Utility of Clot Formation and Lysis Assay to Monitor Global Coagulation State of Patients with Severe Acute Pancreatitis

Zhu, Ruijie; Wei, Sha Xin; Wu, Chuan-Xin; Li, Shengwei; Gong, Jianping

doi:10.1007/s10620-012-2034-6

Cited by 9 publications

(4 citation statements)

References 17 publications

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“… discovered that lower molecular weight heparin can decrease the incidence of pancreatic encephalopathy and improve the survival rate of SAP. Up‐regulation of fibrinogen also contributes to the generation of a hypercoagulable state . Our results might explain this phenomenon.…”

Section: Discussionmentioning

confidence: 51%

The predictive value of the prealbumin-to-fibrinogen ratio in patients with acute pancreatitis

et al. 2015

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Section: Discussionmentioning

confidence: 51%

The predictive value of the prealbumin-to-fibrinogen ratio in patients with acute pancreatitis

et al. 2015

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“…A series of studies show that the levels of coagulation and fibrinolysis markers were associated with severity and prognosis of AP. [28,31–33]…”

Section: Discussionmentioning

confidence: 99%

Prediction of mortality and organ failure based on coagulation and fibrinolysis markers in patients with acute pancreatitis

et al. 2019

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This study explored the predictive value of coagulation and fibrinolysis markers with acute pancreatitis (AP)-related mortality and organ failure. We retrospectively reviewed and analyzed coagulation and fibrinolysis markers and clinical outcomes of the patients with AP. A total of 273 patients with AP were enrolled, 7 patients died and 28 patients suffered from organ failure. Uni- and multivariate logistic regression identified the differences of all of the coagulation and fibrinolysis markers as risk factors for AP-related mortality. The differences of APTT value, TT value, D-dimmer level, FDP level, and AT III level were risk factors for organ failure. Furthermore, the OR of the differences of platelet, PT, APTT, TT, fibrinogen, D-dimmer, FDP, and AT III was substantially improved by grouping with intervals of 10 × 10 9 /L, 2 seconds, 5 seconds, 3 seconds, 0.5 g/L, 3 mg/L FEU, 5 mg/L and 10%, respectively. The risk of mortality can increase up to 1.62, 5.17, and 5.60 fold for every 10 × 10 9 /L, 2 seconds and 5 seconds of increase in platelet, PT and APTT, respectively. There is approximate 2-fold increase in risk of organ failure for every 2 seconds of TT increase. In receiver operating characteristic analysis, there is no difference in the predictive power of bedside index for severity in acute pancreatitis (BISAP) with them in mortality or organ failure. In patients with AP, the dynamic changes of coagulation and fibrinolysis markers are good predictors for AP-related mortality and organ failure, especially platelet, PT and APTT in mortality and TT in organ failure.

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“… 5 One reason may be the intravascular thrombosis, since fibrin deposits have been detected in pancreatic capillaries by electron microscopy, 4 and the process of coagulation in blood samples collected from SAP patients starts in 3 min and culminates within 5 min. 13 Thus, the local and systemic coagulopathy, which is in the range between scattered intravascular thrombosis in pancreatic microcirculation to disseminated intravascular coagulation (DIC), 14 , 15 causes tissue damage or multiple organ failure (MOF). 4 Previous studies have shown that inflammation shifts the hemostatic mechanisms in favor of thrombosis.…”

Section: Mechanism Of Coagulation Disorders In Severe Acute Pancreati...mentioning

confidence: 99%

Pathogenesis and Therapy of Coagulation Disorders in Severe Acute Pancreatitis

Gui¹,

Zhao²,

Huang³

et al. 2023

JIR

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Ischemia superimposed upon pancreatic edema leads to acute necrotizing pancreatitis. One possible mechanism contributing to ischemia is intravascular thrombogenesis since fibrin deposits have been detected in pancreatic capillaries by electron microscope. Current experimental and clinical data provided compelling evidence that the disorders in the blood coagulation system play a critical role in the pathogenesis of severe acute pancreatitis (SAP). This leads to microcirculatory failure of intra- and extrapancreatic organs and multiple organ failure and increases the case fatality rate. However, the mechanism of coagulopathy underlying SAP is not yet clear, although some anticoagulant drugs have entered clinical practice showing improvement in prognosis. Thus, enhanced understanding of the process might improve the treatment strategies with safety and high efficacy. Herein, the pathogenesis of the coagulation system of SAP was reviewed with a focus on the coagulation pathway, intercellular interactions, and complement system, thereby illustrating some anticoagulant therapies and potential therapeutic targets.

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Utility of Clot Formation and Lysis Assay to Monitor Global Coagulation State of Patients with Severe Acute Pancreatitis

Abstract: Our findings using the CloFAL analyzer indicate that the hypercoagulable state was due to increased fibrin generation and invariable fibrinolysis in patients with SAP. CloFAL assay is a simple and useful global coagulation assay to monitor hypercoagulable states during SAP.

Cited by 9 publications

References 17 publications

The predictive value of the prealbumin-to-fibrinogen ratio in patients with acute pancreatitis

The predictive value of the prealbumin-to-fibrinogen ratio in patients with acute pancreatitis

Prediction of mortality and organ failure based on coagulation and fibrinolysis markers in patients with acute pancreatitis

Pathogenesis and Therapy of Coagulation Disorders in Severe Acute Pancreatitis

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