AIM: We assessed various ways of tranexamic acid (TXA) administration on the fibrinolytic system. Blood loss, transfusions, drainage and haematoma were secondary outcomes. METHODS: In this prospective study, we examined 100 patients undergoing primary total knee arthroplasty (TKA) between June and November 2018. Patients were randomly assigned to 4 groups according to the following TXA regimens: 1) loading dose 15 mg TXA/kg single intravenous administration applied at initiation of anesthesia (IV1); 2) loading dose 15 mg TXA/kg + additional dose 15 mg TXA/kg 6 h after the first application of TXA (IV2); 3) IV1 regime in combination with a local wash of 2 g of TXA in 50 mL of saline (COMB); 4) topical administration of 2 g of TXA in 50 mL of saline (TOP). RESULTS: Systemic fibrinolysis interference was insignificant in all of the regimens; we did not detect significant differences between IV1, IV2 and COMB in the monitored parameters within the elapsed time after the TKA; IV regimes had the lowest total drainage blood loss; the lowest blood loss was associated with the IV1 and IV2 regimens (IV1, IV2 < COMB < TOP); the lowest incidence of haematomas was in patients treated with TXA topically (i.e., in COMB + TOP). CONCLUSION: The largest antifibrinolytic effect was associated with intravenous administration of TXA. In terms of blood loss, intravenously administered TXA can interfere with the processes associated with the formation of the fibrin plug more efficiently than the simple washing of wound surfaces with TXA.

• Klíčová slova
• D-dimers, FDP, blood loss, combined administration, intravenous administration, plasminogen, topical application, total knee arthroplasty, tranexamic acid,
• MeSH
• antifibrinolytika aplikace a dávkování   MeSH
• aplikace lokální MeSH
• artróza kolenních kloubů chirurgie   MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• hematokrit MeSH
• hemoglobiny metabolismus   MeSH
• intravenózní podání MeSH
• krvácení při operaci * MeSH
• kyselina tranexamová aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• plazminogen metabolismus   MeSH
• pooperační krvácení epidemiologie   MeSH
• senioři MeSH
• totální endoprotéza kolene metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• antifibrinolytika MeSH
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH
• hemoglobiny MeSH
• kyselina tranexamová MeSH
• plazminogen MeSH

BACKGROUND: Surgery for benign disease is associated with a low-risk of developing venous thromboembolism (VTE). Despite a relatively low incidence of postoperative VTE in patients after elective cholecystectomy and abdominal hernia repair there are data proving hypercoagulability in the early postoperative period. We focused on assessment of the systemic inflammatory response and coagulation status in these surgical patients after hospital discharge. METHODS: Prospectively, patients who underwent surgery for benign disease were included. Two hundred sixteen patients were enrolled - 90 patients in laparoscopic cholecystectomy (LC) group and 126 patients in hernia surgery (HS) group. Risk assessment of VTE according to the Caprini risk assessment model was performed in all patients. Prevalence of VTE in postoperative period was observed. Markers of systemic inflammatory response (IL-6, CRP, α-1-acid glycoprotein, transferrin) and coagulation markers (PLT, fibrinogen, prothrombin fragment F1 + 2 and D-dimer) were measured before surgery, on 7-10th postoperative day and on 28-30th postoperative day. RESULTS: Clinically apparent deep vein thrombosis was diagnosed in only one patient - 0.46%. Statistically significant elevation of inflammatory markers IL-6, CRP and α-1-acid glycoprotein (p < 0.001; all) were proved in both groups of patients on 7-10th postoperative day. Statistically significant elevation of coagulation markers PLT, fibrinogen, prothrombin fragment F1 + 2 and D-dimer (p < 0.001; all) were proved in LC and HS groups on 7-10th postoperative day. No statistical difference was observed in IL-6, CRP and α-1-acid glycoprotein levels a month after surgery as compared with preoperative levels within each group. Statistically significant elevation of fibrinogen and prothrombin fragment F1 + 2 levels (p < 0.001; both) persisted on 28-30th postoperative day in both groups. Persisted elevation of D-dimer levels was proved only in HS group (p < 0.001), not in LC group (p = 0.138), a month after surgery. CONCLUSIONS: Activated systemic inflammatory response and hypercoagulable condition were verified in patients after laparoscopic cholecystectomy and hernia surgery after their hospital discharge. Hypercoagulability persisted even a month after surgery. Nevertheless, we observed very low prevalence of clinically apparent VTE in patients with in-hospital postoperative VTE prophylaxis. TRIAL REGISTRATION: Trials of the Czech Ministry of Health No. RVO-VFN64165 and NT 13251-4 .

