Antifibrinolüütikumid-kellele ja. Kristjan Kalling, Põhja-Eesti Regionaalhaigla
|
|
- Hugh Ray
- 5 years ago
- Views:
Transcription
1 Antifibrinolüütikumid-kellele ja millal? Kristjan Kalling, Põhja-Eesti Regionaalhaigla
2 Antifibrinolüütikumid B02A Antifibrinolytics B02AA Amino acids B02AA01 Aminocaproic acid B02AA02 Tranexamic acid B02AA03 Aminomethylbenzoic acid B02AB Proteinase inhibitors B02AB01 Aprotinin B02AB02 Alfa1 antitrypsin B02AB03 C1-inhibitor B02AB04 Camostat
3 TXA EACA APROTINIIN
4 Traneksaamhape(TXA) Lüsiiniderivaat blokeerib tpa lüsiini sidumise koha pöörduvalt 8-10 X tugevama toimega kui EACA Poolväärtusaeg 8 tundi Eritub neerude kaudu Esineb i/v vorm ja ka tabletina
5 Näidustused 1 Hemofiiliahaigetelprofülaktiliselt (faktor VIII ja IX puudulikkus) Laboratoorselt tõestatud suurenenud Laboratoorselt tõestatud suurenenud fibrinolüüs Kaudselt TCT (thrombine clotting time) FDP ja D-dimeeride määramine ELT (euglobuline lysis time) Tromboelastomeetria(-graafia)
6 Näidustused 2 TRAUMA Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. Brohi, K Journal of Trauma,(2008). 208 pt saabumisel Hüübimisfaktorite defitsiiti ei olnud Hüpoperfusioonkäivitab koagulopaatiaja suurenenud fibrinolüüsi
7 Näidustused 3 TRAUMA Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage 2 (CRASH 2) patsienti võrreldi TXA vs. platseebo Üldsuremus ja verekaotusest suremus oluliselt madalamad Trombootiliste komplikatsioonide hulk ei tõusnud Military Application of Tranexamic Acid in Trauma Emergency Resuscitation(MATTERs) Study Retrospektiivne analüüs 896 patsiendi kohta, 293 sai TXA TXA üldsuremus väiksem, eriti massiivse vereülekande korral Trombootilisi tüsistusi liiga vähe, et analüüsida
8 Näidustused 4 Neurokirurgia CRASH 2 Intracranial Bleeding Studystatistiliselt olulist kasu ei oma, kuid kahju kah ei tee Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage(cochrane 2003)- kasu puudub Seljakirurgia-väheneb veritsus ja vereproduktide kasutus Võib suurendada krampide esinemissagedust?
9 Näidustused 5 Ortopeediline kirurgia Günekoloogia postpartum hemorraagia menorraagia Üldkirurgia maksasiirdamine jne Uroloogia TURP, radikaalne prostata resektsioon Pea ja kela kirurgia Stomatoloogiline kirurgia Trombolüüsi komplikatsioonide ravis
10 Näidustused 6 Desmopressiini lisandiks Antiagregantraviosaliseks pööramiseks kirurgias WeberC; EJA 2011 SenayS; TheHeartSurgeryForum2010
11 Doseerimine Erinevad skeemid Laadimisdoos 2,5-100 mg/kg ja hilisem (1-12tundi) infusioon 0,25-4 mg/kg/h Südamekirurgias on doosid valdavalt (doosi suurendamsiest ei ole kasu näidatud): Laadimisdoos 10 mg/kg Infusioon 1 mg/kg/h
12 Kõrvaltoimed ja vastunäidustused Hästi talutav ravim Probleemid värvinägemisega Ettevaatust eelneva süvaveeni tromboosiga patsientidega Lastel ei ole piisavalt uuringuid Hematuuria?
13 Aminokaproonhape Lüsiini derivaat ja tpa aktiivsuse Kliiniliselt sama efektiivne, kui TXA Manustamise doos ca 10 X suurem Kasutamisega võib kaasneda lihasnekroose ja müalgiat Seedevaevused Ettevaatust ülemise urotrakti veritsusega
14 Aprotiniin Seriini proteaasi inhibiitor Isoleeriti 1930 veise süljenäärmest, hiljem ka kopsust Inhibeerib rida ensüüme: trüpsiin, kümotrüpsiin, plasmiin, kallikreiin Algselt kasutati ägeda pankreatiidi raviks Anafülaksia 1: 200 esmakasutaja kohta Tromboosi oht
15 Erinevad uuringud kinnitasid Aprotiniiniefektiivsust, kuni... observed association between aprotininand serious end-organ damage indicates that continued use is not prudent, whereas the less expensive generic medications aminocaproicacid and tranexamicacid are safe alternatives Mangano aasta suremus 1,6 korda suurem aprotiniini grupis Mangano 2007 BART study 2008 Ferguson et al. Aprotinin versus TXA või EACA Thestrong and consistent negative mortality trend associated with aprotinin, as compared with the lysine analogues, precludes its use in highrisk cardiac surgery.
