OBJECTIVE To test a simple clinical guideline to reduce unnecessary routine testing of coagulation status. DESIGN, SETTING AND PARTICIPANTS A prospective, unblinded, observational study of coagulation testing frequency before and after introduction of a simple clinical guideline. We included 253 patients admitted to a tertiary intensive care unit: 100 patients consecutively enrolled before ou...

Prothrombin complex concentrates are haemostatic blood products containing four vitamin K-dependent clotting factors (II, VII, IX and X). They are a useful, reliable and fast alternative to fresh frozen plasma for the reversal of the effects of oral anticoagulant treatments (vitamin K antagonists). They are sometimes used for factor II or factor X replacement in patients with congenital or acqu...

BACKGROUND Thromboelastometry (ROTEM(®)) might be useful to detect intraoperative coagulation disorders early in major paediatric surgery. This observational trial compares this technique to standard coagulation tests. METHODS Intraoperative blood sampling was obtained in children undergoing elective major surgery. At each time point, standard coagulation tests [activated partial thromboplast...

BACKGROUND Epidural anaesthesia and analgesia are indicated for oesophageal surgery. A rare but serious complication is spinal haematoma, which can occur on insertion, manipulation or withdrawal of catheters. Evidence and guidelines are vague regarding which tests are appropriate and how to interpret their results. We aimed to describe how routine coagulation test results change during oesophag...

Background: The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as the liver synthesizes most of the factors of the coagulation cascade and fibrinolytic proteins. Objective: The objective of this study was to evaluate coagulation abnormalities associated with chronic liver diseases and determine the coagulation abnormal...

In 1916, Douglas and Colebrook noted that blood coagulation was accelerated by the addition of trypsin. A year later, Heard reported that trypsin could actually coagulate oxalated blood, and ascribed the phenomenon to a hypothetical disturbance in the Ca and P content of the fibrinogen, induced by the enzyme. These two reports were apparently overlooked by workers in the field. In 1928, Waldsch...

As fresh frozen plasma (FFP) loses coagulation factor activity during the production process, FFP therapy may not be feasible to completely replenish coagulation factor concentrations in a clinical setting. The aim of this study was to describe the results of early replacement coagulation factors with FFP in a simplified and idealized in vitro model of dilution. Six ml of whole blood drawn from...

A method of investigating the coagulation mechanism is described.Results obtained by this procedure are compared with those of tests carried out on venous blood obtained simultaneously from normal subjects and patients with a variety of clotting defects. Good correlation was found between the results of P and P tests on venous and capillary blood, and also between thromboplastin screening tests...

the mean percentage of cryptogenic strokes among ischemic strokes is 31%, of which one-third may be associated with patent foramen ovale. the foramen ovale is required for blood flow through the fetal atrial septum.  it is formed as of the fourth week of gestation, and this leads to right-left interatrial shunt that allows the passage of oxygenated blood to systemic circulation. in 75% of cases...