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Thrombin Hemostatic

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101. Comparison of hemostatic dressings for superficial wounds using a new spectrophotometric coagulation assay Full Text available with Trip Pro

Comparison of hemostatic dressings for superficial wounds using a new spectrophotometric coagulation assay Due to demographical changes the number of elderly patients depending on oral anticoagulation is expected to rise. Prolonged bleeding times in case of traumatic injuries represent the drawback of these medications, not only in major trauma, but also in superficial wounds. Therefore, dressings capable of accelerating coagulation onset and shortening bleeding times are desirable (...) for these patients.The hemostatic potential and physical properties of different types of superficial wound dressings (standard wound pad, two alginates, chitosan, collagen (Lyostypt(®)), oxidized cellulose, and QuikClot(®)) were assessed in vitro. For this purpose the clotting times of blood under the influence of the named hemostatics from healthy volunteers were compared with Marcumar(®) or ASS(®) treated patients. For that, a newly developed coagulation assay based on spectrophotometric extinction measurements

2015 Journal of translational medicine

102. Evaluation of the Hemostatic Potential in Sickle Cell Disease Patients

as a hypercoagulable state. However, the approach used so far to the measure of clotting in sickle cell disease was segmented in the sense that the various components of the hemostatic balance were studied separately.The thrombin generation test is a functional test which explores the coagulation globally, integrating both pro players that anticoagulants actors in the system. The investigators already used this test to demonstrate that the hemostatic potential was high in a cohort of affected children compared (...) of clotting in sickle cell disease was segmented in the sense that the various components of the hemostatic balance were studied separately. This scale is complex, this approach difficult to give a comprehensive and integrated picture of the various disturbances in the system. The thrombin generation test is a functional test which explores the coagulation globally, integrating both pro players that anticoagulants actors in the system. The investigators have used this test to demonstrate

2015 Clinical Trials

103. Control of bleeding in surgical procedures: critical appraisal of HEMOPATCH (Sealing Hemostat) Full Text available with Trip Pro

Control of bleeding in surgical procedures: critical appraisal of HEMOPATCH (Sealing Hemostat) The need for advanced hemostatic agents increases with the complexity of surgical procedures and use of anticoagulation and antiplatelet treatments. HEMOPATCH (Sealing Hemostat) is a novel, advanced hemostatic pad that is composed of a synthetic, protein-reactive monomer and a collagen backing. The active side is covered with a protein-reactive monomer: N-hydroxysuccinimide functionalized polyethylene (...) glycol (NHS-PEG). NHS-PEG rapidly affixes the collagen pad to tissue to promote and maintain hemostasis. The combined action of the NHS-PEG and collagen is demonstrated to have benefit relative to other hemostatic agents in surgery and preclinical surgical models. This paper reviews the published investigations and case reports of the hemostatic efficacy of HEMOPATCH, wherein HEMOPATCH is demonstrated to be an effective, easy-to-use hemostatic agent in open and minimally invasive surgery of patients

2015 Medical devices (Auckland, N.Z.)

104. The effect of compression socks worn during a marathon on hemostatic balance. (Abstract)

individuals. We investigated the effect of compression socks on exercise-induced hemostatic activation and balance in endurance athletes running the 2013 Hartford Marathon.Adults (n = 20) were divided into compression sock (SOCK; n = 10) and control (CONTROL; n = 10) groups. Age, anthropometrics, vital signs, training mileage and finishing time were collected. Venous blood samples were collected 1 day before, immediately after and 1 day following the marathon for analysis of coagulatory (i.e. thrombin (...) The effect of compression socks worn during a marathon on hemostatic balance. Marathon running evokes parallel increases in markers of coagulation and fibrinolysis (i.e. hemostatic activation) immediately following strenuous, endurance exercise such that hemostatic balance is maintained. However, other factors incident to marathon running (i.e. dehydration, travel) may disproportionately activate the coagulatory system, increasing blood clot risk after an endurance event in otherwise healthy