16 Aprotiniinigaseotud neerupuudlikkus on seotud suurema vereülekandega aga mitte aprotiniinienda toimega Furnary,A. Circulation 2007
17 WASHINGTON, Sept. 29 Bayer A.G., the German pharmaceutical giant, failed to reveal to federaldrug officials the results of a large study suggesting that a widely used heart -surgery medicine mightincrease the risks of death and stroke NY TIMES 30 sept 2006 Okt 2006 avaldas FDA hoiatuse 5 november 2007 tõmbas BAYER Trasyloli turult ära Sept 2011 lubab Kanada uuesti Trasyloli turule
18 , Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion(cochrane Review 2009) 211 RCT, patsienti 116 aprotiniini uuringut, 45 TXA, 11 EACA Aprotiniin, TXA ja EACA on võrdselt efektiivsed kirurgias, peale kõrge riski südamekirurgia Ükski eelmainituist ei põhjusta suuremat vaskulaarsete probleemide riski, ei tõsta üldsuremust Ei saa välistada aprotiniini kahjulikku mõju neerudele
19
Are Anti- Fibrinolytic Drugs the Magic Bullets for Perioperative Hemostasis?
Are Anti- Fibrinolytic Drugs the Magic Bullets for Perioperative Hemostasis? Daniela Filipescu, MD. PhD. Assoc. Prof. of Anesthesia & Intensive Care Carol Davila University Emergency Institute of Cardiovascular
More informationThe Role of Tranexamic Acid in Patient Blood Management Undergoing Cardiac Surgery
The Role of Tranexamic Acid in Patient Blood Management Undergoing Cardiac Surgery Dr Sarah Armarego FANZCA FANZCP Senior Staff Specialist John Hunter Hospital Newcastle Declaration Former member of a
More informationLarge trials vs observational studies in assessing benefit and harm: the example of aprotinin
Large trials vs observational studies in assessing benefit and harm: the example of aprotinin Dean A. Fergusson, MHA, PhD Senior Scientist and Associate Director, Clinical Epidemiology Program, Ottawa
More informationBleeding, Coagulopathy, and Thrombosis in the Injured Patient
Bleeding, Coagulopathy, and Thrombosis in the Injured Patient June 7, 2008 Kristan Staudenmayer, MD Trauma Fellow UCSF/SFGH Trauma deaths Sauaia A, et al. J Trauma. Feb 1995;38(2):185 Coagulopathy is Multi-factorial
More informationBias-adjusted adjusted meta-analysis analysis of randomized and
Association of increased mortality with aprotinin administration in cardiac surgery? Bias-adjusted adjusted meta-analysis analysis of randomized and observational studies Society for Clinical Trials, 2011
More informationCABG in the Post-Aprotinin Era: Are We Doing Better? Ziv Beckerman, David Kadosh, Zvi Peled, Keren Bitton-Worms, Oved Cohen and Gil Bolotin
CABG in the Post-Aprotinin Era: Are We Doing Better? Ziv Beckerman, David Kadosh, Zvi Peled, Keren Bitton-Worms, Oved Cohen and Gil Bolotin DISCLOSURES None Objective(s): Our department routinely used
More informationCRASH ing Trauma Patients: The CRASH trials. Tim Coats Professor of Emergency Medicine University of Leicester, UK
CRASH ing Trauma Patients: The CRASH trials Tim Coats Professor of Emergency Medicine University of Leicester, UK www.le.ac.uk/emag I DO NOT have an affiliation (financial or otherwise) with a pharmaceutical,
More informationTXA. Things Change. Tranexamic Acid TXA. Resuscitation 2017 TXA In The ED March 31, MAST Trousers. High Flow IV Fluids.
Resuscitation 2017 In The ED March 31, 2017 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN SECURE THE ABC S MAST
More informationNew data for preventing postoperative hemorrhage with the use of aprotinin
New data for preventing postoperative hemorrhage with the use of aprotinin Nikolaos BAIKOUSSIS MD, MSc, PhD Cardiac Surgeon Ippokrateio General Hospital of Athens No conflict of interest Bleeding
More informationResuscitation Update
Resuscitation Update? Dr. Edward Pyun Jr., M.D. FACS Trauma Medical Director/Surgical ICU Director OSF St. Anthony Medical Center Trauma Services Perryville Surgical Associates November 10, 2012 2009 Recommendations
More informationAntifibrinolytic drugs for acute traumatic injury(review)
Cochrane Database of Systematic Reviews Antifibrinolytic drugs for acute traumatic injury(review) KerK,RobertsI,ShakurH,CoatsTJ KerK,RobertsI,ShakurH,CoatsTJ. Antifibrinolytic drugs for acute traumatic
More informationMassive Transfusion. MPQC Spring Summit April 29, Roger Belizaire MD PhD
Massive Transfusion MPQC Spring Summit April 29, 2015 Roger Belizaire MD PhD Take home points 1. Blood is always available. Requests for massive transfusion or emergency release typically only require
More informationWhen Should I Use Tranexamic Acid for Children? Dr Andrea Kelleher Consultant Adult and Paediatric Cardiac Anaesthetist
When Should I Use Tranexamic Acid for Children? Dr Andrea Kelleher Consultant Adult and Paediatric Cardiac Anaesthetist When? When a drug is licenced for (the proposed) use When its use is supported by
More information2 Liters. Goal: Basic Algorithm Volume Resuscitation in Trauma. Initial Fluids. Blood. Where do Blood Products Come From?
