Search results for "coagulopathy"
showing 10 items of 33 documents
Coronavirus Disease 2019–Associated Coagulopathy
2021
Patients with the severe form of coronavirus disease 2019 (COVID-19) have been frequently found to suffer from both arterial and venous thrombotic events due to the perpetuation of a hypercoagulable state. This phenomenon, termed COVID-19-associated coagulopathy (CC), is now considered a major component of the pathophysiology of this novel infectious disease, leading to widespread thrombosis. While at first, the vascular insults may be limited to the pulmonary microvasculature, as the disease progresses, systemic involvement occurs, culminating in distant organ thrombosis and multi-organ dysfunction syndrome. In this review article, we discuss recent insights into the pathophysiologic mecha…
Staged acute mesenteric and peripheral ischemia treatment in COVID-19 patient: Case report
2021
Introduction COVID-19 is an infectious disease that has been associated not only with respiratory complications. The COVID-19 disease includes, also damage to other organ systems as well as coagulopathy. The present report describes a case of COVID-19 presenting with acute mesenteric ischemia (AMI) and subsequent acute limb ischemia (ALI). Presentation of case An 84-years old hospitalized female patient presenting diabetes and recent COVID-19 reported acute onset of abdominal pain and typical findings of AMI. The CT-angiography confirmed the AMI secondary to a superior mesenteric artery (SMA) occlusion. The patient was managed through an endovascular approach using a SMA mechanical thrombec…
Safety of plasma-derived protein C for treating disseminated intravascular coagulation in adult patients with active cancer
2012
Cancer-related disseminated intravascular coagulation (DIC) is a life-threatening condition for which no effective treatment is currently available. Protein C (PC), a modulator of coagulation as well as the inflammatory system, has been successfully tested (in its activated recombinant form [a-rPC]) in sepsis-related coagulopathy, but with an increased risk for major bleeding. Plasma-derived PC (pd-PC) is more suitable than a-rPC in patients at high risk from bleeding due to its self-limiting process. We carried out a single-arm study evaluating the role of pd-PC in adult cancer patients with overt DIC. Over a period of 3 years, we treated 19 patients with overt DIC and a PC plasma concentr…
Spontaneous chronic subdural hematomas in young adults with a deficiency in coagulation factor XIII. Report of three cases
2005
✓ Chronic subdural hematomas (SDHs) generally occur in elderly patients. Its pathogenesis is usually related to head trauma with tearing and rupture of the bridging veins, although in some cases a history of trauma is not recognizable. There are many reports regarding the association between spontaneous chronic SDHs and an alteration in coagulative parameters. A coagulative disorder should be suspected when an unexplained hemorrhage occurs, especially in a young patient. The authors report on three young men with a deficiency in coagulation factor XIII (FXIII) who underwent surgery for chronic SDHs. The role of FXIII in the pathogenesis of chronic SDH is emphasized. In patients with unexpla…
Liver assessment and biopsy in patients with marked coagulopathy: value of mini-laparoscopy and control of bleeding.
2003
Evaluation of liver disease in patients with a high risk of postbiopsy bleeding presents a diagnostic challenge. Mini-laparoscopy offers the possibility of coagulation of biopsy site and the additional advantage of macroscopic liver assessment. We wished to assess the value and safety of mini-laparoscopy with guided biopsy as a diagnostic approach in patients in whom percutaneous liver biopsy is considered contraindicated because of a marked coagulopathy.We investigated 61 consecutive patients with marked coagulopathy (prolonged international normalized ratio1.5, thrombocytopenia50/nl, or both; von Willebrand's disease/hemophilia). Diagnostic mini-laparoscopy with visually guided liver biop…
Comparison of the rates of joint arthroplasty in patients with severe factor VIII and IX deficiency: an index of different clinical severity of the 2…
2009
AbstractData from the Italian Hemophilia Centres were collected to perform a retrospective survey of joint arthroplasty in patients with severe hemophilia. Twenty-nine of 49 hemophilia centers reported that 328 of the 347 operations were carried out in 253 patients with severe hemophilia A (HA) and 19 in 15 patients with severe hemophilia B (HB). When results were normalized to the whole Italian hemophilia population (1770 severe HA and 319 severe HB), patients with HA had a 3-fold higher risk of undergoing joint arthroplasty (odds ratio [OR], 3.38; 95% confidence interval [CI], 1.97-5.77; P < .001). These results were confirmed after adjustment for age, HIV, hepatitis C virus (HCV), and…
Successful treatment of life-threatening bleeding after cesarean section with recombinant activated factor VII.
2006
Hemorrhagic shock developed in a 29-year-old nullipara without coagulopathy after emergency caesarean section. Treatment with uterotonic drugs, prostaglandins, and conservative procedures with transfusion of packed red cells and fresh-frozen plasma failed to control the diffuse vaginal and uterine bleeding. Finally an intravenous bolus injection of 90 μg/kg recombinant activated factor VII (rFVIIa, NovoSeven®, Novo Nordisk A/S, Bagsvaerd, Denmark), was given and showed success within 20 minutes after administration, without any side effects.
Immune Tolerance Induction in Hemophilia A: A Review
2003
In this article, a comparative analysis of the data stemming from the studies conducted in the field of immune tolerance treatment (ITT) of hemophilia A was attempted. Comparisons are difficult because previous studies differ in many respects, including the dosage of factor (F) VIII, the number of FVIII administrations per day, the association with immunosuppressive drugs (prednisone, cyclophosphamide), and, most importantly, the definition of success in terms of the reacquisition of tolerance. However, a number of variables consistently influenced outcome: the inhibitor titer, either the maximum one or the one assayed before immune tolerance (IT) start and age. As to the FVIII dose, result…
The impact of del Nido cardioplegia solution on blood morphology parameters
2021
Background: Crystalloid cardioplegic solutions are believed to reduce hemoglobin significantly and increase the transfusion rate. However, recent reports indicate that the del Nido cardioplegia may preserve blood morphology parameters. Methods: In “The del Nido versus cold blood cardioplegia in aortic valve Replacement” trial patients undergoing aortic valve replacement were randomized into the del Nido (DN) or cold blood cardioplegia (CB) group. For the subanalysis, patients who underwent blood transfusions were excluded from the study. Red blood cell (RBC) count, hemoglobin, white blood cell (WBC) count and platelet (PLT) count were measured before the surgery, 24-, 48-, and 96 hours post…
Prophylactic or therapeutic doses of heparins for COVID-19 infection? A retrospective study
2020
Background: Coronavirus disease 19 (COVID-19) is a global outbreak. COVID-19 patients seem to have relevant coagulative abnormalities, even if they are not typical of disseminated intravascular coagulopathy (DIC) of the kind seen in septicaemia. Therefore, anticoagulant therapy with heparins is increasing in interest for a clinical approach to these patients, particularly if older. Studies comparing if prophylactic doses are more effective than therapeutic ones are still missing. Methods: Data were collected in the Geriatric Section of the Dolo Hospital, ULSS 3 “Serenissima”, Venice from 31st March to 01st May 2020. Heparins (calciparin, fondaparinux, enoxaparine) were divided into prophyla…