2015 The Physician and sportsmedicine Controlled trial quality: uncertain

105. Fibrin, γ'-Fibrinogen, and Transclot Pressure Gradient Control Hemostatic Clot Growth During Human Blood Flow Over a Collagen/Tissue Factor Wound. Full Text available with Trip Pro

factors responsible for regulating thrombin-mediated clot growth.Using factor XIIa-inhibited human whole blood perfused in a microfluidic device over collagen/tissue factor at controlled wall shear rate and ΔP, we found thrombin to be highly localized in the P-selectin(+) core of hemostatic clots. Increasing ΔP from 9 to 29 mm Hg (wall shear rate=400 s(-1)) reduced P-selectin(+) core size and total clot size because of enhanced extravasation of thrombin. Blockade of fibrin polymerization with 5 mmol/L (...) Fibrin, γ'-Fibrinogen, and Transclot Pressure Gradient Control Hemostatic Clot Growth During Human Blood Flow Over a Collagen/Tissue Factor Wound. Biological and physical factors interact to modulate blood response in a wounded vessel, resulting in a hemostatic clot or an occlusive thrombus. Flow and pressure differential (ΔP) across the wound from the lumen to the extravascular compartment may impact hemostasis and the observed core/shell architecture. We examined physical and biological

2015 Thrombosis and Vascular Biology

106. Dehydration of blood platelets by zeodration: in vitro characterization and hemostatic properties in vivo. (Abstract)

Dehydration of blood platelets by zeodration: in vitro characterization and hemostatic properties in vivo. Platelets (PLTs) are currently stored at room temperature (RT) for 5 to 7 days. So far, there exists no validated method for the preparation and long-term storage of dehydrated PLTs suitable for transfusion after rehydration. In this study, a desiccation process, zeodration, was applied to PLTs.A complete procedure of dehydration at RT by zeodration was employed. Zeodrated human and mouse (...) PLTs were characterized in vitro. Zeodrated mouse PLTs were transfused into clopidogrel-treated mice to evaluate their hemostatic properties.The optimal conditions for dehydration of PLTs at RT in a laboratory scale zeodrator were defined as 145 mbar and 20.2 ± 1.5 °C. The recovery rate was 85 ± 2% and the dryness of zeodrated PLTs (Z_PLTs) indicated that they were sufficiently stable for long-term storage. Rehydrated Z_PLTs were round, were not aggregated, and expressed the glycoproteins required

2015 Transfusion

107. Multimodal assessment of non-specific hemostatic agents for apixaban reversal. (Abstract)

Multimodal assessment of non-specific hemostatic agents for apixaban reversal. Non-specific hemostatic agents, namely activated prothrombin complex concentrate (aPCC), PCC and recombinant activated factor (F) VII (rFVIIa), can be used, off-label, to reverse the effects of FXa inhibitors in the rare cases of severe hemorrhages, as no approved specific antidote is available. We have evaluated the ability of aPCC, PCC and rFVIIa to reverse apixaban.Healthy volunteer whole blood was spiked (...) with therapeutic or supra-therapeutic apixaban concentrations and two doses of aPCC, PCC or rFVIIa. Tests performed included a turbidimetry assay for fibrin polymerization kinetics analysis, scanning electron microscopy for fibrin network structure observation, thrombin generation assay (TGA), thromboelastometry, prothrombin time and activated partial thromboplastin time.aPCC generated a dense clot constituting thin and branched fibers similar to those of a control without apixaban, increased fibrin

2015 Journal of Thrombosis and Haemostasis

108. Fresh frozen plasma transfusion fails to influence the hemostatic balance in critically ill patients with a coagulopathy. (Abstract)

Fresh frozen plasma transfusion fails to influence the hemostatic balance in critically ill patients with a coagulopathy. Coagulopathy has a high prevalence in critically ill patients. An increased International Normalized Ratio (INR) is a common trigger to transfuse fresh frozen plasma (FFP), even in the absence of bleeding. Therefore, FFP is frequently administered to these patients. However, the efficacy of FFP in correcting hemostatic disorders in non-bleeding recipients has been (...) questioned.To assess whether INR prolongation parallels changes in the results of other tests investigating hemostasis, and to evaluate the coagulant effects of a fixed dose of FFP in non-bleeding critically ill patients with a coagulopathy.Markers of coagulation, individual factor levels and levels of natural anticoagulants were measured. Also, thrombin generation and thromboelastometry (ROTEM) assays were performed before and after FFP transfusion (12 mL kg(-1) ) to 38 non-bleeding critically ill patients