Goal: Basic Algorithm Volume Resuscitation in Trauma Sanjay Arora MD Associate Professor of Emergency Medicine Keck School of Medicine at USC Los Angeles County + USC Medical Center May 23, 2012 Initial
More informationThe principle of 1:1:1 blood product use in the resuscitation of trauma victims. K. D. Boffard
The principle of 1:1:1 blood product use in the resuscitation of trauma victims K. D. Boffard Milpark Hospital Department of Surgery University of the Witwatersrand Johannesburg, South Africa Annual Controversies
More informationTRANSFUSION SUPPORT IN HEPATOBILIARY AND PANCREATIC SURGERIES
TRANSFUSION SUPPORT IN HEPATOBILIARY AND PANCREATIC SURGERIES Dr.K.C.Usha Professor & Head Dept: Of Transfusion Medicine & Director, Model Blood Bank Government Medical College Trivandrum,Kerala INTRODUCTION
More informationPublic Assessment Report Scientific discussion. Trasylol (aprotinin) SE/H/1671/01/MR
Public Assessment Report Scientific discussion Trasylol (aprotinin) SE/H/1671/01/MR This module reflects the scientific discussion for the approval of Trasylol. The procedure was finalised on 2018-02-06.
More informationA Guide To Safe Blood Transfusion Practice
A Guide To Safe Blood Transfusion Practice Marie Browett, Pavlina Sharp, Fiona Waller, Hafiz Qureshi, Malcolm Chambers (on behalf of the UHL Blood Transfusion Team) A Guide To Safe Blood Transfusion Practice
More information5/30/2013. I have no conflicts of interest to disclose. Alicia Privette, MD Trauma & Critical Care Fellow. Trauma = #1 cause of death persons <40 yo 1
I have no conflicts of interest to disclose. Alicia Privette, MD Trauma & Critical Care Fellow Trauma = #1 cause of death persons
More informationHow can ROTEM testing help you in trauma?
How can ROTEM testing help you in trauma? Complicated bleeding situations can appear intra and post operatively. They can be life-threatening and always require immediate action. A fast differential diagnosis
More informationUued antikoagulandid e. NOA-d (DOAC`d) perioperatiivses situatsioonis.
Uued antikoagulandid e. NOA-d (DOAC`d) perioperatiivses situatsioonis. Indrek Rätsep PERH Antitrombootilise ravi perioperatiivsest käsitlusest sõltub: VeritsusRISK Kirurgiline veritsus Anesteesia valik
More information2012, Görlinger Klaus
Gerinnungsmanagement der Gegenwart - wie gehen wir heute vor? 25. Allander Gerinnungsrunde am 15. März 2012 Klaus Görlinger Universitätsklinikum Essen klaus@goerlinger.net CSL Behring GmbH Octapharma AG
More informationComparison of Tranexamic Acid and Aminocaproic Acid in Coronary Bypass Surgery
Butler Journal of Undergraduate Research Volume 2 Article 24 2016 Comparison of Tranexamic Acid and Aminocaproic Acid in Coronary Bypass Surgery Lisa K. LeCleir Butler University, lisa.lecleir@gmail.com
More informationLiberaalne vähiravikorraldus keskhaiglad versus regionaalhaiglad
Liberaalne vähiravikorraldus keskhaiglad versus regionaalhaiglad Andrus Arak, MD, PhD onkoloog, üldkirurg Pärnus 06.05.2016 Liberaalne - salliv, vabameelne Optimaalne - parim, sobivaim, ökonoomseim Konservatiivne
More informationVanderbiltEM.com. Prehospital STEMIs. EMS Today 2018 Research That Should Be On Your Radar Screen 3/1/2018
EMS Today 2018 Research That Should Be On Your Radar Screen Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN VanderbiltEM.com
More informationDIC. Bert Vandewiele Fellow Critical Care 23 May 2011
DIC Bert Vandewiele Fellow Critical Care 23 May 2011 Dissiminated Intravascular Coagulopathie 11/3/2011 Dr. Bert Vandewiele 2 Dissiminated Intravascular Coagulopathie = Consumption coagulopathie = Defibrination
More informationChapter 3. Haemostatic abnormalities in patients with liver disease
Chapter 3 Haemostatic abnormalities in patients with liver disease Ton Lisman, Frank W.G. Leebeek 1, and Philip G. de Groot Thrombosis and Haemostasis Laboratory, Department of Haematology, University
More informationMassive transfusion: Recent advances, guidelines & strategies. Dr.A.Surekha Devi Head, Dept. of Transfusion Medicine Global Hospital Hyderabad
Massive transfusion: Recent advances, guidelines & strategies Dr.A.Surekha Devi Head, Dept. of Transfusion Medicine Global Hospital Hyderabad Massive Hemorrhage Introduction Hemorrhage is a major cause
