Abstract：
:Unexplained intraoperative coagulopathies continue to be a diagnostic and therapeutic dilemma. The pathophysiology behind unexplained intraoperative coagulopathies is of great variety and complexity (preexisting coagulopathies, dilutional coagulopathy, interactions of medications etc.). We have shown in prospective studies that patients undergoing elective surgery who develop "unexplained" intraoperative coagulopathies have significantly less FXIII per unit thrombin available at any point in time (i.e. already preoperatively) than patients without such coagulopathies. The consequence is a significant loss of clot firmness associated with an increase in intraoperative blood loss. Thus, these patients have less cross-linking capacity to begin with, which explains their preoperatively increased fibrin monomer concentration. The association of increased preoperative fibrin monomer and increased intraoperative blood loss was prospectively evaluated and confirmed in a separate clinical study. It is important to note that the acquired or (compared to the amount of thrombin generated) relative F. XIII deficiency in situations with surgical stress shows early clinical relevance (even if only mild to moderate changes are present); this differs from the experiences with patients with inborn FXIII deficiency, where a pronounced deficiency must be present to have clinically significant spontaneous bleeding. Patients undergoing elective surgery, without clinically obvious coagulopathy but increased preoperative fibrin monomer concentration (as a marker of decreased crosslinking capacity) are at risk for increased intraoperative blood loss. This new concept helps to explain the pathophysiology behind unexplained intraoperative coagulopathies and thus allows for corresponding treatment strategies. Further clinical studies for early detection and interventions in patients with such coagulopathies are necessary.
journal_name
Hamostaseologiejournal_title
Hamostaseologieauthors
Korte Wsubject
Has Abstractpub_date
2006-08-01 00:00:00pages
S30-5issue
3 Suppl 1eissn
0720-9355issn
2567-5761pii
06050030journal_volume
26pub_type
杂志文章相关文献
Hamostaseologie文献大全abstract：:Myocardial infarction (MI) shows a strong heritability. For a long time the identification of responsible genes has been rather unsuccessful. However, with the advent of genome wide association studies (GWAS) using DNA-array technology a number of significant loci for MI have been identified which were widely replicat...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：
更新日期：2010-11-01 00:00:00
abstract：:Obesity is a major cause for a spectrum of metabolic syndrome-related diseases that include insulin resistance, type 2 diabetes, and steatosis of the liver. Inflammation elicited by macrophages and other immune cells contributes to the metabolic abnormalities in obesity. In addition, coagulation activation following t...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.5482/HAMO-14-11-0068
更新日期：2015-01-01 00:00:00
abstract：:In Germany one-third of the women in fertile age use combined oral contraceptives (COCs), which consist mostly of ethinylestradiol (EE) and a synthetic progestin. Older COCs with norethisterone or levonorgestrel have a lower risk for venous thromboembolism (VTE) than newer COCs with desogestrel, drospirenone, or gesto...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.1055/s-0039-1677806
更新日期：2019-02-01 00:00:00
abstract：:Haemophilic arthropathy is a complex multifactorial disorder that poses significant challenges to both the treating haematologist and arthroplasty surgeon. Its pathogenesis is incompletely understood. Recent literature has concentrated on the toxic effects of iron and the characteristic inflammatory synovitis. Discuss...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：10.5482/HAMO-15-12-0033
更新日期：2017-01-01 00:00:00
abstract：UNLABELLED:The doses of these drugs are barely tested and the potential clinical thromboembolic risk must be taken into account. Despite the widespread use of NOAC (non vitamin-K dependent oral anticoagulants) and recommendations of regulatory agencies and first consensus meeting on handling the bleeding situation unde...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：
更新日期：2015-01-01 00:00:00
abstract：:The translation of fundamental science-based constructs to the preemptive identification and optimal management of individuals with or those at risk for thrombotic disorders of the cardiovascular system has taken a step closer to being realized with the development of molecular technologies that include nucleic acid a...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：
更新日期：2007-12-01 00:00:00
abstract：:Acquired haemophilia A (AHA) is a rare autoimmune disease caused by antibodies directed against clotting factor VIII. About half of cases are idiopathic, but AHA may also be secondary to autoimmune, dermatologic, or oncologic diseases. In approximately 10% of non-idiopathic cases, the disease occurs after or with the ...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：10.1055/s-0038-1668570
