Perioperative Evaluation of Bleeding Diathesis

Leung, Lawrence L.K.

doi:10.1182/asheducation-2006.1.457

Cited by 25 publications

(22 citation statements)

References 29 publications

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“…The main disadvantage of a laboratory-driven diagnosis is that the correlation between the levels of a specific factor and the severity of bleeding symptoms is usually poor, and therefore the predictive value of laboratory tests (and hence, of the laboratory-driven diagnosis) is low. It is, therefore, not surprising that preoperative screening has been repeatedly reported to be of minimal value in predicting post-surgical bleeding [10]. In fact, screening for MBD before surgery may be considered similar to screening for thrombophilic abnormalities in asymptomatic women before contraceptive pill use [11].…”

Section: Bleeding Risk In Mbd and In Normal Subjectsmentioning

confidence: 99%

How to estimate bleeding risk in mild bleeding disorders

Rodeghiero

Tosetto

Castaman

2007

Journal of Thrombosis and Haemostasis

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Summary. The concept of mild bleeding disorders (MBD) has evolved in contrast to severe hemophilia A and B to indicate less severe disorders, characterized by the presence of more frequent and/or more prominent bleeding symptoms than in the normal population. These symptoms occur mostly after a recognizable challenge and do not lead to major discomfort or organ damage, even in the absence of specific medical intervention. However, it has become clear that, from the most severe to the mildest hemostatic disorders, there is a continuous spectrum of bleeding manifestations, which overlap with the occasional bleeding occurring in people without any identifiable hemostatic abnormality. By reviewing the principal hemorrhagic disorders we have tried to identify those entities that could fit a diagnosis of MBD and result, at the same time, in a net benefit for treatment or prophylaxis of patients rather than being simply accurate. This goal can usually be achieved by comparing the patientÕs phenotype with known nosological entities. However, limitations of this approach are evident, considering the paucity of clinical data and the biases of most published reports on the different disorders. In addition, in a partial deficiency of a clotting factor, a reliable relationship between the residual activity and bleeding severity is not invariably found. Molecular characterization of the defects is also generally useless. Accordingly, an accurate bleeding history in the propositus and his/her family remains of major importance. For this purpose, new standardized and possibly quantitative tools are being developed in several institutions. Innovative approaches, combining into a single probability phenotypic and genetic data, could possibly estimate better the bleeding risk in specific disorders.

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Section: Bleeding Risk In Mbd and In Normal Subjectsmentioning

confidence: 99%

How to estimate bleeding risk in mild bleeding disorders

Rodeghiero

Tosetto

Castaman

2007

Journal of Thrombosis and Haemostasis

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“…Hence, clotting formation time has been used as a critical factor to evaluate any external surface to determine its antithrombogenicity. PT and PTTA are two factors used to reveal the clotting variations that are involved in intrinsic and extrinsic pathways, so they are also used as indicators the clotting time . As can be seen in Figure , PT and APTT levels for PES (M‐1) and modified PES membranes were prolonged in comparison with control (pure plasma).…”

Section: Resultsmentioning

confidence: 98%

“…PT and PTTA are two factors used to reveal the clotting variations that are involved in intrinsic and extrinsic pathways, so they are also used as indicators the clotting time. 2,30 As can be seen in Figure 12, PT and APTT levels for PES (M-1) and the nanocomposite membranes was necessary to induce the antibacterial activity. The antibacterial impact of ZnO nanomaterials toward bacteria has been reported previously.…”

Section: Anticoagulant Properties Of the Modified Pes Membranesmentioning

confidence: 94%

Enhanced antifouling and anticoagulant properties of grafted biomolecule polyethersulfone membranes

Alenazi

Alamry

Hussein

et al. 2019

Polymers for Advanced Techs

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Polyethersulfone (PES) has been widely used in membrane technology and used to purify water in water treatments application or as a dialyzer to purify blood in hemodialysis. In this work, PES was chemically modified by separately grafting two biomolecules, 4‐aminobenzenesulfonamide (ABS), and 4‐amino‐N‐(5‐methylisoxazol‐3‐yl)benzenesulfonamide (AMBS), on PES backbone, and these modified membranes were blended to unmodified PES, in 1:1 ratio, in order to obtain PES‐b‐PES‐ABS and PES‐b‐PES‐AMBS membranes. The first aim of this study is to measure the anticoagulant properties of the modified membrane by measuring the activated partial thromboplastin time (APTT) and prothrombin time (PT). The second aim of the study is to evaluate the antifouling properties of the modified PES membranes by examining its antimicrobial activity against two Gram‐negative bacteria, which are Pseudomonas aeruginosa (P. aeruginosa) and Escherichia coli (E. coli); two Gram‐positive bacteria, which are Bacillus subtilis (B. subtilis) and Staphylococcus aureus (S. aureus); and a fungus, which is Candida albicans (C. albicans). The results showed that grafting of ABS and AMBS improved overall the hydrophilicity properties of the modified PES membranes. PES‐b‐PES‐ABS membranes showed better anticoagulant properties with 13 seconds for PT and 38 seconds for APPT, in comparison with the control sample (pure plasma), which showed 12 seconds for PT and 30 seconds for APPT. For antimicrobial tests, both PES‐b‐PES‐ABS and PES‐b‐PES‐AMBS membranes did not show any antibacterial activity, but when zinc oxide (ZnO) nanoparticles were added to the modified PES membranes in concentrations between 3% to 5% w/w, PES‐b‐PES‐ABS‐ZnO (M‐4 and M‐5), and PES‐b‐PES‐AMBS‐ZnO (M‐8 and M‐9) nanocomposite membranes showed antibacterial activity against P. aeruginosa and S. aureus.

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“…APTT test is widely used in evaluating coagulation abnormalities in the intrinsic pathway, which can detect functional deficiencies in factor II, V, X or fibrinogen [46,47]. APTT assay is thus performed in order to determine whether the blood factors would be activated or not when blood contacts with materials.…”

Section: Activated Partial Thromboplastin Time (Aptt)mentioning

confidence: 99%

A facile approach toward multifunctional polyethersulfone membranes viain situcross-linked copolymerization

Sun

Qin

et al. 2015

Journal of Biomaterials Science, Polymer Edition

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In this study, multifunctional polyethersulfone (PES) membranes are prepared via in situ cross-linked copolymerization coupled with a liquid-liquid phase separation technique. Acrylic acid (AA) and N-vinylpyrrolidone (VP) are copolymerized in PES solution, and the solution is then directly used to prepare PES membranes. The infrared and X-ray photoelectron spectroscopy testing, scanning electron microscopy, and water contact angle measurements confirm the successful modification of pristine PES membrane. Protein adsorption, platelet adhesion, plasma recalcification time, and activated partial thromboplastin time assays convince that the modified PES membranes have a better biocompatibility than pristine PES membrane. In addition, the modified membranes showed good protein antifouling property and significant adsorption property of cationic dye. The loading of Ag nanoparticles into the modified membranes endows the composite membranes with antibacterial activity.

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Perioperative Evaluation of Bleeding Diathesis

Cited by 25 publications

References 29 publications

How to estimate bleeding risk in mild bleeding disorders

How to estimate bleeding risk in mild bleeding disorders

Enhanced antifouling and anticoagulant properties of grafted biomolecule polyethersulfone membranes

A facile approach toward multifunctional polyethersulfone membranes viain situcross-linked copolymerization

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