More informationAnnex III. Summary of Product Characteristics and Package Leaflet
Annex III Summary of Product Characteristics and Package Leaflet 11 SUMMARY OF PRODUCT CHARACTERISTICS AND PACKAGE LEAFLET 12 SUMMARY OF PRODUCT CHARACTERISTICS 13 1. NAME OF THE MEDICINAL PRODUCT Tranexamic
More informationvan Galen KPM, Engelen ET, Mauser-Bunschoten EP, van Es RJJ, Schutgens REG
Cochrane Database of Systematic Reviews Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions(review)
More informationGUIDELINES FOR THE EARLY MANAGEMENT OF PATIENTS WITH ACUTE ISCHEMIC STROKE
2018 UPDATE QUICK SHEET 2018 American Heart Association GUIDELINES FOR THE EARLY MANAGEMENT OF PATIENTS WITH ACUTE ISCHEMIC STROKE A Summary for Healthcare Professionals from the American Heart Association/American
More informationSpanish Consensus Statement on alternatives to allogeneic blood transfusion: the 2013 update of the "Seville Document"
R Spanish Consensus Statement on alternatives to allogeneic blood transfusion: the 2013 update of the "Seville Document" Santiago R. Leal-Noval 1, Manuel Muñoz 2, Marisol Asuero 3, Enric Contreras 3, José
More informationControversies in the Management of SAH
Controversies in the Management of SAH Disclosures: None Controversies Anti-fibrinolytics Anti-epileptic Drugs Goal Hemoglobin Hyponatremia Fever Anti-Fibrinolytics The risk of re-bleeding is highest in
More informationNURSING DEPARTMENT CRITICAL CARE POLICY MANUAL CRITICAL CARE PROTOCOLS. ACUTE CEREBROVASCULAR ACCIDENT TPA (ACTIVASE /alteplase) FOR THROMBOLYSIS
NURSING DEPARTMENT CRITICAL CARE POLICY MANUAL CRITICAL CARE PROTOCOLS ACUTE CEREBROVASCULAR ACCIDENT TPA (ACTIVASE /alteplase) FOR THROMBOLYSIS I. Purpose : A. To reduce morbidity and mortality associated
More informationMASSIVE HAEMORRHAGE J DAVIES ROYAL DEVON AND EXETER NHS FOUNDATION TRUST. Respond Deliver & Enable
MASSIVE HAEMORRHAGE J DAVIES ROYAL DEVON AND EXETER NHS FOUNDATION TRUST Definitions Loss of entire blood volume equivalent within 24hrs Loss of 50% of blood volume within 3hrs Continuing blood loss of
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Medsamic 100 mg/ml solution for injection 2. QUALITATIVE AND QUANTITATIVE COMPOSITION 1 ml contains: tranexamic acid 100 mg. For the
More informationThe current place of tranexamic acid in the management of bleeding
Anaesthesia 2015, 70 (Suppl. 1), 50 53 Review Article doi:10.1111/anae.12910 The current place of tranexamic acid in the management of B. J. Hunt 1,2 1 Professor of Thrombosis & Haemostasis, Kings College
More informationManaging Coagulopathy in Intensive Care Setting
Managing Coagulopathy in Intensive Care Setting Dr Rock LEUNG Associate Consultant Division of Haematology, Department of Pathology & Clinical Biochemistry Queen Mary Hospital Normal Haemostasis Primary
More informationUse of Prothrombin Complex Concentrates (PCC) CONTENTS
CONTENTS Page 1: Exclusion Criteria and Approved Indications for Use Page 2: Dosing / Administration / Storage Page 4: Prescribing / Monitoring / Dispensing Page 5: Cautions / Warnings / Cost Analysis
More informationFOR: JONATHAN WOODSON, M.D., ASSISTANT SECRETARY OF DEFENSE (HEAL TH AFFAIRS)
DEFENSE HEAL TH BOARD FIVE SKYLINE PLACE, SUITE 810 5111 LEESBURG PIKE FALLS CHURCH, VA 22041-3206 SEP 2 3 2011 FOR: JONATHAN WOODSON, M.D., ASSISTANT SECRETARY OF DEFENSE (HEAL TH AFFAIRS) SUBJECT: Recommendations
More information1 Transfusion Medicine and Blood Bank Department, H. São João, Centro
Original Article Interventional Algorithms for the Control of Coagulopathic Bleeding in Surgical, Trauma, and Postpartum Settings: Recommendations From the Share Network Group Clinical and Applied Thrombosis/Hemostasis
More informationDisclosures. Outline. Updated Recommendations for Using Alteplase (TPA) in Acute Ischemic Stroke
Updated Recommendations for Using Alteplase (TPA) in Acute Ischemic Stroke Mark J. Alberts, MD, FAHA Chief of Neurology Hartford Hospital Hartford, CT Disclosures Dr. Alberts is a speaker and consultant
More informationPathophysiologie und Therapie bei Massenblutung
