the USA. The application of hemostatic spray was decided upon at the endoscopist’s discretion. Results 202 patients with UGIB secondary to peptic ulcers were recruited. Immediate hemostasis was achieved in 178/202 patients (88 %), 26/154 (17 %) experienced rebleeding, 21/175 (12 %) died within 7 days, and 38/175 (22 %) died within 30 days (all-cause mortality). Combination therapy of hemostatic spray with other endoscopic modalities had an associated lower 30-day mortality (16 %, P < 0.05) compared with monotherapy or rescue therapy. There were high immediate hemostasis rates across all peptic ulcer disease Forrest classifications. Conclusions This is the largest case series of outcomes of peptic ulcer bleeding treated with hemostatic spray, with high immediate hemostasis rates for bleeding peptic ulcers.
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Lippi, Giuseppe, e Emmanuel J. Favaloro. "Laboratory hemostasis: from biology to the bench". Clinical Chemistry and Laboratory Medicine (CCLM) 56, n. 7 (27 giugno 2018): 1035–45. http://dx.doi.org/10.1515/cclm-2017-1205.
Testo completoAbstract (sommario):
AbstractPhysiological hemostasis is an intricate biological system, where procoagulant and anticoagulant forces interplay and preserves blood fluidity when blood vessels are intact, or trigger clot formation to prevent excessive bleeding when blood vessels are injured. The modern model of hemostasis is divided into two principal phases. The first, defined as primary hemostasis, involves the platelet-vessel interplay, whilst the second, defined as secondary hemostasis, mainly involves coagulation factors, damaged cells and platelet surfaces, where the so-called coagulation cascade rapidly develops. The activation and amplification of the coagulation cascade is finely modulated by the activity of several physiological inhibitors. Once bleeding has been efficiently stopped by blood clot formation, dissolution of the thrombus is essential to restore vessel permeability. This process, known as fibrinolysis, also develops through coordinate action of a vast array of proteins and enzymes. An accurate diagnosis of hemostasis disturbance entails a multifaceted approach, encompassing family and personal history of hemostatic disorders, accurate collection of clinical signs and symptoms, integrated with laboratory hemostasis testing. Regarding laboratory testing, a reasonable approach entails classifying hemostasis testing according to cost, complexity and available clinical information. Laboratory workout may hence initiate with some rapid and inexpensive “screening” tests, characterized by high negative predictive value, then followed by second- or third-line analyses, specifically aimed to clarify the nature and severity of bleeding or thrombotic phenotype. This article aims to provide a general overview of the hemostatic process, and to provide some general suggestions to optimally facilitate laboratory hemostasis testing.
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Aly, Mai M., Noor El deen El Hefny, Mohamed F. Ibrahim e Dina A. Hamad. "Hemostasis disorders in intensive care unit in Assiut University Hospital: a prospective study". Egyptian Journal of Haematology 48, n. 4 (2023): 337–44. http://dx.doi.org/10.4103/ejh.ejh_54_23.
Testo completoAbstract (sommario):
Abstracts Hemostasis disorders either bleeding or thrombosis that occur in intensive care unit (ICU) are common multifactorial problems that affect morbidity and mortality. Prompt identification and correct management improve ICU patient’s outcome. The aim of this study is to assess the incidence of hemostasis disorders among ICU patients and to establish a relationship between hemostasis disorders and outcome of ICU patients. A total of 350 patients were admitted to ICU during the study period. Hundred were excluded secondary to having one or more exclusion criterion; liver diseases (n=33), receiving anticoagulant agents (n=23), bleeding or coagulation disorders at time of admission (n=17), atrial fibrillation (n=12), nephrotic syndrome (n=8), inherited coagulation defects (n=7) and 10 patients were excluded due to incomplete data. A total of 240 patients were recruited in the study analysis. Eighty (33.3%) patients developed different form of hemostatic disorders during their hospital stay within ICU while 160 (66.7%) patients did not develop hemostatic disorders. On admission patients with hemostasis disorder had significantly longer INR (1.10 ± 0.19 vs. 1.05 ± 0.09, P=0.03) and D-dimer (2.32 ± 0.97 vs. 0.55 ± 0.28, P<0.001) with lower fibrinogen level (77.56 ± 9.89 vs. 134.56 ± 10.98, P<0.001). The most frequent form of hemostasis was thrombocytopenia (55%) with mean platelets count (90.87 ± 10.19 × 109/l) followed by pulmonary embolism (16.2%) and DIC (13.7%) with mean D-dimer (2.87 ± 1.11). There were another three patients were found to had thrombasthenia. Four patients developed DVT, three patients were diagnosed as Churg-Strauss syndrome, and two patients had acute limb ischemia. Causes of thrombocytopenia were HIT (4.5%), sepsis (70.5%) and drug-induced (25%). Patients with hemostasis disorders had significantly longer hospital stay (13.12 ± 5.76 vs. 7.01 ± 1.43 (days); P<0.001) while patients without hemostasis disorders had significantly higher overall survival (19.25 (16.69–21.82) vs. 8.55 (8.11–8.98) days; P<0.001) in comparison to those with hemostasis disorders.,In Conclusion, critically ill patients are vulnerable to develop different forms of hemostatic disorders that may seriously affect the outcome. ClinicalTrials.gov Identifier: NCT04179357
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Borges-Vilches, Jessica, Claudio Aguayo e Katherina Fernández. "The Effect on Hemostasis of Gelatin-Graphene Oxide Aerogels Loaded with Grape Skin Proanthocyanidins: In Vitro and In Vivo Evaluation". Pharmaceutics 14, n. 9 (25 agosto 2022): 1772. http://dx.doi.org/10.3390/pharmaceutics14091772.