更新日期：2019-02-01 00:00:00
abstract：:Platelet and coagulation factor-dependent thrombus formation is critical to limit posttraumatic blood loss at sites of vascular injury. However, under pathological conditions like rupture of an atherosclerotic plaque, it may also lead to vessel occlusion causing myocardial infarction or stroke. Therefore, antithrombot...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：
更新日期：2010-08-01 00:00:00
abstract：:This article reviews the current understanding of the pathophysiology of acute coronary syndrome and how these concepts have altered our clinical approach to the acute phase of coronary heart disease. Thrombosis due to erosion or, in most cases, rupture of a vulnerable atherosclerotic plaque underlies most acute coron...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：
更新日期：2006-05-01 00:00:00
abstract：:Patients suffering from haemophilia encounter various phases in life, in which individual needs, life situations, and self- and disease perception change rapidly. One of these phases spans from the beginning of puberty until early adulthood, in which individuals gain self-responsibility and reach independence and auto...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.1055/s-0039-3402804
更新日期：2020-02-01 00:00:00
abstract：:Current antithrombotic therapy in patients with acute coronary syndrome (ACS) comprises antiplatelet and anticoagulant therapy. Dual antiplatelet therapy composed of aspirin plus a third generation P2Y12 inhibitor (prasugrel or ticagrelor) represents the gold standard, while aspirin plus second generation P2Y12 inhibi...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.5482/HAMO-13-09-0048
更新日期：2014-01-01 00:00:00
abstract：:Trauma-induced coagulopathy (TIC) is a heterogeneous entity that contributes to a significant morbidity and mortality following trauma. The activated protein C system, endotheliopathy and platelet dysfunction have been implicated in the pathogenesis of TIC, although there are still controversies on the exact pathogene...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.1055/s-0039-1677853
更新日期：2019-02-01 00:00:00
abstract：:The endothelium lining the vascular lumen is continuously exposed to complement from the circulation. When erroneously activated on host cells, complement may generate a deleterious effect on the vascular wall leading to endothelial injury, exposure of the subendothelial matrix and platelet activation. In this review ...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.5482/HAMO-12-12-0025
更新日期：2013-05-29 00:00:00
abstract：:Platelet cytoskeletal reorganization is essential for platelet adhesion and thrombus formation in hemostasis and thrombosis. The Rho GTPases RhoA, Rac1 and Cdc42 are the main players in cytoskeletal dynamics of platelets responsible for the formation of filopodia and lamellipodia to strongly increase the platelet surf...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.5482/HAMO-14-09-0046
更新日期：2016-08-03 00:00:00
abstract：:Three selected casuistic studies of individual patient problems from my long-standing professional experience are presented. I intend to highlight the potential contribution of case studies, including new approaches of laboratory investigation, for the advancement of pathophysiological knowledge and would encourage to...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：10.1055/a-1191-7198
更新日期：2020-11-01 00:00:00
abstract：UNLABELLED:The retrospective cohort study surveys the influence of age, co-morbidity and laboratory values on FVIII-activity (FVIII:C) in patients with haemophilia A with (mild n = 48, moderate n = 10, severe n = 7 and carriers n = 23). Median observation was 19 years for patients with haemophilia A and 9,5 years for c...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：
更新日期：2011-11-01 00:00:00
abstract：OBJECTIVE: This article aims to analyze the phenotype and genotype of an inherited dysfibrinogenemia pedigree associated with a heterozygous mutation in the FGA gene, and to investigate the pathogenesis of this disease. CLINICAL PRESENTATION: The proband of interest is a 29-year-old woman. She was in her 37 weeks of g...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：10.1055/a-1261-3884
更新日期：2020-12-01 00:00:00
abstract：:Atherosclerosis and its major complications - myocardial infarction and stroke - remain major causes of death and disability in the United States and world-wide. Indeed, with dramatic increases in obesity and diabetes mellitus, the prevalence and public health impact of cardiovascular diseases (CVD) will likely remain...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.5482/HAMO-14-11-0076
更新日期：2016-05-10 00:00:00