Swisstransfusion Bern, 7. September 2012 Pathophysiologie und Therapie bei Massenblutung Lorenzo ALBERIO Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor Coagulopathy of Trauma Haemorrhage
More informationReview of the TICH-2 Trial
Review of the TICH-2 Trial Mikaela Hofer, PharmD PGY-1 Pharmacy Resident Pharmacy Grand Rounds September 18, 2018 2018 MFMER slide-1 Objectives Review the pharmacologic options to limit hematoma expansion
More informationIntraoperative haemorrhage and haemostasis. Dr. med. Christian Quadri Capoclinica Anestesia, ORL
Intraoperative haemorrhage and haemostasis Dr. med. Christian Quadri Capoclinica Anestesia, ORL Haemostasis is like love. Everybody talks about it, nobody understands it. JH Levy 2000 Intraoperative Haemorrhage
More information3/16/15. Management of the Bleeding Trauma Patient: Concepts in Damage Control Resuscitation. Obligatory Traumatologist Slide
Management of the Bleeding Trauma Patient: Concepts in Damage Control Resuscitation Courtney Sommer, MD MPH Duke Trauma Symposium March 12, 2015 Obligatory Traumatologist Slide In 2010 trauma was leading
More informationTransfusion Requirements and Management in Trauma RACHEL JACK
Transfusion Requirements and Management in Trauma RACHEL JACK Overview Haemostatic resuscitation Massive Transfusion Protocol Overview of NBA research guidelines Haemostatic resuscitation Permissive hypotension
More informationShock and Resuscitation: Part II. Patrick M Reilly MD FACS Professor of Surgery
Shock and Resuscitation: Part II Patrick M Reilly MD FACS Professor of Surgery Trauma Patient 1823 / 18 Police Dropoff Torso GSW Lower Midline / Right Buttock Shock This Monday Trauma Patient 1823 / 18
More informationCOAGULATION, BLEEDING, AND TRANSFUSION IN URGENT AND EMERGENCY CORONARY SURGERY
COAGULATION, BLEEDING, AND TRANSFUSION IN URGENT AND EMERGENCY CORONARY SURGERY VALTER CASATI, M.D. DIVISION OF CARDIOVASCULAR ANESTHESIA AND INTENSIVE CARE CLINICA S. GAUDENZIO NOVARA (ITALY) ANTIPLATELET
More informationThe incidence and magnitude of fibrinolytic activation in trauma patients
Journal of Thrombosis and Haemostasis, 11: 37 314 DOI: 1.1111/jth.1278 ORIGINAL ARTICLE The incidence and magnitude of fibrinolytic activation in trauma patients I. RAZA, R. DAVENPORT, C. ROURKE, S. PLATTON,
More informationKatharine Ker, David Prieto-Merino, Nikola Sprigg, Abda Mahmood, Philip Bath 4, Zhe Kang Law 4, Katie Flaherty 4, Ian Roberts 1
STUDY PROTOCOL The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 2; referees:
More informationDisseminated Intravascular Coagulation. M.Bahmanpour MD Assistant professor IUMS
به نام خدا Disseminated Intravascular Coagulation M.Bahmanpour MD Assistant professor IUMS Algorithm for Diagnosis of DIC DIC Score factor score Presence of known underlying disorder No= 0 yes=2 Coagolation
More informationKay Barrera MD. Surgery Grand Rounds June 19, 2014 SUNY Downstate
Kay Barrera MD Surgery Grand Rounds June 19, 2014 SUNY Downstate Kay Barrera MD Surgery Grand Rounds June 19, 2014 SUNY Downstate Outline Why are we talking about this SCORE expectations When do we use
More informationJohn Davidson Consultant in Intensive Care Medicine Freeman Hospital, Newcastle upon Tyne
John Davidson Consultant in Intensive Care Medicine Freeman Hospital, Newcastle upon Tyne Overview of coagulation Testing coagulation Coagulopathy in ICU Incidence Causes Evaluation Management Coagulation
More informationCritical Care in Obstetrics: An Innovative and Integrated Model for Learning the Essentials
Critical Care in Obstetrics: An Innovative and Integrated Model for Learning the Essentials Massive Blood Transfusion Michael A. Belfort, MD, PhD Professor and Chairman Department of Obstetrics and Gynecology
More informationFinancial Disclosure. Objectives 9/24/2018
Hemorrhage and Transfusion Adjuncts in the Setting of Damage Control Joseph Cuschieri, MD FACS Professor of Surgery, University of Washington Adjunct Professor of Orthopedics and Neurosurgery, University
More informationCurrent status of antifibrinolytics in cardiopulmonary bypass and elective deep hypothermic circulatory arrest
Anesthesiology Clin N Am 21 (2003) 527 551 Current status of antifibrinolytics in cardiopulmonary bypass and elective deep hypothermic circulatory arrest Jeffrey A. Green, MD*, Bruce D. Spiess, MD Department