Testo completoAbstract (sommario):
Using in vitro and in vivo models, this study investigated the hemostatic potential to control bleeding of both unloaded gelatin-graphene oxide aerogels and the same loaded with proanthocyanidins (PAs) from Vitis vinifera grape skin extract. Our results showed that the physicochemical and mechanical properties of the aerogels were not affected by PA inclusion. In vitro studies showed that PA-loaded aerogels increased the surface charge, blood absorption capacity and cell viability compared to unloaded ones. These results are relevant for hemostasis, since a greater accumulation of blood cells on the aerogel surface favors aerogel–blood cell interactions. Although PAs alone were not able to promote hemostasis through extrinsic and intrinsic pathways, their incorporation into aerogels did not affect the in vitro hemostatic activity of these composites. In vivo studies demonstrated that both aerogels had significantly increased hemostatic performance compared to SpongostanTM and gauze sponge, and no noticeable effects of PA alone on the in vivo hemostatic performance of aerogels were observed; this may have been related to its poor diffusion from the aerogel matrix. Thus, PAs have a positive effect on hemostasis when incorporated into aerogels, although further studies should be conducted to elucidate the role of this extract in the different stages of hemostasis.
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Chen, Yeyi, Lei Wu, Pengpeng Li, Xiao Hao, Xiao Yang, Guanghui Xi, Wen Liu, Yakai Feng, Hongchao He e Changcan Shi. "Polysaccharide Based Hemostatic Strategy for Ultrarapid Hemostasis". Macromolecular Bioscience 20, n. 4 (18 febbraio 2020): 1900370. http://dx.doi.org/10.1002/mabi.201900370.
Testo completo
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Bruckner, Brian A., e Matthias Loebe. "Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures". Winter 9, n. 2 (8 agosto 2012): 96–98. http://dx.doi.org/10.15420/usc.2012.9.2.96.
Testo completoAbstract (sommario):
Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.
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Park, Jin-Seok, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon e Don Haeng Lee. "Novel hemostatic adhesive powder for nonvariceal upper gastrointestinal bleeding". Endoscopy International Open 07, n. 12 (dicembre 2019): E1763—E1767. http://dx.doi.org/10.1055/a-0982-3194.
Testo completoAbstract (sommario):
Abstract Background and study aims A new hemostatic adhesive powder (UI-EWD) was developed to reduce high rebleeding rates and technical challenges associated with application of currently available hemostatic powders. The aim of the current study was to assess performance of UI-EWD for nonvariceal upper gastrointestinal bleeding (NVUGIB). Patients and methods A total of 56 consecutive patients that received UI-EWD monotherapy for endoscopic hemostasis due to NVUGIB were retrospectively reviewed. Main study outcomes were success rates with immediate hemostasis and rebleeding within 30 days. Outcomes were analyzed by reviewing patient medical records. Results Etiologies of bleeding were: post-endoscopic therapy bleeding in 46 (82.1 %), peptic ulcer in 8 (14.3 %), tumor in 1 (1.8 %), and other in 1 (1.8 %). UI-EWD was successfully applied at bleeding site in all cases. The success rate of immediate hemostasis was 96.4 % (54/56), and the 30-day rebleeding rate among patients that achieved immediate hemostasis was 3.7 % (2/54). No adverse event related to use of UI-EWD occurred. Conclusion UI-EWD was found to have a high immediate hemostasis success rate in NVUGIB when used as monotherapy and showed promising results in terms of preventing rebleeding.
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Barg, Assaf, Ulrike Nowak-Göttl e Gili Kenet. "Hemostasis in the Very Young". Seminars in Thrombosis and Hemostasis 44, n. 07 (18 giugno 2018): 617–23. http://dx.doi.org/10.1055/s-0038-1660852.
Testo completoAbstract (sommario):
AbstractHemostasis is a dynamic process that starts in utero. The coagulation system evolves with age, as evidenced by marked physiological differences in the concentration of the majority of hemostatic proteins in early life compared with adulthood. This concept, known as “developmental hemostasis,” has important biological and clinical implications. Overall, impaired platelet function, along with physiologically reduced levels of vitamin K–dependent and contact coagulation factors, may cause poorer clot firmness even in healthy neonates. However, increased activity of von Willebrand factor and low levels of coagulation inhibitors that promote hemostasis counterbalance the delicate and immature hemostatic system. Since this hemostatic system has little reserve capacity, preterm neonates or sick infants are extremely vulnerable and predisposed to either hemorrhagic or thrombotic complications. This review will address the concept and manifestations of developmental hemostasis with respect to clinical disease phenotypes. It will discuss bleeding diagnosis in neonates, dealing especially with the devastating complications of intracerebral and pulmonary hemorrhage in preterm infants. Neonates, especially the sickest preterm ones, are also extremely susceptible to thrombotic complications; thus, thrombosis in neonates will be reviewed, with special focus on arterial ischemic perinatal stroke. Based on the concept of developmental hemostasis, the phenotypes of clinically relevant bleeding or thrombotic disorders among neonates may differ from those of older infants and children. Treatment options for these conditions will be suggested and reviewed.
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Starkova, A. V., F. V. Sobin, I. P. Rudakova, N. A. Pulina, N. V. Dozmorova e V. G. Luzhanin. "The Effect of New Water-soluble 2-aminoheteryl-3-ium 4-(het)aryl-2-hydroxy-4-oxobut-2-enoates on the Hemostasis System <i>In vitro</i>". Drug development & registration 12, n. 4 (26 dicembre 2023): 151–55. http://dx.doi.org/10.33380/2305-2066-2023-12-4(1)-1679.
