PLATELET INTEGRIN INHIBITION WITH c7E3 ENHANCES THE CORRELATION BETWEEN PLATELET AGGREGROMETRY AND THROMBOELASTOGRAPHIC (TEG) MA VALUES

McCarthy, R. J.; Pharm, D; Kj, Tuman; Chen, B; Ivankovich,

doi:10.1097/00000539-199802001-00217

Cited by 3 publications

(2 citation statements)

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“…These include thrombin generation time, sonorheometry and thromboelastography. Thromboelastography was found to reduce transfusion requirements in liver transplants by effectively identifying the need for platelets or clotting factors [58]. Studies have shown that draining ascites in patients with an international normalized ratio as high as 8.7 and a low platelet count was not associated with a significant risk for bleeding [32,59,60].…”

Section: Bleeding Prophylaxis In Patients With Ascitesmentioning

confidence: 99%

The clinical management of abdominal ascites, spontaneous bacterial peritonitis and hepatorenal syndrome

Pericleous

Sarnowski

Moore

et al. 2016

European Journal of Gastroenterology & Hepatology

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Several pathogenic processes have been implicated in the development of abdominal ascites. Portal hypertension, most usually in the context of liver cirrhosis, can explain about 75% of the cases, whereas infective, inflammatory and infiltrative aetiologies can account for the rest. In this article, we discuss the consensus best practice as published by three professional bodies for the management of ascites, spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS). The aim of this study was to compare available clinical guidelines and identify areas of agreement and conflict. We carried out a review of the guidance documentation published by three expert bodies including the British Society of Gastroenterology, the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD), as well as a wider literature search for ascites, SBP and HRS. Abdominal ultrasonography, diagnostic paracentesis and ascitic fluid cultures are recommended by all three guidelines, especially when there is strong clinical suspicion for infection. EASL and AASLD advocate the use of ascitic amylase and mycobacterial cultures/PCR when there is strong suspicion for tuberculosis and pancreatitis, respectively. Ascitic cytology can be useful when cancer is suspected and has a good diagnostic yield if performed correctly. EASL supports the use of urinary electrolytes for all patients; however, the British Society of Gastroenterology and AASLD only recommend their use for therapy monitoring. All three societies recommend cefotaxime as the antibiotic of choice for SBP and large-volume paracentesis for the management of ascites greater than 5 l in volume. For HRS, cautious diuresis, volume expansion with albumin and the use of vasoactive drugs are recommended. There appears to be good concordance between recommendations by the European, American and British guidelines for the management of ascites and the possible complications arising from it.

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Section: Bleeding Prophylaxis In Patients With Ascitesmentioning

confidence: 99%

The clinical management of abdominal ascites, spontaneous bacterial peritonitis and hepatorenal syndrome

Pericleous

Sarnowski

Moore

et al. 2016

European Journal of Gastroenterology & Hepatology

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“…Also during the reperfusion stage, supplementation of coagulation factors is still crucial, as the newly trans-planted liver resumes its synthetic capabilities [2,5]. Ultimately, the benefit of TEG in liver transplant is clear: it has been shown to reduce transfuse requirements, even in this population in which transfusion is a mainstay of intraoperative therapy, by quantifying the exact need of platelets and coagulation factors [6].…”

Section: Liver Transplantationmentioning

confidence: 99%

Thromboelastography: Current Applications, Future Directions

Trapani

2013

OJAnes

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Analyzing coagulability often hinges on patient surveillance using prothrombin time (PT) or international normalized ratio (INR) and activated partial thromboplastin time (aPTT) to monitor the extrinsic and intrinsic coagulation pathways, respectively A more complete assessment, however, can often be obtained using thromboelastography (TEG), a coagulation assay that evaluates the efficiency of clot formation, as well as the viscoelastic properties of the clot. Developed by Dr. Helmut Hartert in 1948 at the UniversityofHeidelberg, it provides information regarding hemostasis as a dynamic process [1,2]. Here, the TEG technique will be described, as well as its current applications and future directions for its use.

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Thrombelastography: Current clinical applications and its potential role in interventional cardiology

Hobson¹,

Agarwala²,

Swallow³

et al. 2006

Platelets

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Thrombelastography is a bedside blood test used to assess patients' haemostatic status. It has a well-established role in hepatobiliary and cardiac surgery and is also used in obstetrics and trauma medicine to assess coagulation and identify the causes of post-operative bleeding. It is not routinely used in the diagnosis or treatment of thrombosis although recently it has been shown to predict thrombotic events post-operatively and after percutaneous intervention (PCI). In cardiovascular medicine the importance of the platelet in the pathophysiology of vascular events is increasingly apparent. As a result antiplatelet therapy is a cornerstone of the treatment for coronary disease, particularly in the setting of acute coronary syndromes. The increasing utilization of stents, particularly drug-eluting devices, in PCI has also necessitated widespread use of antiplatelet agents to minimize the risk of stent thrombosis. A quick, accurate and reliable test to measure the effect of platelet inhibition by antiplatelet agents on clotting in an individual patient would be of profound clinical value. The results from such a test could provide prognostic information, allow treatment with antiplatelet agents to be tailored to the individual and identify resistance to one or more of these agents. Optimization and tailoring of anti-platelet therapy in patients with cardiovascular disease, particularly those undergoing PCI, using such a test may reduce morbidity and mortality from thrombotic and haemorrhagic complications. Current methods of assessing platelet activity measure platelet count and function in isolation. Optical aggregation is the most widely used method for assessing platelet function but it is relatively time consuming, measures platelet function in isolation rather than in the context of clot formation and is not a bedside test. By contrast the modified thrombelastograph platelet mapping kit marketed by Haemoscope can be used to assess the effects of antiplatelet agents on ex vivo blood clotting, thus giving a measurement more relevant to in vivo responses. This represents a potentially powerful tool to assess response of individual patients to antiplatelet therapy, particularly in the context of PCI.

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PLATELET INTEGRIN INHIBITION WITH c7E3 ENHANCES THE CORRELATION BETWEEN PLATELET AGGREGROMETRY AND THROMBOELASTOGRAPHIC (TEG) MA VALUES

Cited by 3 publications

References 0 publications

The clinical management of abdominal ascites, spontaneous bacterial peritonitis and hepatorenal syndrome

The clinical management of abdominal ascites, spontaneous bacterial peritonitis and hepatorenal syndrome

Thromboelastography: Current Applications, Future Directions

Thrombelastography: Current clinical applications and its potential role in interventional cardiology

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