More informationTrasylol KIE/ml - Infusionsflasche
Annex I List of the invented names, pharmaceutical forms, strengths of the medicinal products, route of administration, marketing authorisation holders in the member states 1 Aprotinin containing medicinal
More informationDisseminated intravascular coagulation (DIC) Dr. Klara Vezendi Szeged University Transfusiology Department
Disseminated intravascular coagulation (DIC) Dr. Klara Vezendi Szeged University Transfusiology Department Disseminated intravascular coagulation (DIC, consumptive coagulopathy) is a clinicopathologic
More informationRecombinant Activated Factor VII: Useful. Department of Surgery Grand Rounds 11/8/10 David Mauchley MD
Recombinant Activated Factor VII: Useful Department of Surgery Grand Rounds 11/8/10 David Mauchley MD Hemostasis and Coagulation Traditional cascade model Two convergent pathways Series of proteolytic
More informationTreatment of Acute Hemorrhagic Stroke 5th QSVS Neurovascular Conference Dar Dowlatshahi MD PhD FRCPC Sept 14, 2012
Treatment of Acute Hemorrhagic Stroke 5th QSVS Neurovascular Conference Dar Dowlatshahi MD PhD FRCPC Sept 14, 2012 Disclosure of potential conflicts of interest Quebec Society of Vascular Sciences presents
More informationUnderstanding the Mechanism and Chemical Properties of Tranexamic Acid and Its Applications in Orthopedics, Specifically Trauma Patients
Understanding the Mechanism and Chemical Properties of Tranexamic Acid and Its Applications in Orthopedics, Specifically Trauma Patients Temple University Hospital Anastassia Newbury M.D. Christopher Haydel
More informationBACKGROUND AND SCIENTIFIC RATIONALE. Protocol Code: ISRCTN V 1.0 date 30 Jan 2012
BACKGROUND AND SCIENTIFIC RATIONALE Protocol Code: ISRCTN15088122 V 1.0 date 30 Jan 2012 Traumatic Brain Injury 10 million killed or hospitalised every year 90% in low and middle income countries Mostly
More informationMitteinvasiivne ventilatsioon kiirabi ja EMO praktikas, ehk morfiinivaba kopsuturse ravi
Mitteinvasiivne ventilatsioon kiirabi ja EMO praktikas, ehk morfiinivaba kopsuturse ravi Arkadi Popov Põhja-Eesti Regionaalhaigla reanimobiil A. Bobrov ja tema aparaat Morfiin ja kopsutuse: kas vennad
More informationManagement of Massive Transfusion. Philippe Van der Linden MD, PhD CHU Brugmann-HUDERF, Free University of Brussels
Management of Massive Transfusion Philippe Van der Linden MD, PhD CHU Brugmann-HUDERF, Free University of Brussels Massive Hemorrhage: definition? Replacement of one blood mass in less than 24 hours Dynamic
More informationMANAGEMENT OF COAGULOPATHY AFTER TRAUMA OR MAJOR SURGERY
MANAGEMENT OF COAGULOPATHY AFTER TRAUMA OR MAJOR SURGERY 19th ANNUAL CONTROVERSIES AND PROBLEMS IN SURGERY Thabo Mothabeng General Surgery: 1 Military Hospital HH Stone et al. Ann Surg. May 1983; 197(5):
More informationTransfusion in major bleeding: new insights. Gert Poortmans
Transfusion in major bleeding: new insights Gert Poortmans Trauma Cardiac Surgery Major Surgery with ongoing blood loss Burn Surgery Lethal Triad Polytransfusion: definitions Coagulation Coagulopathy of
More informationUniversity of Pennsylvania Health System Aprotinin Task Force
Aprotinin Use in Adult Cardiac Surgery: A Recommendation Statement from the University of Pennsylvania Health System Center for Evidence-based Practice *Note: This guideline was originally released on
More informationThrombolysis administration
Thrombolysis administration Liz Mackey Stroke Nurse Practitioner Western Health Sunshine & Footscray Hospital, Melbourne Thanks ASNEN committee members Skye Coote, Acute Stroke Nurse, Eastern Health (slide
More informationOriginal Article Post-Operative Bleeding Pak Armed Forces Med J 2014; 1(1): S13-18
Original Article Post-Operative Bleeding Pak Armed Forces Med J 2014; 1(1): S13-18 COMPARISON OF DIFFERENT DOSES OF TRANEXAMIC ACID ON POST-OPERATIVE BLEEDING IN PATIENTS OF CABG SURGERY Fakher-e-Fayaz,
More informationContents. Version 1.0: 01/02/2010 Protocol# ISRCTN Page 1 of 7
Contents 1. INTRODUCTION... 2 2. STUDY SYNOPSIS... 2 3. STUDY OBJECTIVES... 2 3.1. Primary Objective... 2 3.2. Secondary Objectives... 2 3.3. Assessment of Objectives... 3 3.4. Change the Primary Objective
