Article
Hematology
Hunter B. Moore
Summary: Low fibrinolytic activity is associated with pathological thrombosis and multiple-organ failure. There are two commonly associated terms, hypofibrinolysis and fibrinolysis shutdown, to describe this condition. However, these terms are often used interchangeably in describing critically ill patients, leading to confusion in understanding the underlying disease processes. The lack of research on the cellular mediators of these processes further complicates the issue. This article aims to review the mechanisms of fibrinolysis in the context of low fibrinolytic states and emphasize the importance of differentiating hypofibrinolysis from fibrinolysis shutdown.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2023)
Article
Emergency Medicine
Gregory R. Stettler, Ernest E. Moore, Geoffrey R. Nunns, Hunter B. Moore, Benjamin R. Huebner, Christopher C. Silliman, Anirban Banerjee, Angela Sauaia
Summary: This study investigated the association between blood alcohol levels and fibrinolysis in trauma patients, finding that high alcohol consumption is linked to an increased incidence of fibrinolysis shutdown, which may impact post-injury hemostatic resuscitation strategies.
EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
(2021)
Article
Critical Care Medicine
Margot DeBot, Andrew P. Eitel, Ernest E. Moore, Angela Sauaia, Patrick Lutz, Terry R. Schaid, Jamie B. Hadley, Daniel J. Kissau, Mitchell J. Cohen, Marguerite R. Kelher, Christopher C. Silliman
Summary: The study found that patients with blood type O have an increased risk of bleeding and coagulation disorders after trauma, which is associated with lower von Willebrand factor activity.
Article
Critical Care Medicine
Gael B. Morrow, Timea Feller, Zoe McQuilten, Elizabeth Wake, Robert A. S. Ariens, James Winearls, Nicola J. Mutch, Mike A. Laffan, Nicola Curry
Summary: This study compares the effects of cryoprecipitate and fibrinogen concentrate on clot strength and structure. The results show that cryoprecipitate can restore key fibrinolytic regulators and limit plasmin generation, leading to the formation of stronger and more stable clots, while fibrinogen concentrate cannot achieve this effect.
Article
Critical Care Medicine
Julia R. Coleman, Ernest E. Moore, Marguerite R. Kelher, Kenneth Jones, Mitchell J. Cohen, Anirban Banerjee, Christopher C. Silliman
Summary: This study revealed that thrombin-activatable fibrinolysis inhibitor (TAFI) plays a major role in fibrinolysis shutdown after trauma-induced coagulopathy.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2023)
Article
Medicine, General & Internal
Andreas G. Tsantes, Dimitrios V. Papadopoulos, Ioannis G. Trikoupis, Stavros Goumenos, Daniele Piovani, Konstantina A. Tsante, Andreas F. Mavrogenis, Aristeidis G. Vaiopoulos, Panagiotis Koulouvaris, Georgios K. Nikolopoulos, Panayiotis J. Papagelopoulos, Stefanos Bonovas, Argirios E. Tsantes
Summary: COVID-19 patients with hip fractures have higher clot strength and impaired fibrinolysis, indicating increased thrombotic risk and the need for potential modification of thromboprophylaxis strategies.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Biochemistry & Molecular Biology
Liam Barrett, Nicola Curry, Jeries Abu-Hanna
Summary: Trauma-induced coagulopathy (TIC) is a major cause of morbidity and mortality in traumatic injury patients, ranging from bleeding to widespread clot formation. The endotheliopathy of trauma (EoT) is believed to underlie TIC, but our understanding of it is still limited due to the lack of experimental research. This review discusses the mechanisms of haemostasis regulation by the vascular endothelium and their dysregulation in traumatic injury, as well as available in vitro and in vivo models for studying EoT and its contribution to TIC.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Medicine, General & Internal
Hironori Matsumoto, Suguru Annen, Naoki Mukai, Muneaki Ohshita, Satoru Murata, Yutaka Harima, Shirou Ogawa, Mitsuo Okita, Yuki Nakabayashi, Satoshi Kikuchi, Jun Takeba, Norio Sato
Summary: This study aimed to evaluate the association between endotheliopathy represented by high levels of circulating syndecan-1 (SDC-1) and coagulofibrinolytic responses due to trauma. The results showed that elevated SDC-1 levels were associated with intense and prolonged coagulation activation, impairment of anticoagulation, fibrinolytic activation, and consumption coagulopathy, which are all related to the development of DIC.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Surgery
Gregory R. Stettler, Ernest E. Moore, Geoffrey R. Nunns, Marguerite Kelher, Anirban Banerjee, Christopher C. Silliman
Summary: The study found that no single blood component or volume of whole blood led to attenuation of tPA-mediated fibrinolysis in an in vitro model of TIC. Cryoprecipitate was the most effective at improving coagulation function.
