Thrombin Vs. Plasmin generation in disseminated lntravascular coagulation associated with various underlying disorders

Takahashi, Hiroyuki; Tatewaki, Wataru; Wada, Ken; Hanano, Manabu; Shibata, Akira

doi:10.1002/ajh.2830330204

Cited by 98 publications

(50 citation statements)

References 21 publications

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“…Increased TAT or PAP levels could be regarded as sufficient biochemical evidence of DIC, although raised TAT or PAP levels alone do not necessarily reflect increased fibrin formation or clot lysis [8,10,11]. One could assume that thrombin or plasmin are neutralized by their inhibitors as soon as they are generated, thus leaving no free thrombin or plasmin to interact with their substrates.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, the severity of DIC is variable resulting in a great variety of hemostatic abnormalities which are also changeable in the same patient from time to time. TAT (thrombin + ATIII complex) and PAP (plasmin + a 2 -antiplasmin) values have recently been used as indicators of coagulation and fibrinolytic system activation respectively, and have been also considered as an early biochemical evidence of DIC [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Indications of Coagulation and/or Fibrinolytic System Activation in Healthy and Sick Very-Low-Birth-Weight Neonates

et al. 1998

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A combined hemostatic defect consisting of a reduction in certain procoagulants, anticoagulants (antithrombin III-ATIII-, protein C-PC-) and components of the fibrinolytic system (plasminogen-Plg-) was demonstrated in very-low-birth-weight infants (VLBW <1,500 g) with gestational age 26–32 weeks. Sixteen of them were healthy, 28 were suffering from RDS and 24 from septicemia. The hemostatic defect was more profound in the RDS group, nevertheless increased TAT (thrombin + ATIII complex) and/or PAP values (plasmin + a₂-antiplasmin complex) was a more frequent finding in the septicemic group of infants (91.8 vs. 17.9%). Moderate-to-severe thrombocytopenia was detected in a higher percentage in the septicemic (70.8%) than in the RDS group (50%), and increased D-dimers were demonstrated in 34.8 and 28.6% of the infants, respectively. Elevated TAT or PAP values were not always associated with gross coagulation abnormalities, and advanced disseminated intravascular coagulation (DIC) was only documented in 16.7% of the septicemic and 7.1% of the RDS infants. None of the VLBW neonates presented with clinical evidence of thrombosis, although hemorrhagic manifestations were apparent in 34.8 and 14.3% of the neonates with septicemia or RDS, respectively, mainly due to DIC or severe thrombocytopenia. In conclusion, increased TAT and/or PAP values are good indicators of the in vivo activation of the hemostatic system, but still their impact on sick neonates morbidity and mortality remains unknown.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Indications of Coagulation and/or Fibrinolytic System Activation in Healthy and Sick Very-Low-Birth-Weight Neonates

et al. 1998

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“…TATs were significantly elevated in the treatment groups relative to the control group. Despite the fact that elevation of TATs has been associated with thrombogenic situations and disseminated intravascular coagulation, 22 " 24 the absence of decreased platelet counts and fibrinogen levels in the treatment groups provides strong evidence that rFVIIa did not induce any systemic activation of the coagulation system or disseminated intravascular coagulation. The data suggest that rFVIIa resulted in enhanced thrombin formation only at the site of injury.…”

Section: Discussionmentioning

confidence: 96%

The Effect of Recombinant Factor VIIa and Fibrinogen on Bleeding from Grade V Liver Injuries in Coagulopathic Swine