abstract：:Coronary heart disease and the acute coronary syndrome are the leading causes of death in Germany. In prospective observational studies conventional risk factors such as smoking, arterial hypertension, hypercholesterolaemia, and diabetes can explain over 80% of cardiovascular diseases. Therefore, cardiovascular diseas...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：
更新日期：2006-05-01 00:00:00
abstract：:An overview is given on congenital and acquired thrombocytopenias, their pathophysiology, symptoms, diagnosis and therapy with emphasizing heparin-induced thrombocytopenia (HIT) and the thrombotic thrombocytopenic purpura (TTP). ...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：
更新日期：2003-11-01 00:00:00
abstract：:Characteristic features of disseminated intravascular coagulation (DIC) are the opposing risks of bleeding (due to consumptive coagulopathy and hyperfibrinolysis) and organ failure (due to widespread microvascular thromboses). The purpose of anticoagulation in DIC is to attenuate excessive thrombin generation and fibr...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：10.1055/s-0038-1675386
更新日期：2019-08-01 00:00:00
abstract：:We describe the case of a 30-year-old woman with homozygous prothrombin G20210A transition and heterozygous FV Leiden mutation and a history of postpartum venous thrombosis. Despite the high thrombotic risk to be assumed in the presence of this combined thrombophilia our patient suffered her first venous thrombotic ev...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：
更新日期：2003-08-01 00:00:00
abstract：:Platelets play a crucial role in haemostasis and several pathophysiological processes. Collagen is a main initiator for platelet activation and aggregation. Given that Wnt signalling negatively regulates platelet function, and IWR-1 (a small molecule inhibitor for Wnt signalling) has the potential of inhibiting collag...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：10.1055/s-0038-1676822
更新日期：2019-11-01 00:00:00
abstract：:Platelet number or function disorders cause a range of bleeding symptoms from mild to severe. Patients with platelet dysfunction but normal platelet number are the most prevalent and typically have mild bleeding symptoms. The study of this group of patients is particularly difficult because of the lack of a gold-stand...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：
更新日期：2010-01-01 00:00:00
abstract：UNLABELLED:Secondary arthrosis of the upper ankle joint (talocalcanean joint) is one of the most frequent forms of haemophilic arthropathy. It is a secondary form of arthrosis not only because of chronic synovitis and cartilage injury resulting from chronic recurrent intraarticular bleeds, but also due to the misalignm...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：
更新日期：2009-10-01 00:00:00
abstract：:Vitamin K 2,3-epoxide reductase complex, subunit 1 (VKORC1) is an enzyme essential for the vitamin K cycle. VKORC1 catalyses the reduction of vitamin K 2,3-epoxide to the quinone form of vitamin K and further to vitamin K hydroquinone. The generated vitamin K hydroquinone serves as substrate for the enzyme γ-glutamyl-...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：
更新日期：2016-11-08 00:00:00
abstract：:Atherosclerosis and its sequelae have a major impact on morbidity and mortality. The rupture of an inflamed atherosclerotic plaque is a crucial event, since it can result in acute thrombotic closure of an arterial vessel, resulting e. g. in myocardial infarction or stroke. Not only detection of early plaque rupture wi...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.5482/HAMO-14-11-0061
更新日期：2015-01-01 00:00:00
abstract：:Placenta-mediated pregnancy complications are clinically important conditions and include preeclampsia, placental abruption, intrauterine growth restriction, and late fetal loss. Pathophysiology is complex, and may be linked to prothrombotic disorders such as antiphospholipid syndrome, whose understanding is still evo...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：10.1055/a-1184-8388
更新日期：2020-08-01 00:00:00
abstract：AIM:In children, screening for haemorrhagic disorders is further complicated by the fact that infants and young children with mild disease in many cases most likely will not have a significant history of easy bruising or bleeding making the efficacy of a questionnaire even more questionable. PATIENTS, METHODS:We compa...
journal_title：Hamostaseologie
pub_type： 杂志文章
doi：
更新日期：2009-10-01 00:00:00
abstract：:For the last decades, anticoagulation for stroke prevention in atrial fibrillation (AF) as well as for the prophylaxis and long-term treatment of venous thromboembolism has been entirely based on vitamin K antagonists (VKA). Although very effective under optimal conditions, long-term treatment with these drugs is flaw...
journal_title：Hamostaseologie
pub_type： 杂志文章,评审
doi：10.5482/ha-12050008
更新日期：2012-01-01 00:00:00