2015 Journal of Thrombosis and Haemostasis Controlled trial quality: uncertain

109. Early Hemostatic Responses to Trauma: Identified Using Hierarchical Clustering Analysis. Full Text available with Trip Pro

increased in cluster 3. Trauma clusters were most noticeably different in their relative fibrinogen concentration, peak thrombin generation, and platelet-induced clot contraction.Hierarchical clustering analysis identified three distinct hemostatic responses to trauma. Further insights into the underlying hemostatic mechanisms responsible for these responses are needed.© 2015 International Society on Thrombosis and Haemostasis. (...) Early Hemostatic Responses to Trauma: Identified Using Hierarchical Clustering Analysis. Trauma-induced coagulopathy is a complex multifactorial hemostatic response that is poorly understood.To identify distinct hemostatic responses to trauma and identify key components of the hemostatic system that vary between responses.A cross-sectional observational study of adult trauma patients at an urban level I trauma center emergency department was performed. Hierarchical clustering analysis was used

2015 Journal of Thrombosis and Haemostasis

110. Platelets and platelet-derived factor Va confer hemostatic competence in complete factor V deficiency. Full Text available with Trip Pro

Platelets and platelet-derived factor Va confer hemostatic competence in complete factor V deficiency. Whole genome sequencing of an individual completely devoid of plasma- and platelet-derived factor V (FV) identified 167 variants in his F5 gene including previously identified and damaging missense mutations at rs6027 and Leu90Ser. Because the administration of fresh frozen plasma (FFP) prevents gastrointestinal bleeding in this individual, its effects on his plasma- and platelet-derived FV (...) concentrations were assessed. The patient's plasma FV levels peaked by 2 hours following FFP administration and were undetectable 96 hours later. In contrast, increased platelet-derived FV/Va concentrations were observed within 6 hours, peaked at 24 hours, decreased slowly over 7 days, and originated from megakaryocyte endocytosis and intracellular processing of plasma FV. Ten days after transfusion, no thrombin was generated in a tissue factor-initiated whole blood clotting assay unless exogenous FV

2015 Blood

111. Hemostatic agents of broad applicability produced by selective tuning of factor Xa zymogenicity. Full Text available with Trip Pro

Hemostatic agents of broad applicability produced by selective tuning of factor Xa zymogenicity. There is a clinical need to develop safe therapeutic strategies to mitigate bleeding. Previously, we found that a novel zymogen-like factor Xa variant (FXa-I16L) was effective in correcting the coagulation defect in hemophilic mice. Here we expand the mutational framework to tune the FX(a) zymogen-like state. Alteration of FXa zymogenicity yields variants (V17M, I16L, I16M, V17T, V17S, and I16T (...) ) with a wide range (≤1000-fold) of reduced function toward physiologic substrates and inhibitors. The extent of zymogen-like character, including resistance to antithrombin III, correlates well with plasma half-life (<2 minutes to >4 hours). Importantly, biologic function, including that of the most zymogen-like variant (FXa-I16T), was greatly enhanced when bound to FVa membranes. This resulted in improvement of clotting times and thrombin generation in hemophilic plasma. The FXa variants were remarkably

2015 Blood

112. Android fat distribution affects some hemostatic parameters in women with polycystic ovary syndrome compared with healthy control subjects matched for age and body mass index. (Abstract)

the thrombin generation curve (TAUC).In the PCOS group, BMI and WC correlated positively with TAFI, D-dimer, PAI-1, Cmax, and TAUC; HC with D-dimer and PAI-1; WHR with TAFI, D-dimer, and PAI-1; glucose with TAFI; insulin and homeostasis-model assessment of insulin resistance with PAI-1; and FT with Cmax and TAUC. Age correlated positively with D-dimer and PAI-1, and negatively with Tlag and Tmax. In the control group, there were no correlations between clinical markers of fat distribution and hemostatic (...) Android fat distribution affects some hemostatic parameters in women with polycystic ovary syndrome compared with healthy control subjects matched for age and body mass index. To correlate hemostatic parameters with clinical markers of fat distribution and laboratory variables in women with polycystic ovary syndrome (PCOS) compared with healthy control subjects.Cross-sectional study.Tertiary teaching hospital.Forty-five women with PCOS and 45 control women matched for age and body mass index