Brundage¹,

Schreiber²

2003

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of Information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Washington Headquarters Services, Directorate FUNDING NUMBERSDAMD17-01-1-0693 PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)Baylor College of Medicine Houston, Texas 77030 E-Mail: bcochran@bcm.tmc.edu PERFORMING ORGANIZATION REPORT NUMBER SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES)U 12b. DISTRIBUTION CODEObjectives: Recombinant factor Vila (rFVIIa) has been used to decrease bleeding in a number of settings including hemophilia, liver transplantation, intractable bleeding and cirrhosis. This study was performed to determine if rFVIIa would reduce bleeding after a grade V liver injury in hypothermic, dilutionally coagulopathic pigs when used as an adjunct to abdominal packing and to determine the optimal dose of the drug. Methods: Thirty animals were randomized to receive 180 ng/kg of rFVIIa, 720 ng/kg of rFVIIa or control. After laparotomy and splenectomy animals underwent a 60% of blood volume isovolemic exchange transfusion with 5% human albumin. The animals' temperature was maintained at 33°C and a grade V liver injury was made with a clamp. Thirty seconds after injury the abdomen was packed with laparotomy sponges, resuscitation was initiated and blinded therapy was given. Animals were resuscitated to their baseline mean arterial pressure (MAP) and the study was continued for 2 hours. Serial coagulation parameters were measured at the temperature they were drawn. Following the study period, surviving animals were euthanized, post-treatment blood loss was measured and an autopsy was performed. Results: Ten animals were randomized to each group. Following administration of study drug, the mean prothrombin time (PT) was shorter in the treatment groups than in the control group. MAP was lower in the control group than the treatment groups throughout the study, (p<0.01). Mean blood loss was significantly less in the treatment groups than the control group. Mortality was not different between groups. There were no differences between the groups that received rFVIIa in any measured parameters. Conclusions: rFVIIa reduces blood loss in hypothermic, dilutionally coagulopathic pigs with grade V injuries when used as an adjunct to packing. Increasing the dose does not enhance the hemostatic effect.14. SUBJECT TERMS wounds, liver, recombinant factor Vila, fibrinogen, hemorrhage, swine, hypothermia, coagulopathy INTRODUCTION:The majority of deaths following combat are secondary to hemorrhage. The goal of this research is to elucidate new methods of hemorrhage control that can be applied to the injured soldier in the field and hospital. This proposal was designed to determine t...

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“…Two procoagulants produced by cancer have been considered: (a) tissue factor which, in the presence of calcium ions, transforms factor VII into an active form (VIIa) which, in turn, transforms factor X into Xa, and (b) cysteine proteinase which directly transforms factor X into Xa [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Transient Increase in Thrombin Generation during Radiotherapy of Uterine Carcinoma: A Preliminary Study using Thrombin-Antithrombin III Complex Measurements

Uszyński¹,

Żekanowska

1998

Gynecol Obstet Invest

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The question of the study was whether irradiation therapy applied to women with cervical or endometrial carcinoma leads to increased thrombin generation. The study group consisted of 42 women with cervical carcinoma (22 cases) and endometrial carcinoma (20 cases). Irradiation (brachytherapy or/and teletherapy) was applied as follows: 200 cGy/day, 5 days a week, therapeutic dose of 4,500–5,000 cGy. Complexes of thrombin-antithrombin III in blood plasma were measured (ELISA method) before radiotherapy and 4–5 times during therapy. A transient increase in thrombin generation was noticed in 16 of 42 patients: the median value of all ‘peaks’ was 19.25 (range 3.20–30.00 µg/l) in cases of cervical carcinoma, and 14.50 (range 5.25–27.75 µg/l) in cases of endometrial carcinoma. It was concluded that therapeutic doses of ionic energy cause only a transient increase in thrombin generation.

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Thrombin Vs. Plasmin generation in disseminated lntravascular coagulation associated with various underlying disorders

Cited by 98 publications

References 21 publications

Indications of Coagulation and/or Fibrinolytic System Activation in Healthy and Sick Very-Low-Birth-Weight Neonates

Indications of Coagulation and/or Fibrinolytic System Activation in Healthy and Sick Very-Low-Birth-Weight Neonates

The Effect of Recombinant Factor VIIa and Fibrinogen on Bleeding from Grade V Liver Injuries in Coagulopathic Swine

Transient Increase in Thrombin Generation during Radiotherapy of Uterine Carcinoma: A Preliminary Study using Thrombin-Antithrombin III Complex Measurements

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