Article
Anesthesiology
Justyna Bartoszko, Jeannie Callum, Keyvan Karkouti
Summary: In patients with post-cardiopulmonary bypass bleeding, the use of PCC was associated with lower transfusion of RBC and platelets compared to FP. Prospective, randomized clinical trials comparing FP with PCC in this setting are needed to confirm these findings.
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2021)
Article
Medicine, General & Internal
Kirsty Marshall, Eileen Merriman, Merit Hanna, Henry Chan
Summary: This audit reviewed the clinical and laboratory outcomes of patients treated with fixed-dose PCC for warfarin reversal, with the primary objective being to evaluate post-reversal INR. Secondary objectives included the proportion of patients requiring repeat PCC and 30-day complication rates. Subgroup analysis showed no significant differences in outcomes between reduced-dose and standard-dose subgroups.
INTERNAL MEDICINE JOURNAL
(2021)
Review
Medicine, General & Internal
Giovanni Punzo, Valeria Di Franco, Valter Perilli, Teresa Sacco, Liliana Sollazzi, Paola Aceto
Summary: The risk/benefit ratio of using prothrombin complex concentrates (PCCs) to correct coagulation defects in patients with end-stage liver disease is still unclear. This systematic review found that PCC use did not affect blood product transfusions during liver transplantation. Preliminary evidence suggests a lack of efficacy in reducing blood product transfusions, but further investigation is needed to determine if patients undergoing liver transplantation will benefit from four-factor PCC therapy.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Hematology
Haley Bajdas, Michele Handzel, Elizabeth Uttaro, Courtney M. C. Jones, Kate Kokanovich, Nicole M. Acquisto
Summary: This study compared the hemostatic efficacy of fixed-dose and variable-dose four-factor prothrombin complex concentrate (4F-PCC) for warfarin reversal. The results showed that fixed-dose 4F-PCC was associated with a higher likelihood of achieving hemostatic efficacy, quicker time to administration, and reduced cost compared to variable-dose 4F-PCC.
THROMBOSIS RESEARCH
(2022)
Review
Critical Care Medicine
Ioannis Hannadjas, Arthur James, Ross Davenport, Charlotte Lindsay, Karim Brohi, Elaine Cole
Summary: Among studies on TIC, PCCs did not significantly lower mortality and did not increase the risk of VTE. However, the potential thrombotic risk should be addressed in future studies. Several ongoing RCTs are exploring the efficacy and safety of PCC.
Review
Cardiac & Cardiovascular Systems
Dolly M. Munlemvo, Joseph D. Tobias, Kristin M. Chenault, Aymen Naguib
Summary: Coagulation disturbances following cardiac surgery for congenital heart disease can lead to various complications. Conventional treatments involve the use of fresh frozen plasma, platelet transfusions, or cryoprecipitate. When these treatments fail, activated recombinant factor VII or prothrombin complex concentrates can be used as adjuncts to rapidly correct coagulation disturbances.
CARDIOLOGY RESEARCH
(2022)
Article
Anesthesiology
Corinna Velik-Salchner, Helmuth Tauber, Verena Rastner, Werner Pajk, Markus Mittermayr, Dieter Wally, Juliane Kilo, David Vondrys, Dietmar Fries, Josef Fritz, Werner Streif
Summary: The study investigated the use of fibrinogen concentrate (FC) in combination with prothrombin complex concentrate (PCC) versus standard treatment with fresh frozen plasma (FFP) in children undergoing cardiac surgery. Results showed that FC/PCC was well tolerated and allowed hemostasis to be maintained, with no signal for inferiority compared to FFP. Fibrinogen concentration was higher in children receiving FC/PCC upon admission to the ICU, indicating a potential benefit for using FC/PCC in these patients.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2021)
Article
Hematology
Bosko M. Stojanovski, Enrico Di Cera
Summary: A plasma assay has been developed that directly monitors prothrombin activation without the need for fluorogenic substrates. The availability of factor V in plasma strongly influences the rate of prothrombin activation, while deficiencies in FVIII and FIX significantly slow down the cleavage of prothrombin. The assay is sensitive enough to assess how deficiencies in coagulation factors affect thrombin formation.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Medicine, Research & Experimental
Christopher R. Reed, Desiree Bonadonna, James C. Otto, Charles Griffin McDaniel, Charlene Vongai Chabata, Maragatha Kuchibhatla, James Frederiksen, Juliana M. Layzer, Gowthami M. Arepally, Bruce A. Sullenger, Elisabeth T. Tracy
Summary: In this study using a piglet model of pediatric VA ECMO, DTRI-178 showed comparable thromboprotection to UFH but resulted in significantly less surgical site bleeding and lower blood transfusion volumes. This suggests that DTRI-178, an aptamer targeting factor IXa, may be a feasible and safer alternative for anticoagulation during ECMO, potentially reducing the need for transfusions and clinical bleeding events.