2015 Fertility and Sterility

113. Hemostasis During Urologic Surgery: Fibrin Sealant Compared With Absorbable Hemostat Full Text available with Trip Pro

Hemostasis During Urologic Surgery: Fibrin Sealant Compared With Absorbable Hemostat In the United States, fibrin sealants have been used to achieve hemostasis for nearly two decades. Although their clinical utility was first demonstrated in cardiac surgery, their effectiveness and safety have since been demonstrated to extend to a wide array of procedures. Fibrin sealants typically contain two components-fibrinogen and thrombin-that are combined and delivered simultaneously to a target (...) bleeding site in order to achieve hemostasis. However, many commercial formulations contain other additional components, such as antifibrinolytic agents, that have been associated with adverse outcomes. This subanalysis compares the safety and effectiveness of a fibrin sealant versus an absorbable hemostat for achieving hemostasis during urologic procedures with mild to moderate bleeding.

2015 Reviews in urology

114. Hemostatic effect and distribution of new rhThrombin formulations in rats Full Text available with Trip Pro

Hemostatic effect and distribution of new rhThrombin formulations in rats Recombinant human thrombin (rhThrombin) is a potential hemostatic alternative to bovine and human plasma-derived thrombin. Hemostatic, liver regeneration effect and plasma concentrations of rhThrombin (SCILL) tested in the form of solution and hydrogels (thermo-sensitive poloxamer gel and carbomer gel; hameln rds) were evaluated. In the bleeding model, rhThrombin was applied locally on the bleeding site. The time (...) in comparison to the liquid form - solution; differences were insignificant. Low [(125)I]-rhThrombin radioactivity was evaluated in plasma after topical application (solution and both hydrogels) at hemostatic effective doses to partial hepatectomy in rats. Locally applied rh Thrombin on the rat damaged liver tissue never reached pharmacologically active systemic levels. The plasmatic levels and the content of this active protein in injured liver tissue were lower after application of its hydrogels versus

2015 Interdisciplinary toxicology

115. Rapid hemostasis in a sheep model using particles that propel thrombin and tranexamic acid. Full Text available with Trip Pro

Rapid hemostasis in a sheep model using particles that propel thrombin and tranexamic acid. Bleeding during endoscopic sinus surgery and open surgeries can easily obstruct the surgeons' field of view and increase morbidity and risk of intraoperative complications. Intraoperative bleeding could potentially be addressed by a hemostatic agent that safely disperses itself through the escaping blood. We tested the safety and efficacy of a self-propelling formulation of thrombin and tranexamic acid

2016 Laryngoscope

116. Coagulation and non-coagulation effects of thrombin. Full Text available with Trip Pro

Coagulation and non-coagulation effects of thrombin. Thrombin is a multifunctional serine protease produced from prothrombin, and is a key regulator in hemostatic and non-hemostatic processes. It is the main effector protease in primary hemostasis by activating platelets, and plays a key role in secondary hemostasis. Besides its well-known functions in hemostasis, thrombin also plays a role in various non-hemostatic biological and pathophysiologic processes, predominantly mediated through (...) pathways, the exact mechanism behind the dichotomy of thrombin is yet still unknown. In this review, we highlight the hemostatic and non-hemostatic functions of thrombin, and specifically focus on the non-hemostatic dual role of thrombin under various conditions and in relation to cardiovascular disease.© 2016 International Society on Thrombosis and Haemostasis.