Testo completoAbstract (sommario):
Introduction. The hemostasis system is a set of functional, morphological and biochemical mechanisms of a living organism that ensure the preservation of the liquid state of the blood, the prevention and stopping of bleeding, as well as the integrity of blood vessels. Anticoagulants and hemostatic agents can significantly change the mechanism of hemostasis. Interest in the synthesis and search for compounds that affect the blood coagulation system remains high. Substances exhibiting anticoagulant and hemostatic effects have been found. The search for compounds among the products of organic synthesis that affect the hemostasis system seems relevant.Aim. To study the effect of new water-soluble 2-amino heteryl-3-ium 4-(get)aryl-2-hydroxy-4-oxobut-2-enoates on the hemostasis system using an in vitro model.Materials and methods. Direct interaction 4-(het)aryl-2-hydroxy-4-oxobut-2-enoic acids with heterocyclic amines have been obtained new water soluble 2-aminoheteryl-3-ium 4-(het)aryl-2-hydroxy-4-oxobut-2-enoates. The study of the effect of substances on the hemostasis system was carried out using the coagulometer "APK 4-02-P". Ethamsylate and sodium heparin were used as comparison drugs for hemostatic and anticoagulant activity, respectively. Acute toxicity of the compounds was determined by intravenous administration of aqueous solutions of the compounds to non-linear white mice of both sexes with the definition of LD50.Results and discussion. 10 New 2-aminoheteryl-3-ium 4-(het)aryl-2-hydroxy-4-oxobut-2-enoates have been synthesized. In vitro screening of the effect of compounds on the hemostasis system found that 3 substances have a pronounced anticoagulant effect, and 4 compounds showed hemostatic activity. Some patterns of the "structure-pharmacological action" relationship have been found. The studied butenoates can be classified as moderately toxic compounds according to the classification of chemical toxicity.Conclusion. Pharmacological screening in vitro of the effect of compounds on the hemostasis system was carried out. It was found that all the studied compounds have an effect on the blood coagulation system of varying degrees of severity. The combination of a pronounced pharmacological effect, low acute toxicity and water solubility of butenoates may become a prerequisite for further search and possible development of new domestic medicines that have an effect on the hemostasis system.
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Zhang, Chen, Rui Zeng, Zhencheng Liao, Chaomei Fu, Hui Luo, Hanshuo Yang e Yan Qu. "Bletilla striataMicron Particles Function as a Hemostatic Agent by Promoting Rapid Blood Aggregation". Evidence-Based Complementary and Alternative Medicine 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/5820405.
Testo completoAbstract (sommario):
The human body cannot control blood loss without treatment. Available hemostatic agents are ineffective at treating cases of severe bleeding and are expensive or raise safety concerns.Bletilla striataserve as an inexpensive, natural, and promising alternative. However, no detailed studies on its hemostatic approach have been performed. The aim of this study was to examine the hemostatic effects ofB. striataMicron Particles (BSMPs) and their hemostatic mechanisms. We prepared and characterized BSMPs of different size ranges and investigated their use as hemostatic agent. BSMPs of different size ranges were characterized by scanning electron microscope. In vitro coagulation studies revealed BSMP-blood aggregate formation via stereoscope and texture analyzers. In vivo studies based on rat injury model illustrated the BSMP capabilities under conditions of hemostasis. Compared to other BSMPs of different size ranges, BSMPs of 350–250 μm are most efficient in hemostasis. As powder sizes decrease, the degree of aggregation between particles and hemostatic BSMP effects declines. The BSMP in contact with a bleeding surface locally forms a visible particle/blood aggregate as a physical barrier that facilitates hemostasis. Considering the facile preparation, low cost, and long shelf life ofB. striata, BSMPs offer great potential as mechanisms of trauma treatment.
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Minici, Roberto, Raffaele Serra, Claudio Maglia, Giuseppe Guzzardi, Marco Spinetta, Federico Fontana, Massimo Venturini e Domenico Laganà. "Efficacy and Safety of Axiostat® Hemostatic Dressing in Aiding Manual Compression Closure of the Femoral Arterial Access Site in Patients Undergoing Endovascular Treatments: A Preliminary Clinical Experience in Two Centers". Journal of Personalized Medicine 13, n. 5 (11 maggio 2023): 812. http://dx.doi.org/10.3390/jpm13050812.
Testo completoAbstract (sommario):
Background: Hemostasis of the femoral arterial access site by manual compression or a vascular closure device is critical to the safe completion of any endovascular procedure. Previous investigations evaluated the hemostatic efficacy at the radial access site of some chitosan-based hemostatic pads. This study aims to assess the efficacy and safety of a new chitosan-based hemostatic dressing, namely Axiostat®, in aiding manual compression closure of the femoral arterial access site in patients undergoing endovascular treatments. Furthermore, the outcomes were compared with evidence on manual compression alone and vascular closure devices. Methods: This investigation is a two-center retrospective analysis of 120 consecutive patients who had undergone, from July 2022 to February 2023, manual compression closure of the femoral arterial access site aided by the Axiostat® hemostatic dressing. Endovascular procedures performed with introducer sheaths ranging from 4 Fr to 8 Fr were evaluated. Results: Primary technical success was achieved in 110 (91.7%) patients, with adequate hemostasis obtained in all cases of prolonged manual compression requirements. The mean time-to-hemostasis and time-to-ambulation were 8.9 (±3.9) and 462 (±199) minutes, respectively. Clinical success was achieved in 113 (94.2%) patients, with bleeding-related complications noted in 7 (5.8%) patients. Conclusions: Manual compression aided by the Axiostat® hemostatic dressing is effective and safe in achieving hemostasis of the femoral arterial access site in patients undergoing endovascular treatment with a 4–8 Fr introducer sheath.
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Toubi, Elias, e Zahava Vadasz. "Hemostasis in Allergy". Seminars in Thrombosis and Hemostasis 44, n. 07 (19 giugno 2018): 669–75. http://dx.doi.org/10.1055/s-0038-1648232.
