Activation of FXII during haemodialysis

Svensson, Maria; Friberger, P.; Lundström, Ola; Stegmayr, Bernd

doi:10.3109/00365519609090600

Cited by 24 publications

(22 citation statements)

References 6 publications

(1 reference statement)

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“…The continuous hemotherapies may be difficult to perform because of the increased bleeding risk induced by parallel anticoagulation (48). The blood-membrane interaction by itself activates the complement (49,50) and coagulation systems (51). Because continuous renal replacement therapy has not been proven to be more beneficial (52,53), intermittent daily dialysis or, especially if there is low blood pressure or congestive heart failure present, the use of peritoneal dialysis may be an alternative (20).…”

Section: Discussionmentioning

confidence: 99%

Plasma exchange as rescue therapy in multiple organ failure including acute renal failure*

Stegmayr

Berggren

et al. 2003

Critical Care Medicine

105

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Section: Discussionmentioning

confidence: 99%

Plasma exchange as rescue therapy in multiple organ failure including acute renal failure*

Stegmayr

Berggren

et al. 2003

Critical Care Medicine

105

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“…Subsequently, it is possible that this could contribute to the increased extent of lung fibrosis in dialysis patients due to secondary effect of the microemboli. During dialysis, the platelets (15) as well as the coagulation system measured by factor XIIa (16) are activated. Besides blood membrane interaction, however, the presence of air in the blood in addition will enhance the development of blood clots by activation of the coagulation system (17).…”

Section: Discussionmentioning

confidence: 99%

Air Bubbles Pass the Security System of the Dialysis Device Without Alarming

Jönsson¹,

Karlsson²,

Forsberg

et al. 2007

Artificial Organs

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During hemodialysis microembolic findings have been noted after the venous chamber (subclavian vein). The aim of this study was to evaluate if air could pass the venous chamber and, if so, if it passes the safety-system detector for air-infusion without triggering an alarm. Various in vitro dialysis settings were performed using regular dialysis devices. A dextran fluid was used instead of blood to avoid the risk of development of emboli. Optical visualization as well as recirculation and collection of eventual air into an intermediate bag were investigated. In addition, a specifically designed ultrasound monitor was placed after the venous air trap to measure the presence of eventual microbubbles. Speed of dialysis fluid was changed, as was the level of the fluid in the air trap. Thereby a fluid level was considered "high" if it was close to the top of the air trap and "low" if it was around the mid part of the air trap. By optical vision microbubbles were seen at the bottom of the air trap and could pass the air trap towards the venous line without alarming. During recirculation several mL of air were collected in an intermediate bag after the venous line. Ultrasound monitoring exhibited the presence of microbubbles of the size of approximately 5 microm upwards passing to the venous line in all runs performed. Amount of bubbles differed between devices and in general an increased fluid speed correlated significantly with the increased counts of microbubbles/min. No alarming of the detector occurred. A more concentrated fluid allowed higher counts/min when flow was increased to 600 mL/min. Data revealed that air passes the safety-sensor in the air trap without alarming. The presence of air increased in general with fluid speed and a lower fluid level in the air trap. Differences were present between devices. If this affects the patients has to be elucidated.

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“…Some recent studies indicate that the intrinsic pathway may play a role during in thrombosis in vivo via a heretofore-unknown mechanism [4, 5]. Elevated levels of activated enzymes of the intrinsic pathway from blood-biomaterial contact associated with the use of cardiopulmonary bypass-oxygenators, haemodialysis membranes and left-ventricular-assist-devices underscore the significance of this pathway with the use of such medical devices [6–9]. …”

Section: Introductionmentioning

confidence: 99%

Moderation of prekallkrein–factor XII interactions in surface activation of coagulation by protein-adsorption competition

et al. 2009

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Traditional biochemistry of contact activation of blood coagulation suggesting that anionic hydrophilic surfaces are specific activators of the cascade is inconsistent with known trends in protein adsorption. To investigate contact activation reactions, a chromogenic assay was used to measure prekallikrein (PK) hydrolysis to kallikrein (Kal) by activated factor XII (FXIIa) at test hydrophilic (clean glass) and hydrophobic (silanized glass) surfaces in the presence of bovine serum albumin (BSA). Hydrolysis of PK by FXIIa is detected after contact of the zymogen FXII with a test hydrophobic surface only if putatively-adsorbed FXIIa is competitively displaced by BSA. By contrast, FXIIa activity is detected spontaneously following FXII activation by a hydrophilic surface and requires no adsorption displacement. These results (i) show that an anionic hydrophilic surface is not a necessary cofactor for FXIIa-mediated hydrolysis of PK, (ii) indicate that PK hydrolysis does not need to occur by an activation complex assembled directly on an anionic, activating surface, (iii) confirms that contact activation of FXII (autoactivation) is not specific to anionic hydrophilic surfaces, and (iv) demonstrates that protein-adsorption competition is an essential feature that must be included in any comprehensive mechanism of surface-induced blood coagulation.

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Activation of FXII during haemodialysis

Cited by 24 publications

References 6 publications

Plasma exchange as rescue therapy in multiple organ failure including acute renal failure*

Plasma exchange as rescue therapy in multiple organ failure including acute renal failure*

Air Bubbles Pass the Security System of the Dialysis Device Without Alarming

Moderation of prekallkrein–factor XII interactions in surface activation of coagulation by protein-adsorption competition

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