Isolated reduction of haematocrit does not compromise in vitro blood coagulation

Iselin, B.; Willimann, Patrick; Seifert, Burkhardt; Casutt, Mattias; Bombeli, Thomas; Zalunardo, Marco P.; Pasch, Thomas; Spahn, Donat R.

doi:10.1093/bja/87.2.246

Cited by 65 publications

(54 citation statements)

References 24 publications

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“…This may relate to the presence of the enzyme elastase on the surface of RBC membranes, which may activate coagulation factor IX [236,237]. However, a moderate reduction of the Hct does not increase blood loss from a standard spleen injury [235], and an isolated in vitro reduction of the Hct did not compromise blood coagulation as assessed by thromboelastometry [238]. …”

Section: Resultsmentioning

confidence: 99%

Management of bleeding and coagulopathy following major trauma: an updated European guideline

Bouillon²,

et al. 2013

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IntroductionEvidence-based recommendations are needed to guide the acute management of the bleeding trauma patient. When these recommendations are implemented patient outcomes may be improved.MethodsThe multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document represents an updated version of the guideline published by the group in 2007 and updated in 2010. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature.ResultsKey changes encompassed in this version of the guideline include new recommendations on the appropriate use of vasopressors and inotropic agents, and reflect an awareness of the growing number of patients in the population at large treated with antiplatelet agents and/or oral anticoagulants. The current guideline also includes recommendations and a discussion of thromboprophylactic strategies for all patients following traumatic injury. The most significant addition is a new section that discusses the need for every institution to develop, implement and adhere to an evidence-based clinical protocol to manage traumatically injured patients. The remaining recommendations have been re-evaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies.ConclusionsA comprehensive, multidisciplinary approach to trauma care and mechanisms with which to ensure that established protocols are consistently implemented will ensure a uniform and high standard of care across Europe and beyond.Please see related letter by Morel et alhttp://ccforum.com/content/17/4/442

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Section: Resultsmentioning

confidence: 99%

Management of bleeding and coagulopathy following major trauma: an updated European guideline

Bouillon²,

et al. 2013

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show abstract

“…This may relate to the presence of the enzyme elastase on the surface of RBC membranes, which may activate coagulation factor IX [225,226]. However, a moderate reduction of the Hct does not increase blood loss from a standard spleen injury [224], and an isolated in vitro reduction of the Hct did not compromise blood coagulation as assessed by thrombelastometry [227]. …”

Section: Resultsmentioning

confidence: 99%

Management of bleeding following major trauma: an updated European guideline

et al. 2010

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IntroductionEvidence-based recommendations are needed to guide the acute management of the bleeding trauma patient, which when implemented may improve patient outcomes.MethodsThe multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document presents an updated version of the guideline published by the group in 2007. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature.ResultsKey changes encompassed in this version of the guideline include new recommendations on coagulation support and monitoring and the appropriate use of local haemostatic measures, tourniquets, calcium and desmopressin in the bleeding trauma patient. The remaining recommendations have been reevaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies.ConclusionsThis guideline provides an evidence-based multidisciplinary approach to the management of critically injured bleeding trauma patients.

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“…However, this view is an oversimplification because systematic studies show a decreased maximum aggregation and a prolongation of aggregation time in thrombelastography in patients with iron deficiency anemia compared to controls [9,18], while isovolemic hemodilution leads to a shortening of reaction and coagulation times in a hematocrit dependent manner [16,21]. In this study only severe anemia was independently associated with CVT, which might be interpreted as a higher dependence of hypercoagulability on the hemoglobin and hematocrit levels rather than on the extent of thrombocytosis.…”

Section: Discussionmentioning

confidence: 99%

Anemia as a risk factor for cerebral venous thrombosis? An old hypothesis revisited

et al. 2007

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Isolated reduction of haematocrit does not compromise in vitro blood coagulation

Cited by 65 publications

References 24 publications

Management of bleeding and coagulopathy following major trauma: an updated European guideline

Management of bleeding and coagulopathy following major trauma: an updated European guideline

Management of bleeding following major trauma: an updated European guideline

Anemia as a risk factor for cerebral venous thrombosis? An old hypothesis revisited

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