Testo completoAbstract (sommario):
AbstractThe involvement of the hemostatic system in immune-mediated inflammation is widely reported. Many coagulation factors play a role in the pathogenesis of autoimmune diseases, such as systemic vasculitis and systemic lupus erythematosus. Hemostatic disorders are also involved in asthma and chronic spontaneous urticaria (CSU). Factor XIIa (FXIIa) was one of the first coagulation factors implicated in inducing both humoral and cellular responses and is therefore considered a prime new therapeutic target in immune-mediated inflammation. The involvement of coagulation factors, such as tissue factor and fibrinogen, in the pathogenesis of asthma has been reported. The finding of platelet activation in asthma also indicates a link between bronchial inflammation and hemostasis. The pathogenesis of mast cell degranulation and CSU was also shown to be associated with the activation of hemostatic factors such as fibrinogen and FXIIa. Increased plasma levels of D-dimer have been widely reported as a biological marker for the duration and severity of CSU. In addition, endothelial-induced cell activation by the kallikrein–high molecular weight complex and the release of heat shock protein 90 was shown to be involved in mast cell degranulation disorders. In this narrative review, the authors aim to summarize the role of hemostasis in inflammation, asthma, and CSU by focusing on the increasing information linking hemostatic factors and immune-mediated disorders.
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Reshetnyak, V. I., I. V. Maev, T. M. Reshetnyak, S. V. Zhuravel e V. M. Pisarev. "Liver Diseases and the Hemostasis (Rewiew) Part 1. Non-Cholestatic Diseases of the Liver and Hemostasis". General Reanimatology 15, n. 5 (9 novembre 2019): 74–87. http://dx.doi.org/10.15360/1813-9779-2019-5-74-87.
Testo completoAbstract (sommario):
In liver diseases, most commonly in the terminal stage of liver failure, a variety of hemostatic defects affecting almost all parts of the blood coagulation system are developing. This leads to diminishing the capabilities of patients with liver diseases to correctly maintain the hemostatic balance.The severity of hemostatic disorders depends on the nosological form and degree of a liver damage. Depending on the imbalance of the hemostasis system and accumulated clinical/laboratory data, patients with liver diseases can be subdivided into three groups as exhibiting: 1. non-cholestatic liver damage; 2. cholestatic liver damage and 3. liver damage of vascular origin.The first part of the review discusses multiple alterations in the hemostasis system in patients with noncholestatic liver diseases, which are commonly accompanied by hypocoagulation.
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Su, Wenting, Yi Sun, Sining Lv, Bo He e Wenzhong Lou. "Rapid Pressure Hemostatic Drug Delivery and Microsystem Design Based on Battlefield Trauma". Journal of Physics: Conference Series 2478, n. 12 (1 giugno 2023): 122071. http://dx.doi.org/10.1088/1742-6596/2478/12/122071.
Testo completoAbstract (sommario):
Abstract The battlefield rapid pressure hemostatic microsystem maximizes hemostasis efficiency. Battlefield wound has the characteristics of rapid blood loss and irregular surface, which needs to be treated in a very short time. The existing rapid hemostasis method has poor efficiency and no sterilization and disinfection effect. Therefore, we reported a wound pressure hemostatic microsystem based on gas generated by rapid chemical reaction. Before the device is used, the two chemicals in the device are isolated. During hemostasis, the flexible device is applied to the wound surface, and the two chemicals in the device are mixed and chemically reacted. And the large amount of gas generated by the reaction causes the balloon in the device to expand and exert lateral and longitudinal pressure on the surface of the wound, so that the wound quickly closed. At the same time, the drug storage unit in the device is under pressure to release the drug to the wound surface. In addition, the chemical reaction of the device has an endothermic effect, which can rapidly cool the wound surface. The lateral and longitudinal pressures of the flexible microsystem in the process of hemostasis were analyzed by numerical simulation. In the experiment, the maximum longitudinal pressure reached 270mmHg, meeting the requirements of surface wound hemostasis.
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Al-Zahrani, Faisal M. "New and more effective application assays for hemostatic disorder assessment: A systematic review". Electronic Journal of General Medicine 20, n. 6 (1 novembre 2023): em538. http://dx.doi.org/10.29333/ejgm/13570.
Testo completoAbstract (sommario):
<b>Background:</b> Hemostasis research lacked novel platform assays for hemostatic disorder diagnosis. The current review study’s goal is to compare various assays for evaluating the novel hemostatic techniques used in the diagnosis of coagulation disturbances and to highlight each method’s strongest and weakest points.<br /> <b>Methods:</b> The PRISMA guidelines and the recommendations for observational studies in epidemiology were both followed in the current systematic review. The PRISMA-compliant electronic databases (PubMed), a novel platform for evaluating hemostasis, were searched using the keywords. The electronic databases (PubMed), a cutting-edge platform to assess hemostasis, were searched using the keywords. Articles published between December 2016 and December 2021 were only included in searches; original articles were written in English. In order to assess hemostasis studies, we gathered bibliographies of abstracts that were published on the new and more effective application assays for assessments of hemostasis disorders.<br /> <b>Results:</b> Following the removal of duplicates, articles were determined by examining the titles and abstracts. Disagreements were resolved through consensus and the application of novel hemostatic analysis methods. Then independently reviewed the relevant studies of the recognized records (n=503), excluding duplicates (n=9) and irrelevant studies (n=249). The remaining 254 studies were read in their entirety, the data from the seven included studies had been extracted.<br /> <b>Conclusions:</b> When expressed as an anticoagulant for the in vivo assessment of on the complement system, nanotechnology-based study was more effective in some laboratory tests, and flow cytometer evaluation could be a promising platform approach for use in hemostasis management.
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Murakami, Takashi, Eiji Kamba, Keiichi Haga, Yoichi Akazawa, Hiroya Ueyama, Tomoyoshi Shibuya, Mariko Hojo e Akihito Nagahara. "Emergency Endoscopic Hemostasis for Gastrointestinal Bleeding Using a Self-Assembling Peptide: A Case Series". Medicina 59, n. 5 (12 maggio 2023): 931. http://dx.doi.org/10.3390/medicina59050931.