• Klíčová slova
• Acute phase reaction, Hernia repair, Hypercoagulability, Laparoscopic cholecystectomy, Venous thromboembolism (VTE),
• MeSH
• biologické markery krev   MeSH
• cholecystektomie laparoskopická škodlivé účinky   MeSH
• dospělí MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• hodnocení rizik MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• operace kýly škodlivé účinky   MeSH
• peptidové fragmenty krev   MeSH
• prospektivní studie MeSH
• protrombin MeSH
• senioři MeSH
• trombofilie krev   diagnóza   etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH
• peptidové fragmenty MeSH
• prothrombin fragment 2 MeSH Prohlížeč
• protrombin MeSH

BACKGROUND: The prognostic value of D-dimer testing in patients with acute pulmonary embolism (PE) has not been thoroughly studied. METHODS: We used the RIETE Registry data to assess the 90-day prognostic value of increased IL Test D-dimer levels at baseline in patients with PE, according to the presence or absence of cancer. RESULTS: As of May 2013, 3,283 patients with acute PE underwent D-dimer testing using IL Test D-dimer. Among 2,588 patients without cancer, those with D-dimer levels in the highest quartile had a higher rate of fatal PE (2.6% vs. 0.9%; p=0.002), fatal bleeding (1.1% vs. 0.3%; p=0.017) and all-cause death (9.1% vs. 4.4%; p<0.001) at 90 days compared with those with levels in the lowest quartiles. Among 695 patients with cancer, those with levels in the highest quartile had a similar rate of fatal PE or fatal bleeding but higher mortality (35% vs. 24%; p<0.01). On multivariate analysis, non-cancer patients with D-dimer levels in the highest quartile had an increased risk for fatal PE (odds ratio [OR]: 3.3; 95% CI: 1.6-6.6), fatal bleeding (OR: 4.3; 95% CI: 1.4-13.7) and all-cause death (OR: 2.1; 95% CI: 1.4-3.1) compared with patients with levels in the lowest quartiles. CONCLUSIONS: Non-cancer patients with acute PE and IL Test D-dimer levels in the highest quartile had an independently higher risk for fatal PE, fatal bleeding and all-cause death at 90 days than those with levels in the lowest quartiles. In patients with cancer, D-dimer levels failed to predict fatal PE or fatal bleeding.

• MeSH
• antikoagulancia terapeutické užití   MeSH
• fibrin-fibrinogen - produkty degradace analýza   metabolismus   MeSH
• lidé MeSH
• nádory krev   MeSH
• plicní embolie krev   MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antikoagulancia MeSH
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH

In critically ill patients, either arterial or venous blood is usually available for sampling and measurement of basic coagulation parameters. The aim of this study was to examine whether in these patients the values of coagulation parameters differ significantly with respect to the source of the blood samples. In a group of 44 patients with severe sepsis, we compared the values of coagulation, thromboelastography and selected hematological parameters between the arterial and venous blood. In most of the investigated parameters (international normalized ratio, activated partial thromboplastin time, fibrinogen concentration, erythrocyte count, leukocyte and platelet count, hemoglobin level and thromboelastography parameters), we did not find significant differences (P > 0.1). However, we found a significantly lower antithrombin activity and a significantly higher D-dimer concentration in venous blood compared to arterial blood (P < 0.05). This could be associated with increased consumption of antithrombin and generation of D-dimer as a consequence of microthrombi formation in the capillaries. We therefore conclude that for the purpose of assessment of coagulation status in septic patients, arterial and venous blood cannot be treated as equivalent.

