Document Detail


Compensated activation of coagulation in patients with abdominal aortic aneurysm: effects of heparin treatment prior to elective surgery.
MedLine Citation:
PMID:  15543326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elective surgery of abdominal aortic aneurysm (AAA) sometimes leads to excessive bleeding and disseminated intravascular coagulation (DIC), even in patients with normal preoperative coagulation parameters. Coagulation screen, performed routinely before surgery is of limited value in the assessment of compensated activation of the haemostatic system. In this study, we used a number of additional tests (D-dimer, prothrombin fragment 1+2, antithrombin, and activation of fibrinolysis in the platelet poor plasma) for the diagnosis of compensated activation of the haemostatic system in AAA-patients. D-dimer and marker of thrombin generation (prothrombin fragment 1+2) positively correlated with each other (r = 0.768, P < 0.001). Out of 71 AAA patients, 15 patients had normal global coagulation times, but those with a D- dimer concentration above 3000 ng/ml were selected for preoperative low molecular weight heparin (LMWH) treatment. Administration of LMWH diminished coagulation abnormalities (D-dimer and prothrombin fragment 1+2 decreased significantly) and resulted in the increase of platelet number and fibrinogen concentration, indicating their previous consumption. Despite differences in aneurysm diameters between the groups of 15 LMWH treated patients (mean 70.9 +/- 16 mm) and the reference group of 20 untreated AAA patients (mean 52.3 +/- 8.0 mm), intraoperative parameters (operation time, blood loss and transfusion demands) were similar.
Authors:
Maria Magdalena Jelenska; Jacek Szmidt; Krzystof Bojakowski; Tomasz Grzela; Magorzata Palester-Chlebowczyk
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  92     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-15     Completed Date:  2005-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  997-1002     Citation Subset:  IM    
Affiliation:
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland. magdajel@amwaw.edu.pl
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Aneurysm, Abdominal / blood*,  pathology,  surgery
Biological Markers / blood
Blood Coagulation / drug effects*
Blood Coagulation Tests
Blood Loss, Surgical / prevention & control
Female
Fibrin Fibrinogen Degradation Products / analysis
Hemorrhage / prevention & control
Heparin, Low-Molecular-Weight / administration & dosage,  pharmacology*
Humans
Intraoperative Complications / prevention & control
Male
Middle Aged
Postoperative Complications / prevention & control
Premedication
Preoperative Care
Surgical Procedures, Elective / adverse effects*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/Heparin, Low-Molecular-Weight; 0/fibrin fragment D

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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