Testo completoAbstract (sommario):
Background and Objectives: A novel synthetic self-assembling peptide, PuraStat, has been introduced as a hemostatic agent. This case series aimed to evaluate the clinical efficacy of PuraStat for gastrointestinal bleeding during emergency endoscopy. Cases: Twenty-five patients with gastrointestinal bleeding who had undergone emergency endoscopy with PuraStat between August 2021 and December 2022 were retrospectively examined. Six patients were receiving antithrombotic agents, and ten patients with refractory gastrointestinal bleeding had undergone at least one endoscopic hemostatic procedure. The breakdown of bleeding was gastroduodenal ulcer/erosion in 12 cases, bleeding after gastroduodenal or colorectal endoscopic resection in 4 cases, rectal ulcer in 2 cases, postoperative anastomotic ulcer in 2 cases, and gastric cancer, diffuse antral vascular ectasia, small intestinal ulcer, colonic diverticular bleeding, and radiation proctitis in each case. The method of hemostasis was only PuraStat application in six cases, and hemostasis in combination with high-frequency hemostatic forceps, hemostatic clip, argon plasma coagulation, and hemostatic agents (i.e., thrombin) in the remaining cases. Rebleeding was observed in three cases. Hemostatic efficiency was observed in 23 cases (92%). Conclusions: PuraStat has the expected hemostatic effect on gastrointestinal bleeding during emergency endoscopy. The use of PuraStat should be considered in emergency endoscopic hemostasis of gastrointestinal bleeding.
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Sharma, Saurabh, Tejraj P. Kale, Lingaraj J. Balihallimath e Abhishek Motimath. "Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs". Journal of Contemporary Dental Practice 18, n. 9 (2017): 802–6. http://dx.doi.org/10.5005/jp-journals-10024-2130.
Testo completoAbstract (sommario):
ABSTRACT Aim The aim of this study was to evaluate the efficacy of Axiostat Hemostatic Dental dressing in achieving hemostasis postextraction and determining its effect on pain and healing of the extraction wound, compared with control, i.e., conventional method of extraction in patients on oral antiplatelet therapy. Materials and methods Totally, 40 patients on oral antiplatelet drugs were included in the study and overall 80 extractions were done applying split mouth study design, without altering patient's drug regime. Extraction sites were divided into two groups: Group I received Axiostat Hemostatic Dental Dressing (study site), and group II received conventional method; pressure pack with sterile gauze under biting pressure followed by suturing if required (control site) was used to attain hemostasis. Results Extraction sites treated with Axiostat Hemostatic Dressing achieved hemostasis earlier (mean 1 minute 13 seconds) compared with control sites (mean = 14 minutes 1 second), which was also statistically significant (p < 0.001). Postoperative pain was considerably lower and significantly better healing was seen in the study group (p < 0.001) compared with the control. Conclusion Axiostat demonstrated to be an effective hemostatic agent that considerably lessens the bleeding time in patients on oral antiplatelet drugs postextraction. In addition, it even offered minimal postoperative pain and improved healing of the extraction wound. On comparing the results of this study with our study on HemCon Dental Dressing, Axiostat Dental Dressing (ADD) is found to be as effective and at par in achieving hemostasis in patients on oral antiplatelet therapy. Clinical significance The past few decades have seen an upsurge in use of low-dose aspirin either alone or in combination with other drugs. When these patients require dental/maxillofacial treatment, earlier concept of stopping these medications is associated with increased risk of thromboembolic event. The present study highlights an alternative approach using ADD which aids in quick hemostasis, accentuates healing, and reduce postoperative pain. How to cite this article Sharma S, Kale TP, Balihallimath LJ, Motimath A. Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs. J Contemp Dent Pract 2017;18(9):802-806.
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Jain, Neha. "Evaluation of Different Hemostatic Method in Achieving Hemostasis in Patient on Oral Anticoagulant Therapy". SVOA Dentistry 5, n. 1 (9 febbraio 2024): 26–32. http://dx.doi.org/10.58624/svoade.2024.05.0166.
Testo completoAbstract (sommario):
Patients receiving oral anticoagulant therapy are at an increased risk of bleeding complications, necessitating effective hemostatic interventions. This study aims to evaluate and compare the efficacy of four hemostatic agent (figure of eight suturing, Absorbable gelatin sponge (ABGEL), Topical application of hemocogulase, and pressure gauze pack) in achieving hemostasis among patients on oral anticoagulant therapy. The study was conducted on 100 patients which were randomly divided in four groups and we found that all methods of achieving hemostasis are equally beneficial.
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Chapman, William C., Sherry M. Wren, Gail S. Lebovic, Martin Malawer, Randolph Sherman e Jon E. Block. "Effective Management of Bleeding during Tumor Resection with a Collagen-Based Hemostatic Agent". American Surgeon 68, n. 9 (settembre 2002): 802–7. http://dx.doi.org/10.1177/000313480206800914.
Testo completoAbstract (sommario):
In a prospective controlled trial hemostatic effectiveness of a novel collagen-based composite (CoStasis®) was compared with a collagen sponge applied with manual pressure at diffusely bleeding sites after surgical tumor resection. The proportion of subjects achieving complete cessation of bleeding within 10 minutes (i.e., hemostatic success) and the time to “complete hemostasis” were determined at raw surgical sites after tumor resection among 23 experimental and 30 control subjects. There was a similar distribution in tumor types (e.g., benign vs malignant) evaluated between treatment groups. A significantly greater proportion of experimental subjects achieved complete hemostasis within 10 minutes of observation compared with controls [23 of 23 (100%) vs 21 of 30 (70%); P = 0.003]. The median time required to achieve complete hemostasis was more than three times longer for subjects treated with the collagen sponge compared with subjects treated with CoStasis® (243 vs 78 seconds; P = 0.0001). Approximately 80 per cent of experimental subjects achieved complete hemostasis within 2 minutes compared with only 35 per cent of controls. There were no adverse events related to the experimental treatment in this study. These results support the use of this novel hemostatic agent to control diffuse surgical site bleeding after tumor resection at diverse anatomical locations.