MOLECULAR THERAPY-NUCLEIC ACIDS
(2022)
Article
Medicine, General & Internal
Yuanjian Fang, Xiaoyu Wang, Jianan Lu, Hui Shi, Lei Huang, Anwen Shao, Anke Zhang, Yibo Liu, Reng Ren, Cameron Lenahan, Jiping Tang, Jianmin Zhang, John H. Zhang, Sheng Chen
Summary: This study investigates the role of caspase-1-mediated inflammasome activation on extrinsic blood coagulation in cerebrospinal fluid (CSF) after subarachnoid hemorrhage (SAH). The results demonstrate that inhibiting caspase-1 with VX-765 can attenuate neuroinflammation and blood coagulation, leading to improved neurological outcomes and memory capacity in SAH rats. These findings suggest that VX-765 may be a potential treatment for SAH-related neuroinflammatory and hemostatic disorders.
Article
Hematology
Osamu Ishida, Kohsuke Hagisawa, Nozomu Yamanaka, Hiroyuki Nakashima, Bradley M. Kearney, Koji Tsutsumi, Shinji Takeoka, Manabu Kinoshita
Summary: This study investigated the safety of using H12-ADP-liposomes in patients who received platelet transfusion after cardiopulmonary bypass surgeries. The results showed that H12-ADP-liposomes did not cause abnormal coagulation, platelet activation, or platelet-leukocyte aggregation in these patients. Therefore, H12-ADP-liposomes could likely be safely used in these patients to provide hemostasis without causing considerable adverse reactions.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Anesthesiology
Michael Vandenheuvel, Carla VAN Gompel, Korneel Vandewiele, Pieter M. De Kesel, Piet Wyffels, Filip De Somer, Katrien M. Devreese, Patrick F. Wouters
Summary: This study compared the results of two viscoelastic tests, Sonoclot Analyzer and ROTEM Sigma, and assessed their agreement with conventional coagulation tests. The study found that both tests showed acceptable agreement on the severity of coagulation dysfunction, but poor agreement on the diagnosis of underlying causes. ROTEM demonstrated better correlation with conventional coagulation tests compared to Sonoclot.
MINERVA ANESTESIOLOGICA
(2022)
Article
Gastroenterology & Hepatology
Annabel Blasi, Vishal C. Patel, Eva N. H. E. Spanke, Jelle Adelmeijer, Marilena Stamouli, Ane Zamalloa, Eleanor Corcoran, Andrea Calvo, Javier Fernandez, William Bernal, Ton Lisman
Summary: The study found that patients with AD and ACLF had higher thrombin generation but lower levels of prothrombin, fibrinogen, and factor XIII compared to healthy controls. Fibrinogen concentrate improved clot quality, while prothrombin complex concentrate increased clot resistance. Further research is needed to determine the clinical benefits of coagulation factor concentrates in preventing or treating bleeding in liver disease patients.
LIVER INTERNATIONAL
(2022)
Article
Hematology
Sakura Minami, Hiroyuki Nagafuchi, Kaori Yamada, Takeru Abe, Ichiro Takeuchi
Summary: This study aimed to investigate whether early alteration in coagulation was associated with AKI onset following surgeries involving cardiopulmonary bypass (CPB) in children. The results showed that an increase in absolute TAT level in toddlers during the early postoperative period following CPB was associated with AKI onset.
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
(2023)
Review
Biochemistry & Molecular Biology
Max Liu, Khalequz Zaman, Yolanda M. Fortenberry
Summary: Aptamers are single-stranded DNA or RNA sequences that exhibit high specificity and affinity in binding target molecules. They are non-immunogenic, easier to synthesize and modify, and can bind targets with greater affinity, making them a promising therapeutic candidate for treating various conditions. Active research is ongoing in developing aptamers to target blood coagulation factors, with potential applications in treating cardiovascular diseases, blood disorders, and cancers. Although no aptamers targeting blood coagulation factors have been approved for clinical use, several have shown promise in clinical trials and preclinical studies.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)