Impact of stress on hemostasis: A review

Salukhov, Vladimir V.; Kharitonov, Mikhail A.; Varavin, Nikita A.; Krasovskaya, Alisa S.; Santakov, Alexander A.

doi:10.26442/20751753.2023.2.202183

Consilium Medicum

2023

DOI: 10.26442/20751753.2023.2.202183

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Impact of stress on hemostasis: A review

Vladimir V. Salukhov,

Mikhail A. Kharitonov,

Nikita A. Varavin

et al.

Abstract: The article presents an overview of current views of changes in the hemostasis system in response to stress. Stress-induced neurohormonal responses activate the clotting system and inhibit the fibrinolysis system, leading to hypercoagulation. An evolutionary interpretation of such responses is that hypercoagulation under stress protects a healthy body from excessive bleeding in case of trauma in fight-or-flight situations. Acute psychological stress can cause significant hemoconcentration and prothrombotic cha… Show more

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2024

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Cited by 3 publications

References 27 publications

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Risk Factors of Deep Vein Thrombosis in Combat Gunshot Injury

Salukhov,

Gavrilov,

Varavin

et al. 2024

J. Ven. Disord.

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Risk Factors of Deep Vein Thrombosis in Combat Gunshot Injury

Salukhov,

Gavrilov,

Varavin

et al. 2024

J. Ven. Disord.

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Personalized Anticoagulation of Distal Deep Vein Thrombosis After Combat Gunshot Injury

Varavin,

Kryukov,

Salukhov

et al. 2024

J. Ven. Disord.

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Comparison of thrombodynamic tests with determination of anti-Xa activity in evaluation of the efficacy of anticoagulant therapy in patients suffering deep vein thrombosis of the lower extremities

Salukhov,

Kryukov,

Varavin

et al. 2024

Bulletin of the Russian Military Medical Academy

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Deep vein thrombosis of the lower extremities remains an important medical and social problem in practical medicine. Currently, a weight-dependent low-molecular-weight heparin dosing approach is used to treat deep vein thrombosis of the lower extremities in wounded patients without regard to the state of the hemostasis system. This observational study included 30 patients with deep vein thrombosis of the lower extremities who were hospitalized for examination and treatment at the Kirov Military Medical Academy. During treatment with enoxaparin sodium at therapeutic doses, depending on body weight, the parameters of the thrombodynamics test were assessed in all patients, and antiXa activity was determined at the peak of the drug (after 3–4 h) and at the end (before the next injection) of its action. A strong inverse correlation was established between the growth rate indicator of the thrombodynamics test clot and antiXa activity at the peak (–0.777; p 0.05) and at the end (–0.715; p 0.05) of the action of sodium enoxaparin. The standard dose of anticoagulant drug, depending on body weight, revealed that 30% of patients were in the hypercoagulation zone, not reaching the target values of the thrombodynamic clot growth rate and anti-Xa activity. The thrombodynamics test results identified the growth rate of the test clot with antiXa activity, which allows both methods to be considered comparable for laboratory monitoring low-molecular-weight heparin therapy in wounded individuals. The insufficient anticoagulant effect in one-third of the injured individuals that received the standard and therapeutic doses of low-molecular-weight heparins requires the development of a personalized approach to titration of low-molecular-weight heparins, which may be based not on the concentration of the drug per body weight but on the achieved anticoagulant effect that optimizes the treatment outcomes and patient prognosis. Accordingly, further research is required.

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Impact of stress on hemostasis: A review

Cited by 3 publications

References 27 publications

Risk Factors of Deep Vein Thrombosis in Combat Gunshot Injury

Risk Factors of Deep Vein Thrombosis in Combat Gunshot Injury

Personalized Anticoagulation of Distal Deep Vein Thrombosis After Combat Gunshot Injury

Comparison of thrombodynamic tests with determination of anti-Xa activity in evaluation of the efficacy of anticoagulant therapy in patients suffering deep vein thrombosis of the lower extremities

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