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Ali-Mohamad, Nabil, Massimo Cau, James Baylis, Veronika Zenova, Hugh Semple, Andrew Beckett, Andrew McFadden, Fergal Donnellan e Christian Kastrup. "Severe upper gastrointestinal bleeding is halted by endoscopically delivered self-propelling thrombin powder: A porcine pilot study". Endoscopy International Open 09, n. 05 (22 aprile 2021): E693—E698. http://dx.doi.org/10.1055/a-1374-5839.
Testo completoAbstract (sommario):
Abstract Background and study aims Hemostatic powders have emerged recently to treat upper gastrointestinal bleeding (UGIB). Previously, we developed a novel self-propelling thrombin powder (SPTP) that effectively manages external pulsatile arterial bleed without compression, by effervescing and carrying thrombin into the wound. Here, we tested if SPTP, sprayed endoscopically, can manage severe UGIB in a live porcine model. Materials and methods Anesthetized pigs underwent laparotomy to insert the gastroepiploic vascular bundles into the stomach lumen via a gastrotomy. Bleeding was initiated endoscopically in the stomach by needle knife. SPTP was delivered to the site of bleeding from a CO2-powered spray device using a 7 FR catheter. Successful primary hemostasis, time to hemostasis, and the mass of SPTP delivered were measured. Results Hemostasis was achieved at all bleeding sites using SPTP. Mean time to hemostasis was 4.2 ± 0.9 minutes (mean ± standard error of the mean, n = 12). The average mass of SPTP delivered was 2.4 ± 0.6 g. Conclusions In this pilot study, SPTP successfully stopped 12 cases of severe UGIB, demonstrating early promise asa novel hemostatic powder.
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Kontovazainitis, Christos-Georgios, Dimitra Gialamprinou, Theodoros Theodoridis e Georgios Mitsiakos. "Hemostasis in Pre-Eclamptic Women and Their Offspring: Current Knowledge and Hemostasis Assessment with Viscoelastic Tests". Diagnostics 14, n. 3 (5 febbraio 2024): 347. http://dx.doi.org/10.3390/diagnostics14030347.
Testo completoAbstract (sommario):
Pre-eclampsia (PE) is a placenta-mediated disease and remains a major cause of maternal and neonatal mortality and morbidity. As PE develops, normal pregnancy’s hypercoagulable balance is disrupted, leading to platelet hyperactivation, excessive pathological hypercoagulability, and perturbed fibrinolysis. This narrative review aims to summarize the current knowledge regarding hemostasis in PE compared with healthy gestation and the potential effects of maternal PE on neonatal hemostasis. Finally, it aims to discuss hemostasis assessments for normal pregnancies and PE, emphasizing the role of viscoelastic tests, namely, thromboelastography (TEG) and thromboelastometry (ROTEM), for monitoring PE-associated hemostatic alterations. The use of TEG/ROTEM for assessing the hemostatic profile of PE women has been little considered, even though conventional coagulation tests (CCTs) have not helped to monitor hemostasis in this population. Compared with normal pregnancy, TEG/ROTEM in PE reveals an excessive hypercoagulability analogous with the severity of the disease, characterized by higher-stability fibrin clots. The TEG/ROTEM parameters can reflect PE severity and may be used for monitoring and as predictive markers for the disease.
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Fan, Peng, Yanbo Zeng, Dionisio Zaldivar-Silva, Lissette Agüero e Shige Wang. "Chitosan-Based Hemostatic Hydrogels: The Concept, Mechanism, Application, and Prospects". Molecules 28, n. 3 (3 febbraio 2023): 1473. http://dx.doi.org/10.3390/molecules28031473.
Testo completoAbstract (sommario):
The design of new hemostatic materials to mitigate uncontrolled bleeding in emergencies is challenging. Chitosan-based hemostatic hydrogels have frequently been used for hemostasis due to their unique biocompatibility, tunable mechanical properties, injectability, and ease of handling. Moreover, chitosan (CS) absorbs red blood cells and activates platelets to promote hemostasis. Benefiting from these desired properties, the hemostatic application of CS hydrogels is attracting ever-increasing research attention. This paper reviews the recent research progress of CS-based hemostatic hydrogels and their advantageous characteristics compared to traditional hemostatic materials. The effects of the hemostatic mechanism, effects of deacetylation degree, relative molecular mass, and chemical modification on the hemostatic performance of CS hydrogels are summarized. Meanwhile, some typical applications of CS hydrogels are introduced to provide references for the preparation of efficient hemostatic hydrogels. Finally, the future perspectives of CS-based hemostatic hydrogels are presented.
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Adili, Reheman, Madeline Jackson, Livia Stanger, Xiangrong Dai, Mandy Li, Benjamin Xiaoyi Li e Michael Holinstat. "Slounase, a Batroxobin Containing Activated Factor X Effectively Enhances Hemostatic Clot Formation and Reducing Bleeding in Hypocoagulant Conditions in Mice". Clinical and Applied Thrombosis/Hemostasis 27 (1 gennaio 2021): 107602962110185. http://dx.doi.org/10.1177/10760296211018510.
Testo completoAbstract (sommario):
Uncontrolled bleeding associated with trauma and surgery is the leading cause of preventable death. Batroxobin, a snake venom-derived thrombin-like serine protease, has been shown to clot fibrinogen by cleaving fibrinopeptide A in a manner distinctly different from thrombin, even in the presence of heparin. The biochemical properties of batroxobin and its effect on coagulation have been well characterized in vitro. However, the efficacy of batroxobin on hemostatic clot formation in vivo is not well studied due to the lack of reliable in vivo hemostasis models. Here, we studied the efficacy of batroxobin and slounase, a batroxobin containing activated factor X, on hemostatic clot composition and bleeding using intravital microcopy laser ablation hemostasis models in micro and macro vessels and liver puncture hemostasis models in normal and heparin-induced hypocoagulant mice. We found that prophylactic treatment in wild-type mice with batroxobin, slounase and activated factor X significantly enhanced platelet-rich fibrin clot formation following vascular injury. In heparin-treated mice, batroxobin treatment resulted in detectable fibrin formation and a modest increase in hemostatic clot size, while activated factor X had no effect. In contrast, slounase treatment significantly enhanced both platelet recruitment and fibrin formation, forming a stable clot and shortening bleeding time and blood loss in wild-type and heparin-treated hypocoagulant mice. Our data demonstrate that, while batroxobin enhances fibrin formation, slounase was able to enhance hemostasis in normal mice and restore hemostasis in hypocoagulant conditions via the enhancement of fibrin formation and platelet activation, indicating that slounase is more effective in controlling hemorrhage.
