Whereas red blood cell transfusions have been used since the 19th century, plasma has only been available since 1941. It was originally mainly used as volume replacement, mostly during World War II and the Korean War. Over the years, its indication has shifted to correct coagulation factors deficiencies or to prevent bleeding. Currently, it remains a frequent treatment in the intensive care uni...

We present a methodology for personalizing the clinical treatment of severely injured patients with acute traumatic coagulopathy (ATC), an endogenous biological response of impaired coagulation that occurs early after trauma and shock and that is associated with increased bleeding, morbidity, and mortality. Despite biological characterization of ATC, it is not easily or rapidly diagnosed, not a...

hypercoagulable states are a group of conditions associated with an enhanced tendency toward blood clotting. although usual clinical manifestations of hypercoagulable states are thrombotic events such as deep venous thrombosis, hematoma can also occurs as a result of hypercoagulability in some patients. several inherited or acquired conditions may lead to hypercoagulable states. some of them in...

Editor—Reversing heparin-induced anticoagulation quickly and effectively can be challenging in bleeding patients undergoing emergency surgery. The required dose of protamine to neutralize unfractionated heparin (UFH) is difficult to predict and use of standard coagulation tests such as activated partial thromboplastin time (aPTT) to assess the effectiveness of reversal may delay surgery, compro...

Oral anticoagulant therapy (OAT) using warfarin (Coumadin®) has surged in recent years due to an increased number of indications and its demonstrated effectiveness.1 The primary means of monitoring the response to warfarin is the Prothrombin Time (PT) test, which is measured in seconds.2,3 The increased use of OAT has led to the development of point-of-care (POC) portable monitoring devices des...

The Australian health system has been the subject of multiple reviews and reorganisations over the last twenty years or more. The year 2004-2005 was no different. This paper reviews the reforms, (re)structures and governance arrangements in place at both the national and state/territory levels in the last year. At the national level some progress has been made in 2004/05 through the Australian ...

The objective of the Commonwealth’s Environmental Flows Initiative (EFI) was to assist state and territory water resource agencies meet the COAG Water Reform requirements for making environmental water allocations. The NT received support due in part to the focus on water resource development shifting to Northern Australia and the concurrent lack of understanding about tropical water resources ...

Ian Jennings, Dianne Kitchen, David Keeling, David Fitzmaurice and Carl Heneghan on behalf of the BCSH Committee UK NEQAS (Blood Coagulation), Sheffield, Oxford University Hospitals, Oxford Haemophilia and Thrombosis Centre, Churchill Hospital, Oxford, The University of Birmingham, Primary Care Clinical Sciences, Edgbaston, Birmingham, and Department of Primary Care Health Sciences, Oxford Univ...

Oral anticoagulant therapy (OAT) using warfarin (Coumadin®) has surged in recent years due to an increased number of indications and its demonstrated effectiveness.1 The primary means of monitoring the response to warfarin is the Prothrombin Time (PT) test, which is measured in seconds.2,3 The increased use of OAT has led to the development of point-of-care (POC) portable monitoring devices des...

Warfarin induction is accomplished by titrating dosage to coagulation test results. Algorithms can guide this process but not identify the starting dose. We hypothesized that an initial warfarin dose approximating the maintenance value would safely enhance rapidity of induction. In a randomized trial we compared a fixed-dose to a maintenance-dose strategy for beginning warfarin therapy. To pred...