More informationHeme (Bleeding and Coagulopathies) in the ICU
Heme (Bleeding and Coagulopathies) in the ICU General Topics To Discuss Transfusions DIC Thrombocytopenia Liver and renal disease related bleeding Lack of evidence in managing critical illness related
More informationManagement of Massive Blood Loss
Asuccessful outcome requires prompt action and good communication between clinical specialties, diagnostic laboratories, hospital transfusion laboratory staff and the Blood Service. Therapeutic goals These
More informationMehaaniline trombi eemaldamine ajuarterist (Ajuarteri trombektoomia)
Mehaaniline trombi eemaldamine ajuarterist (Ajuarteri trombektoomia) Taotluse number - 1124 1. Meditsiiniline näidustus teenuse osutamiseks (taotluse punkt 3.1); Esitatud näidustused on õiged ja asjakohased
More informationTranexamic Acid for Trauma Patients: A Critical Review of the Literature
REVIEW ARTICLE Tranexamic Acid for Trauma Patients: A Critical Review of the Literature Andrew P. Cap, MD, PhD, David G. Baer, PhD, Jean A. Orman, MPH, ScD, James Aden, PhD, Kathy Ryan, PhD, and Lorne
More informationADVANCES IN HEMATOLOGY
ADVANCES IN HEMATOLOGY Current Developments in the Management of Hematologic Disorders Section Editor: Craig M. Kessler, MD Antifibrinolytic Agents in Acquired Bleeding Disorders Mark Walsh, MD Emergency
More informationTranexamic Acid for Trauma-Related Hemorrhage
Advanced Emergency Nursing Journal Vol. 36, No. 2, pp. 123 131 Copyright C 2014 Wolters Kluwer Health Lippincott Williams & Wilkins A P P L I E D Pharmacology Column Editor: Kyle A. Weant, PharmD, BCPS
More informationHyperfibrinolysis and the risk of hemorrhage in stable cirrhotic patients
Asian Biomedicine Vol. 4 No. 2 April 2010; 199-206 Original article Hyperfibrinolysis and the risk of hemorrhage in stable cirrhotic patients Anoree Surawong a, Ponlapat Rojnuckarin a, Jumlong Juntiang
More informationDISSEMINATED INTRAVASCULAR COAGULATION (DIC) Pichika Chantrathammachart MD Division of Hematology, Department of Medicine Ramathibodi Hospital
DISSEMINATED INTRAVASCULAR COAGULATION (DIC) Pichika Chantrathammachart MD Division of Hematology, Department of Medicine Ramathibodi Hospital Disseminated intravascular coagulation (DIC) Disseminated
More informationEfficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery
Sui et al. BMC Musculoskeletal Disorders (2016) 17:187 DOI 10.1186/s12891-016-1006-y RESEARCH ARTICLE Open Access Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic
More informationBleeding and Management of Coagulopathy
Bleeding and Management of Coagulopathy Jerrold H. Levy, MD, FAHA Professor of Anesthesiology Deputy Chair for Research Emory University School of Medicine Director, Cardiothoracic Anesthesiology CT Anesthesiology
More informationThrombolysis-WAKE UP Intra-arterial interventions DEFUSE 3 Haemorrhagic Stroke - TICH 2 Secondary Prevention CROMIS 2 Secondary Prevention NAVIGATE
Thrombolysis-WAKE UP Intra-arterial interventions DEFUSE 3 Haemorrhagic Stroke - TICH 2 Secondary Prevention CROMIS 2 Secondary Prevention NAVIGATE ESUS Progression of haematoma Anticoagulation Large ICH
More informationTranexamic acid and trauma-induced coagulopathy
Nishida et al. Journal of Intensive Care (2017) 5:5 DOI 10.1186/s40560-016-0201-0 REVIEW Tranexamic acid and trauma-induced coagulopathy Takeshi Nishida, Takahiro Kinoshita and Kazuma Yamakawa * Open Access
More informationAPPROVED PACKAGE INSERT
Page 1 of 6 APPROVED PACKAGE INSERT SCHEDULING STATUS: S4 PROPRIETARY NAME AND DOSAGE FORM: CYKLOKAPRON T 500 (Tablets) CYKLOKAPRON IV 500 (Injection) COMPOSITION: Each tablet contains 500 mg tranexamic
More informationLondon School of Hygiene and Tropical Medicine, Keppel Street, London, UK 2
CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage) intracranial bleeding study: the effect of tranexamic acid in traumatic brain injury a nested, randomised, placebo-controlled
More informationPatient Blood Management Are you providing this? Jeannie Callum, BA, MD, FRCPC Associate Professor, University of Toronto