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Hwang, Yeok Gu, Jin Woo Lee, Eun Ae Won e Seung Hwan Han. "Prospective Randomized Controlled Study of Hemostatic Efficacy with Kaolin-Impregnated Dressings in Diabetic Foot Ulcers Taking Anticoagulants Undergoing Debridement in an Outpatient Clinic". Journal of Diabetes Research 2019 (11 novembre 2019): 1–6. http://dx.doi.org/10.1155/2019/9316380.
Testo completoAbstract (sommario):
Background. The effective hemostasis after minor debridement in an outpatient clinic is important and essential. This study is aimed at evaluating the hemostatic efficacy and safety of the kaolin-impregnated dressing for diabetic foot ulcer patient who take an anticoagulant. Methods. A prospective, randomized, clinical trial study was performed in twenty-six patients with diabetic foot ulcers who take an anticoagulant requiring minor debridement in an outpatient clinic. Minor debridement and removal of break down skin were performed by one orthopedic surgeon. Hemostasis on wound bed was achieved using kaolin-impregnated gauze (study group) and standard sterilized dry gauze (control group). Two randomized groups were compared for hemostatic efficacy and side effect. Results. For the purpose of this study, the presence or absence of hemostasis was assessed at 5 and 10 minutes after the application of dressing material. Treatment was evaluated as successful if bleeding was ceased adequately, and no extra hemostatic measures were required within 10 minutes. At 5 minutes, 80% of patients using the kaolin-impregnated gauze successfully achieved complete hemostasis versus 40% in the control group that controlled bleeding partially. With kaolin-impregnated gauze, 100% of patients show complete hemostasis at 10 minutes versus 58.3% in the standard gauze (P<.001). An adverse effect was not noted in all patients. Conclusions. The use of kaolin-impregnated gauze appears to be a safe and feasible option in managing bleeding after debridement of diabetic foot ulcers, and merits to patient who had a bleeding tendency is high. This trial is registered with CRIS registration number KCT0003894.
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Matsubara, Makoto, Masataka Banshodani, Akira Takahashi, Yusuke Kawai, Tomoki Saiki, Masahiro Yamashita, Nobuaki Shiraki et al. "Vascular access management after percutaneous transluminal angioplasty using a calcium alginate sheet: a randomized controlled trial". Nephrology Dialysis Transplantation 34, n. 9 (28 maggio 2018): 1592–96. http://dx.doi.org/10.1093/ndt/gfy143.
Testo completoAbstract (sommario):
Abstract Background Management of vascular access (VA) is essential in hemodialysis (HD) patients. However, VA often fails and percutaneous transluminal angioplasty (PTA) is required. Conventional hemostasis at the puncture site is associated with complications. This study aimed to analyze the efficacy and safety of a hemostatic wound dressing made of calcium alginate at the puncture site of VA after PTA and evaluate other factors affecting hemostasis. Methods After PTA for VA, 200 HD patients were randomized to a calcium alginate sheet (CA) group (n = 100) or a no drug-eluting sheet (control) group (n = 100). We recorded time to hemostasis at the puncture site every 5 min, noting any complications. Results In the CA group, rates of hemostatic achievement at 5, 10, 15 and >15 min were 57, 25, 8 and 10%, respectively. In the control group, the rates were 39, 28, 14 and 19%, respectively. Rates of hemostatic achievement at 5 min were significantly higher in the CA group (P = 0.01). In logistic regression analysis, factors affecting hemostasis within 5 min were use of the CA sheet [odds ratio (OR) 2.33; 95% confidence interval (CI) 1.26–4.37], platelet count ≤100 000/μL (OR 0.19; 95% CI 0.04–0.69), number of antithrombotic tablets used per day ≥1 tablet (OR 0.50; 95% CI 0.26–0.94) and upper arm VA (OR 0.16; 95% CI 0.03–0.55). Conclusions A CA sheet can safely reduce time to hemostasis at the puncture site after PTA, and should be considered for treating patients with a bleeding tendency.
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Kostko, N. A., e G. M. Kostin. "THE SYSTEM OF HEMOSTASIS FOR POLICYTHEMIA AND CHRONIC MYELOLEUKOSIS". Health and Ecology Issues, n. 4 (28 dicembre 2006): 56–62. http://dx.doi.org/10.51523/2708-6011.2006-3-4-10.
Testo completoAbstract (sommario):
It has been discovered that for chronic myeloleukosis and policythemia changes of a hemostasis are typical at those stage where directly participates platelet component, namely at the final stage of a blood clot formation and at a level of a platelet hemostasis. We demonstrate: on the background of normal or increased platelets level, saved based secondary hemostasis tests, the combination of hyperfibrinolysis, decrease in a clot volume, its density and a general hemostatic parameter results in functionally defective blood clot formation, which, in its turn, testifies about hemorrhagic risk.
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Denisov, A. V., A. M. Nosov, S. Yu Telitskii e K. N. Demchenko. "Assessing effectiveness of topical hemostatic chitosan-based agents in experiments". Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, n. 3 (28 settembre 2018): 65–72. http://dx.doi.org/10.25016/2541-7487-2018-0-3-65-72.
