Practical management of anticoagulation, bleeding and blood product support for cardiac surgery Part one: Bleeding and anticoagulation issues

Robinson, Kathryn; Marasco, Silvana; Street, Alison

doi:10.1046/j.1444-2892.2001.00096.x

Cited by 9 publications

(6 citation statements)

References 65 publications

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“…For example, latency and activation of transforming growth factor-β1 (TGFβ1) is orchestrated by binding to the fibrillin protein family member latent TGFβ1 binding protein-1 (LTBP-1), decorin or thrombospondin-1 9 - 11 . Vascular endothelial growth factor (VEGF) also binds to heparin or proteoglycans, and release of VEGF by plasmin or heparanase triggers endothelial cell proliferation 12 . The importance of maintaining ECM homeostasis becomes evident during aging when ECM synthesis and degradation get out of balance.…”

Section: The Stroma Of Normal Organsmentioning

confidence: 99%

The role of the myofibroblast in tumor stroma remodeling

Otranto

Sarrazy

Bonté

et al. 2012

Cell Adhesion & Migration

218

200

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Since its first description in wound granulation tissue, the myofibroblast has been recognized to be a key actor in the epithelial-mesenchymal cross-talk that plays a crucial role in many physiological and pathological situations, such as regulation of prostate development, ventilation-perfusion in lung alveoli or organ fibrosis. The presence of myofibroblasts in the stroma reaction to epithelial tumors is well established and many data are accumulating which suggest that the stroma compartment is an active participant in tumor onset and/or evolution. In this review we summarize the evidence in favor of this concept, the main mechanisms that regulate myofibroblast differentiation and function, as well as the biophysical and biochemical factors possibly involved in epithelial-stroma interactions, using liver carcinoma as main model, in view of achieving a better understanding of tumor progression mechanisms and of tools directed toward stroma as eventual therapeutic target.

show abstract

Section: The Stroma Of Normal Organsmentioning

confidence: 99%

The role of the myofibroblast in tumor stroma remodeling

Otranto

Sarrazy

Bonté

et al. 2012

Cell Adhesion & Migration

218

200

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show abstract

“…Corticosteroids have been recommended to attenuate inflammatory response during cardiac surgery in order to decrease the proinflammatory to antiinflammatory interleukin ratio (14)(15)(16)(17)(18)(19). In this way, some clinical benefits of methylprednisolone as an inflammatory agent during CPB have been reported previously (20), although there is always concern about the potential adverse effects, such as vein graft occlusion and ischemic events with methylprednisolone (4). There is some evidence in favor of interaction between inflammatory and coagulation systems, supported by the hemostatic derangement observed in severe inflammation (2,12).…”

Section: Introductionmentioning

confidence: 99%

“…Coronary surgery with cardiopulmonary bypass (CPB) is the most common heart surgery in the world and it is almost always associated with acquired hemostatic disturbance that induces postoperative bleeding (1)(2)(3)(4)(5). Excessive bleeding and high usage of blood products after CPB are among the most important complications of cardiac surgery (6)(7)(8) in association with economic consequences.…”

Section: Introductionmentioning

confidence: 99%

The effect of methylprednisolone treatment on fibrinolysis, thecoagulation system, and blood loss in cardiac surgery

Ebrahimi¹,

Kheirandish²,

Foroughi³

2016

Turk J Med Sci

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Background/aim: The purpose of this study was to examine steroid pretreatment in order to decrease postoperative coagulopathy disorders and bleeding. Materials and methods:In this randomized double-blinded study, the efficacy of low versus high doses of methylprednisolone on the coagulation system and postoperative bleeding was compared in patients who were undergoing cardiac surgery with cardiopulmonary bypass (CPB). The platelet response to agonists, D-dimer concentration, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) antigens, and platelet receptors CD42b, CD62P, and CD41a were evaluated. Results:The platelet response to agonists was reduced. The mean concentrations of D-dimer and tPA antigen increased although PAI-1 concentration did not show any significant changes following heparin neutralization. Postoperative expression of CD42b showed no changes in comparison with preoperation values in both groups. There was a significant increase in the expression of CD62P with a methylprednisolone dose of 15 mg/kg, while there was just a slight increase with a dose of 5 mg/kg. CD41a, as a fibrinogen receptor, was increased significantly after CPB in both groups. Significant data were shown in decreasing blood loss with a high dose of methylprednisolone. Conclusion:Methylprednisolone at a dose of 15 mg/kg reduced bleeding, probably by increasing CD62P after heparin neutralization, which can activate platelet activation in favor of better hemostasis.

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“…In a timely review, Robinson and her coauthors have provided a valuable overview for all involved in cardiac surgery. They have summarised the current state of knowledge regarding the aetiology of bleeding and the acquired aspects of anticoagulation disorders and transfusion medicine 1,2 …”

mentioning

confidence: 99%

“…They have summarised the current state of knowledge regarding the aetiology of bleeding and the acquired aspects of anticoagulation disorders and transfusion medicine. 1,2 Predicting which patients are at increased risk of bleeding is notoriously difficult. Sophisticated testing such as platelet aggregometry has been shown to have some predictive value.…”

mentioning

confidence: 99%

Anticoagulation and transfusion management in cardiac surgery

Bidstrup

2002

Heart, Lung and Circulation

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Practical management of anticoagulation, bleeding and blood product support for cardiac surgery Part one: Bleeding and anticoagulation issues

Cited by 9 publications

References 65 publications

The role of the myofibroblast in tumor stroma remodeling

The role of the myofibroblast in tumor stroma remodeling

The effect of methylprednisolone treatment on fibrinolysis, thecoagulation system, and blood loss in cardiac surgery

Anticoagulation and transfusion management in cardiac surgery

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