Afibrinogenemia
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Researchers at Aarhus University publish new data on coagulation therapy
2009 JUL 20 - (NewsRx.com) -- A new study, 'Mechanisms of hydroxyethyl starch-induced dilutional coagulopathy,' is now available. According to recent research published in the Journal of Thrombosis and Haemostasis, "The biochemical mechanisms causing dilutional coagulopathy following infusion of hydroxyethyl starch 130/0.4 (HES) are not known in detail. To give a detailed biochemical description of the mechanism of coagulopathy following 30%in vivo dilution with HES, to present a systematic ex vivo test of various hemostatic agents, and to investigate the hypothesis that acquired fibrinogen deficiency constitutes the most important determinant of the coagulopathy." "Dynamic whole blood clot formation assessed by thromboelastometry, platelet count, thrombin generation, and the activities of von Willebrand factor, coagulation factor II, FVII, FVIII, FIX, FX and FXIII were measured in 20 bleeding patients enrolled in a prospective clinical study investigating in vivo substitution of blood loss with HES up to a target level of 30%. Thromboelastometry parameters were further evaluated after ex vivo spiking experiments with fibrinogen, prothrombin complex concentrate (PCC), FXIII, activated recombinant FVIIa (rFVIIa), fresh frozen plasma, and platelets. Hemodilution reduced maximum clot firmness (MCF), whereas whole blood clotting time (CT) and maximum velocity remained unaffected. All coagulation factor activities were reduced. Fibrinogen, FII, FXIII and FX activities decreased significantly below the levels expected from dilution. The endogenous thrombin potential was unchanged. Ex vivo addition of fibrinogen normalized the reduced MCF and increased the maximum velocity, whereas PCC, rFVIIa and platelets shortened the CT but showed no effect on the reduced MCF," wrote C. Fenger-Eriksen and colleagues, Aarhus University. The researchers concluded: "Acquired fibrinogen deficiency seems to be the leading determinant in dilutional coagulopathy, and ex vivo addition corrected the coagulopathy completely." Fenger-Eriksen and colleagues published their study in the Journal of Thrombosis and Haemostasis (Mechanisms of hydroxyethyl starch-induced dilutional coagulopathy. Journal of Thrombosis and Haemostasis, 2009;7(7):1099-105). For additional information, contact C. Fenger-Eriksen, Aarhus University Hospital, Dept. of Anaesthesiology, Centre for Haemophilia and Thrombosis, Aarhus, Denmark. The publisher's contact information for the Journal of Thrombosis and Haemostasis is: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA. Keywords: Denmark, Aarhus, Coagulation Therapy, Afibrinogenemia, Angiology, Biochemical, Blood Clot, Clinical Trial Research, Clotting, Coagulation, Enzyme Research, Haemostasis, Hematology, Therapy, Thrombin, Thrombosis, Treatment, Von Willebrand Disease. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.
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