JOURNAL OF SURGICAL RESEARCH
(2021)
Article
Hematology
Maria J. Colomina, Esther Mendez, Antoni Sabate
Summary: Major surgery can induce physiological changes in hemostasis and coagulation, resulting in a postoperative hypercoagulable or hypocoagulable state for patients. Factors such as the type of surgery, comorbidities, and preoperative medication can influence the surgical hemostasis response.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2021)
Review
Biochemistry & Molecular Biology
Thembaninkosi G. Gaule, Ramzi A. Ajjan
Summary: Fibrinogen plays a crucial role in blood clotting, with alterations in its structure or incorporation of antifibrinolytic proteins potentially leading to unstable or persistent clots, increasing the risk of bleeding or thrombosis. Understanding fibrinogen function can help in developing effective therapies to modulate clotting and bleeding risk while maintaining the delicate balance between clot formation and lysis.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Surgery
Michael S. Farrell, Ernest E. Moore, Anthony V. Thomas, Julia R. Coleman, Scott Thomas, Stefani Vande Lune, Thomas Marconi, Mitchell J. Cohen, Michael P. Chapman, Hunter B. Moore, Mark M. Walsh, Sherry Sixta
Summary: The study found that the death diamond (DD) in trauma patients highly predicts mortality rate, and the serial appearance of DD may represent a marker of futility, serving as a potential biomarker.
Article
Medical Laboratory Technology
Hyunjung Kim, Maru Kim, Hae Kyung Lee, Dae Sang Lee, Dae Hyun Cho, Hangjoo Cho
Summary: The study aimed to investigate coagulation status in trauma patients using thromboelastography and its association with survival and blood transfusion. Results showed that TEG markers were more useful than routine coagulation tests for diagnosis and prediction of survival, with dysfunctional fibrinolysis showing higher mortality rates compared to the physiologic group.
CLINICAL LABORATORY
(2021)
Article
Critical Care Medicine
Michael A. Lawson, Lori A. Holle, Nathan E. Dow, Grant Hennig, Bas de Laat, Hunter B. Moore, Ernest E. Moore, Mitchell J. Cohen, Beth A. Bouchard, Kalev Freeman, Alisa S. Wolberg
Summary: Dehydration therapy can dissolve solid substances in water and selectively absorb drug and dye substances using the suction force of colloidal particles on paper.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2022)
Article
Oncology
Andreas G. Tsantes, Ilectra Loukopoulou, Dimitrios V. Papadopoulos, Ioannis G. Trikoupis, Anastasios G. Roustemis, Stavros Goumenos, Rozeta Sokou, Konstantina A. Tsante, Anastasios G. Kriebardis, Panagiotis Koulouvaris, Dimitra Houhoula, Daniele Piovani, Panayiotis J. Papagelopoulos, Stefanos Bonovas, Argirios E. Tsantes
Summary: Malignancy-associated coagulopathy (MAC) in surgical patients with bone tumors is characterized by activations of the coagulation cascade, platelet activation, and hypofibrinolysis, resulting in a hypercoagulable state. Rotational thromboelastometry (ROTEM) analysis is more effective than conventional coagulation tests in detecting these qualitative changes in the hemostatic profile of patients with bone tumors.