We evaluated coagulation abnormalities via traditional tests and rotational thromboelastometry (ROTEM) in a group of 94 patients with confirmed SARS-CoV-2 infection and different severity of pneumonia (34 moderate, 25 severe, 35 critical) with the hypothesis that ROTEM parameters differed by coronavirus disease 2019 (COVID-19) severity. Shorter than normal clotting time (CT) and higher than normal maximum clot firmness (MCF) in extrinsic rotational thromboelastometry (EXTEM) and fibrinogen rotational thromboelastometry (FIBTEM), shorter than normal EXTEM clot formation time (CFT), and higher than normal α-angle were classified as markers of hypercoagulable state. Increment in the number of patients with ≥2 hypercoagulable parameters, higher EXTEM (P = .0001), FIBTEM MCF (P = .0001) and maximum lysis decrement (P = .002) with increment in disease severity was observed (P = .0001). Significant positive correlations between IL6 and CT EXTEM (P = .003), MCF EXTEM (P = .033), MCF FIBTEM (P = .01), and negative with ML EXTEM (P = .006) were seen. Our findings based on analysis of different disease severity groups confirmed that a hypercoagulable ROTEM pattern characterized by clot formation acceleration, high clot strength, and reduced fibrinolysis was more frequent in advanced disease groups and patients with high IL6. These results supported the need for different thromboprophylaxis approaches for different severity groups.
This case report shows primary hyperfibrinolysis with bleeding symptoms, which is an uncommon paraneoplastic phenomenon within expanded prostate malignancy. Rotation thrombelastometry in this severe complication helped to achieve the prompt and proper diagnosis and treatment.
ApstraktDobrovoljno davalaštvo (DDK) je jedini način za obezbeđivanje kontinuirane zalihe ovog jedinstvenog leka. Stoga je neophodno motivisati i informisati stanovištvo o pozitivnim efektima donatorstva krvi, a u cilju da se regrutuju novi i zadržavanja postojećih DDK.Cilj ovog rada bio je ispitivanje načina informisanosti, motiva i prepreka za dobrovoljno davanje krvi, kao i razloga za ponovno davalaštvo.Ispitivanje je obuhvatilo 65 DDK koji su popunjavali upitnik u Službi za transfuziju krvi KBC Zemun-Beograd. Pitanja su se odnosila na strukturne podatke (pol, starosna dob, obrazovanje), znanje i informisanost o davalaštvu, kao i na motaviciju i prepreke u vezi budućeg dobrovoljnog davanja krvi. Statistička obrada je obuhvatila standardne metode deskriptivne statistike kao i grafičke prikaze.Dobijeni rezultati su pokazali da je većina ispitanika za dobrovoljno davanje krvi saznalo od porodice i prijatelja (40.6%). Namensko davanje krvi je u većini slučajeva (33.8%) bio prvi kontakt sa davalaštvom. Čak 66.5% DDK se tokom procedure davanja krvi oseća odlično, međutim 7.7% kao prepreku u davanju krvi bira ubod igle. Njih 73.9% se odlučilo da će nastaviti redovno da daruje krv, a kao glavni razlog su uglavnom navodili altruizam (33.8%). Među onima koji bi krv darovali možda povremeno (26.1%), glavni motiv je bio slučaj da krv zatreba nekome iz bliskog okruženja (12.3%).Na osnovnu ispitivanja, može se reći da je u našoj lokalnoj zajednici dobrovoljno davalaštvo krvi zasnovano na altruizmu. Ipak, u cilju okupljanja većeg broja potencijalnih DDK i zarad zadržavanja postojećih, neophodna je stalna motivacija i promocija davalaštva kao jedinstvne karike zdravstvenog sistema u koje je uključeno celokupno stanovništvo.Ključne reči: dobrovoljni davalac krvi, motivacija, informisanost, altruizam. Blood collection and motivation in local community AbstractVoluntary blood donation is the only source of continous blood supply. That is why motivation and informing about positive effects of donating is of key importance in order to recruit and keep existing donors.The study was performed in Department of blood Transfusion, Clinical Hospital Center Zemun-Belgrade, where questionnaire was given to 65 volontary blood donors. The questionnaire comprised structural questions (sex, age, education), questions about previous knowladge and information, as well as motivation and obstacles for donating blood. Descriptive analyses and grafics were used for analizing and presentig results.Collected data showed that the majority of respondents got information about donating from family and friends (40.6%). Dedicated donation was the most common first contact with donating (33.8%). Although, 66.5% of respondents were feeling excelent during the procedure of blood donation, 7.7% of them choose needle as the most common obstacle. 73.9% declared that are willing to continue with regular donating and alturism was the most quoted motiv (33.8%). Among those who would donate blood periodically (26.1%), the most common motiv was if family or friend...
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