2018
DOI: 10.1111/trf.14605
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Clinical bleeding and thrombin generation in admissions to critical care with prolonged prothrombin time: an exploratory study

Abstract: Future studies need to explore a role for alternatives tests of coagulation in critical illness. Development of TG assays is required to positively identify more patients at increased bleeding risk or to exclude a larger number at low risk and how this relates to subgroups, such as patients with liver disease, and the need for prophylactic plasma transfusion.

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Cited by 4 publications
(9 citation statements)
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“…24 The follow-up ISOC-2 study evaluated the use of an alternative global assay termed 'thrombin generation' (TG), that might provide more information on the summation of procoagulant activities or better address the net balance between procoagulant and anticoagulant forces. 25 Plasma samples were collected and analysed from 306 patients admitted to intensive care with prolonged PT. Overall, despite prolonged PT, 47.8% patients had endogenous thrombin potential (ETP) within normal limits.…”
Section: Cme Haematologymentioning
confidence: 99%
“…24 The follow-up ISOC-2 study evaluated the use of an alternative global assay termed 'thrombin generation' (TG), that might provide more information on the summation of procoagulant activities or better address the net balance between procoagulant and anticoagulant forces. 25 Plasma samples were collected and analysed from 306 patients admitted to intensive care with prolonged PT. Overall, despite prolonged PT, 47.8% patients had endogenous thrombin potential (ETP) within normal limits.…”
Section: Cme Haematologymentioning
confidence: 99%
“…However, we now know that these basic coagulation tests provide limited assessment of thrombin generation in vivo and are poor at predicting clinical bleeding. [1][2][3][4][5] This is due to several factors: (a) the tests record clotting time when only 5% of TG has occurred; (b) the tests reflect only the pro-coagulant factors, and do not take in to account natural anticoagulants; [5][6][7][8] and (c) they are insensitive to modest, but clinically relevant reductions in factor concentrations.…”
Section: Introductionmentioning
confidence: 99%
“…This study uses samples obtained from the Intensive Care Study of Coagulopathy 2 (ISOC-2), a heterogeneous group of critically ill patients on intensive care units (ICUs) in which there was uncertainty with regard to bleeding risk and requirement for fresh frozen plasma (FFP) transfusion. 5,9 Introduction of a novel diagnostic assay to assess coagulation, such as TG, could avoid delays in interventional procedures, avoid complications of unnecessary plasma transfusion, and reduce bleeding. FFP is not without risk for the patient [9][10][11][12][13][14][15][16] and yet is frequently administered to non-bleeding patients with mild or moderate abnormalities of PT, for example, as prophylaxis prior to invasive procedures, although evidence indicates negligible effects on correction of any PT prolongation when conventional doses are used.…”
Section: Introductionmentioning
confidence: 99%
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