Testo completoAbstract (sommario):
Relevance.Persistent profuse external hemorrhage is known to be one of the main causes of death in combat casualties.Intention.To evaluate experimentally the effectiveness of new chitosan-based topical hemostatic agents (THA) in various models of profuse external arterial hemorrhage.Method.New hemostatic chitosan-based agents of Hemohit type in various pharmaceutical dosage forms (Hemohit powder, 20 g per package and Hemohit-applicator [fine chitosan powder Hemohit-A or chitosan granules Hemohit-AG 6 g in the syringe-applicator]) were assessed for effectiveness in the model of profuse external arterial hemorrhage (bevelled laceration of the femoral artery) in 10 large laboratory animals (pigs). Evaluation of the THA effectiveness was performed according to the following parameters: primary hemostasis – stopping of bleeding immediately after application of the 1st THA package and application of a pressure bandage; secondary haemostasis – stopping bleeding immediately after applying the 2nd THA package and applying a pressure bandage, if the 1st THA package is ineffective; final hemostasis – no bleeding within 3 hours of follow-up; absence / resumption of bleeding after the march test; total amount of blood loss during the experiment; survival.Result and their analysis. It was experimentally found that in the case of external profuse arterial hemorrhage the powder and the syringe-applicator provided permanent hemostasis and 100 % animal survival. In two cases out of four, a second package of Hemohit powder was required for the final stop of bleeding. The bleeding stopped due to the formation of an edge thrombus in the area of the vascular wall defect.Conclusion.Hemohit THA can effectively stop arterial bleeding. The effectiveness of applicator with local hemostats can be assessed in the proposed experimental model with a deep narrow wound canal and femoral artery damage.
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de Nucci, Germana, Raffaella Reati, Ilaria Arena, Cristina Bezzio, Massimo Devani, Cristina della Corte, Daniela Morganti et al. "Efficacy of a novel self-assembling peptide hemostatic gel as rescue therapy for refractory acute gastrointestinal bleeding". Endoscopy 52, n. 09 (21 aprile 2020): 773–79. http://dx.doi.org/10.1055/a-1145-3412.
Testo completoAbstract (sommario):
Abstract Background Acute gastrointestinal bleeding (AGIB) results in significant morbidity and mortality. Topical hemostatic products have been developed for endoscopic use to help in the management of difficult bleeding. Our aim was to demonstrate the ease of use, safety, and efficacy of PuraStat, a novel hemostat, to control AGIB. Methods We describe 77 patients (41 men) who were treated for acute upper and lower AGIB in a 2-year period. In 50 patients, bleeding occurred as a complication of a previous endoscopic procedure, predominantly endoscopic mucosal resection (EMR) and endoscopic retrograde cholangiopancreatography (ERCP); however, in the other 27 patients, it derived from peptic ulcers, angiodysplasia, cancers, and surgical anastomoses. Bleeding was spurting in 13 of the 77 patients and oozing in 64. PuraStat was used after the failure of at least two conventional hemostatic methods. Results A mean of 2.6 conventional hemostatic methods had been attempted prior to the application of PuraStat. PuraStat achieved successful hemostasis in 90.9 % of patients. In 41 patients, once hemostasis was obtained with PuraStat, endoscopists further stabilized hemostasis by using at least one additional method. Recurrence of bleeding was observed in eight patients (10.4 %). In 16 patients with intraprocedural bleeding, it was possible to complete the procedures (14 EMR, 2 ERCP) after PuraStat hemostasis. No adverse events related to PuraStat were recorded. Conclusions PuraStat is feasible, safe, and effective in controlling different types of gastrointestinal hemorrhage after failure of conventional hemostatic methods. Its application also does not hinder continuing endotherapy.
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Roberts, Lara N. "Rebalanced hemostasis in liver disease: a misunderstood coagulopathy". Hematology 2021, n. 1 (10 dicembre 2021): 485–91. http://dx.doi.org/10.1182/hematology.2021000283.
Testo completoAbstract (sommario):
Abstract The combination of frequently abnormal hemostatic markers and catastrophic bleeding as seen with variceal hemorrhage has contributed to the longstanding misperception that chronic liver disease (CLD) constitutes a bleeding diathesis. Laboratory studies of hemostasis in liver disease consistently challenge this with global coagulation assays incorporating activation of the protein C pathway demonstrating rebalanced hemostasis. It is now recognized that bleeding in CLD is predominantly secondary to portal hypertension (rather than a coagulopathy) and additionally that these patients are at increased risk of venous thrombosis, particularly in the portal venous system. This narrative review describes the current understanding of hemostasis in liver disease, as well as the periprocedural management of hemostasis and anticoagulation for management of venous thromboembolism in patients with CLD.
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Clapp, Mara, e Jaou-Chen Huang. "Use of FloSeal Sealant in the Surgical Management of Tubal Ectopic Pregnancy". Case Reports in Obstetrics and Gynecology 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/906825.
Testo completoAbstract (sommario):
Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue.Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy.Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.
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Hu, Zhang, Dong-Ying Zhang, Si-Tong Lu, Pu-Wang Li e Si-Dong Li. "Chitosan-Based Composite Materials for Prospective Hemostatic Applications". Marine Drugs 16, n. 8 (4 agosto 2018): 273. http://dx.doi.org/10.3390/md16080273.
Testo completoAbstract (sommario):
Effective hemostasis is vital to reduce the pain and mortality of patients, and the research and development of hemostatic materials are prerequisite for effective hemostasis. Chitosan (CS), with good biodegradability, biocompatibility and non-toxicity, has been widely applied in bio-medicine, the chemical industry, the food industry and cosmetics. The excellent hemostatic properties of CS have been extensively studied. As a result, chitosan-based composite hemostatic materials have been emerging. In this review, the hemostatic mechanism of chitosan is briefly discussed, and then the progress of research on chitosan-based composite hemostatic materials with multiple forms such as films, sponges, hydrogels, particles and fibers are introduced. Finally, future perspectives of chitosan-based composite hemostatic materials are given. The objective of this review is to provide a reference for further research and development of effective hemostatic materials.