Patient Blood Management Are you providing this? Jeannie Callum, BA, MD, FRCPC Associate Professor, University of Toronto Disclosures Relevant relationships with commercial entities: Octapharma, CSL Behring
More informationEmergency Management of Patients on Direct Oral Anticoagulants (DOACs)
Emergency Management of Patients on Direct Oral Anticoagulants (DOACs) Dr Tina Biss Consultant Haematologist Newcastle upon Tyne Hospitals NHS Foundation Trust NE RTC Annual Education Symposium 11 th October
More informationHEMOSTASIS AND LIVER DISEASE. P.M. Mannucci. Scientific Direction, IRCCS Ca Granda Foundation Maggiore Hospital, Milan, Italy
HEMOSTASIS AND LIVER DISEASE P.M. Mannucci Scientific Direction, IRCCS Ca Granda Foundation Maggiore Hospital, Milan, Italy 1964 ACQUIRED HEMOSTASIS DISORDERS: LIVER DISEASE Severe liver disease not uncommonly
More informationANTICOAGULANTS & FIBRINOLYTIC AGENTS Chapter 34
ANTICOAGULANTS & FIBRINOLYTIC AGENTS Chapter 34 Dr. Azadeh Mesripour (Ph.D) Pharm.MUI 2015 Dr. Mesripour 1 Platelet membrane receptors include the glycoprotein (GP) Ia receptor, binding to collagen (C);
More informationAntifibrinolytic drugs, such as the bovine-derived
CMAJ DOI:10.1503/cmaj.081109 The safety of aprotinin and lysine-derived antifibrinolytic drugs in cardiac surgery: a meta-analysis David Henry MBChB, Paul Carless BHSc MMedSc (ClinEpid), Dean Fergusson
More informationIs TXA a Lifesaving Drug That s Too Cheap to Bother Using?
Is TXA a Lifesaving Drug That s Too Cheap to Bother Using? Tue, Jan 2, 2018 By Matt Bivens, MD Photo courtesy Ed Pepin/Fairhaven Fire Department Is TXA a lifesaving drug that s too cheap to bother using?
More informationPatient Blood Management in the Netherlands: Between practice and evidence
Patient Blood Management in the Netherlands: Between practice and evidence Marian van Kraaij MD PhD hematologist transfusion medicine specialist Department of Transfusion Medicine, Sanquin Blood Bank Radboud
More informationBalanced Transfusion Resuscitation
Transparency in Transfusion Medicine 2013 Balanced Transfusion Resuscitation HGD Hendriks MD, PhD University Medical Center Groningen Balancing 1 2 3 Preoperative Peroperative Postoperative Balanced Coagulation
More informationTranexamic acid: a clinical review
REVIEWS Anaesthesiology Intensive Therapy 2015, vol. 47, no 4, 339 350 ISSN 0209 1712 10.5603/AIT.a2015.0011 www.ait.viamedica.pl Tranexamic acid: a clinical review William Ng 1, Angela Jerath 1, 2, Marcin
More informationPrecilla V. Veigas 1, Jeannie Callum 2, Sandro Rizoli 3, Bartolomeu Nascimento 4 and Luis Teodoro da Luz 4*
Veigas et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2016) 24:114 DOI 10.1186/s13049-016-0308-2 REVIEW Open Access A systematic review on the rotational thrombelastometry
More informationSystemic and Topical Use of Tranexamic Acid in Spinal Surgery: A Systematic Review
284 Review Article GLOBAL SPINE JOURNAL THIEME Systemic and Topical Use of Tranexamic Acid in Spinal Surgery: A Systematic Review Sebastian F. Winter 1 Carlo Santaguida 2 Jean Wong 3 Michael G. Fehlings
More informationCOMBATING. Piya Samankatiwat Ramathibodi hospital
COMBATING SEVERE COAGULOPATHY O Piya Samankatiwat y Ramathibodi hospital Haemostasis Mechanisms Endothelium and Vascular function Platelet l t amount and function Coagulation factors Fibrinolysis Vascular
More informationObjectives. Pediatric Trauma Update: Objectives: Topics
Objectives Pediatric Trauma Update: 2013 Christopher Newton MD, FACS, FAAP Medical Director Trauma Services and Surgical Critical Care Children s Hospital Oakland Review recent trends and advancements
More informationUANL UNIVERSIDAD AUTÓNMA DE NUEVO LEÓN
First comparative study of the effectiveness of the use of Tranexamic Acid against!- Aminocapróic Acid in multiple doses via the oral route for the reduction of post-operative bleeding and transfusion
More informationRole of NOACs in AF Management. From Evidence to Real World Data Focus on Cardioversion
Role of NOACs in AF Management. From Evidence to Real World Data Focus on Cardioversion John Rickard MD, MPH Staff Electrophysiologist Cleveland Clinic Agenda NOACs: Update on Real World Data NOAC reversal:
More information