2016 Journal of Thrombosis and Haemostasis

117. Dynamics of Thrombin Generation and Flux from Clots during Whole Human Blood Flow over Collagen/Tissue Factor Surfaces Full Text available with Trip Pro

coating became less efficient on a per μm2 basis, likely due to distal boundary layer depletion of platelets. Overall, thrombin is robustly generated within clots by the extrinsic pathway followed by late-stage FXIa contributions, with fibrin localizing thrombin via its antithrombin-I activity as a potentially self-limiting hemostatic mechanism.© 2016 by The American Society for Biochemistry and Molecular Biology, Inc. (...) Dynamics of Thrombin Generation and Flux from Clots during Whole Human Blood Flow over Collagen/Tissue Factor Surfaces Coagulation kinetics are well established for purified blood proteases or human plasma clotting isotropically. However, less is known about thrombin generation kinetics and transport within blood clots formed under hemodynamic flow. Using microfluidic perfusion (wall shear rate, 200 s-1) of corn trypsin inhibitor-treated whole blood over a 250-μm long patch of type I fibrillar

2016 The Journal of biological chemistry

118. Patients Referred for Bleeding Symptoms of Unknown Cause: Does Evaluation of Thrombin Generation Contribute to Diagnosis? Full Text available with Trip Pro

Patients Referred for Bleeding Symptoms of Unknown Cause: Does Evaluation of Thrombin Generation Contribute to Diagnosis? Patients with mild to moderate bleeding symptoms referred for coagulation investigation sometimes never receive a definitive diagnosis. Bleed assessment tools have been developed and validated to assess the severity of symptoms. Global coagulation assays, e.g., the thrombin generation test (thrombogram) have a potential to identify hemostatic defects that are not detected (...) in specific assays.One hundred and eighty-five patients referred to our centre because of bleeding symptoms were evaluated using the bleeding assessment tool (BAT) described by Tosetto and colleagues in 2006. Blood samples were investigated for thrombin generation (TG) capacity (Technoclone), in platelet poor (PPP) plasma, and specific clotting factors, i.e., von Willebrand factor, factor VIII and IX, as well as INR, APTT, platelet count, and platelet adhesion.Of the 185 patients, five women were

2016 Mediterranean journal of hematology and infectious diseases

119. Thrombin Generation in Zebrafish Blood Full Text available with Trip Pro

Thrombin Generation in Zebrafish Blood To better understand hypercoagulability as an underlying cause for thrombosis, the leading cause of death in the Western world, new assays to study ex vivo coagulation are essential. The zebrafish is generally accepted as a good model for human hemostasis and thrombosis, as the hemostatic system proved to be similar to that in man. Their small size however, has been a hurdle for more widespread use in hemostasis related research. In this study we developed (...) a method that enables the measurement of thrombin generation in a single drop of non-anticoagulated zebrafish blood. Pre-treatment of the fish with inhibitors of FXa and thrombin, resulted in a dose dependent diminishing of thrombin generation, demonstrating the validity of the assay. In order to establish the relationship between whole blood thrombin generation and fibrin formation, we visualized the resulting fibrin network by scanning electron microscopy. Taken together, in this study we developed

2016 PloS one

120. Improved bleeding scores using Gelfoam® Powder with incremental concentrations of bovine thrombin in a swine liver lesion model Full Text available with Trip Pro

Improved bleeding scores using Gelfoam® Powder with incremental concentrations of bovine thrombin in a swine liver lesion model Topical hemostatic agents are used intra-operatively to prevent uncontrolled bleeding. Gelfoam(®) Powder contains a hemostatic agent prepared from purified pork skin gelatin, the efficacy of which is increased when combined with thrombin. However, the effect of increasing concentrations of thrombin on resultant hemostasis is not known. This study sought to evaluate (...) system; comparison of bleeding scores was performed using ANOVA with the post hoc Tukey test. The bleeding scores with thrombin concentrations at 770 IU/mL were significantly lower than at 250 and 375 IU/mL at all four time points. The percentage of biopsies with a clinically acceptable bleeding score rose from 37.9, 46.6, and 71.2 % at 3 min to 55.2, 69.0, and 88.1 % at 12 min in the 250, 375, and 770 IU/mL thrombin groups, respectively. The study showed that the hemostatic response to thrombin

2016 Journal of thrombosis and thrombolysis

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