• MeSH
• antitrombiny krev   MeSH
• arterie MeSH
• dospělí MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• hemokoagulace fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sepse krev   MeSH
• tromboelastografie MeSH
• vény MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antitrombiny MeSH
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH

Sixty-five patients scheduled for coronary surgery were randomized into three groups: A - conventional coronary artery bypass grafting, B - off-pump surgery, C - coronary artery bypass grafting with modified, rheoparin coated cardiopulmonary bypass with the avoidance of re-infusion of cardiotomy blood into the circuit. On the completion of peripheral bypass anastomoses, highly significant inter-group differences were found in the thromboelastographic parameter lysis of set time at 60 min of assessment (P=0.003) and at 150 min of assessment (P<0.001), the mean values of these parameters were significantly lower in group A as compared with both groups B and C, which were statistically indistinguishable. Lysis on set time on the completion of peripheral bypass anastomoses <50% was detected in 12 patients (52.2%) originating from group A. At the other sampling times (preoperatively, 15 min after sternotomy, at the end of the procedures, and 24 h later) thromboelastographic parameters were similar in all groups. In group A no significant correlations between lysis on set time, postoperative blood loss and D-dimer levels were found. Based on our results, thromboelastographic signs of fibrinolysis were clearly detectable during cardiopulmonary bypass in group A, but not at any time in groups B and C.

• MeSH
• anastomóza chirurgická MeSH
• biokompatibilní materiály MeSH
• časové faktory MeSH
• design vybavení MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• fibrinolýza * MeSH
• ischemická choroba srdeční krev   chirurgie   MeSH
• kardiopulmonální bypass přístrojové vybavení   MeSH
• koronární bypass bez mimotělního oběhu * MeSH
• koronární bypass * MeSH
• krvácení při operaci prevence a kontrola   MeSH
• lidé MeSH
• prospektivní studie MeSH
• transfuze erytrocytů MeSH
• tromboelastografie * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• biokompatibilní materiály MeSH
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH

The aim of this preliminary, prospective, randomized study was to compare rotation thromboelastography (roTEG) results and D-dimer levels in off-pump versus on-pump coronary surgery in order to identify the activation of fibrinolysis. Twenty patients scheduled for coronary bypass grafting were assessed (off-pump group A, n = 10; on-pump group B, n = 10). Blood samples for roTEG examination were taken preoperatively (t0), 15 minutes after sternotomy (t1), on the completion of peripheral bypass anastomoses (t2), and at the end of procedures (t3). The time points for D-dimer levels analyses were before operation, at the end of procedures, and 24 hours later. A certain degree of roTEG signs of fibrinolysis was noticed at time t2 in both groups and in group B these marks were quite widely, but not significantly expressed (P for intergroup differences for Lysis on Set Time at 60 and 150 minutes were P = 0.190 and P = 0.122, respectively), borderline differences were found for Maximum Clot Firmness (P = 0.082) with a lower mean value for group B (arithmetic means [95% confidence intervals]--57.7 [54.2; 61.2] mm). Completely expressed roTEG signs of hyperfibrinolysis were observed in 2 patients from group B. In group B also the highest geometric means of D-dimers (1326.0 [943.5; 1863.6] ng mL(-1)) and thus a dramatic intergroup difference (P < 0.001) were observed at the end of surgery; 24 hours later the significantly elevated D-dimer levels in both groups (A: 1070.0 [723.5; 1582.6] versus B: 1093.3 [732.0; 1632.9] ng mL(-1)) were equalized (P = 0.932). Our roTEG results display a slightly greater, but fairly subtle activation of fibrinolysis during the course of cardiopulmonary bypass, compared to off-pump cardiac surgery.

• MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• fibrinolýza fyziologie   MeSH
• infarkt myokardu krev   chirurgie   MeSH
• kardiopulmonální bypass metody   MeSH
• koronární bypass bez mimotělního oběhu metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• peroperační monitorování MeSH
• prospektivní studie MeSH
• senioři MeSH
• tromboelastografie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH

AIMS: To determine the systemic thrombogenic effect of radiofrequency catheter isolation of the pulmonary veins (PVI) in the treatment of atrial fibrillation. METHODS AND RESULTS: We studied endothelial damage marker (von Willebrand factor [vWf]), fibrinolysis markers (tissue plasminogen activator [t-PA], plasminogen activator inhibitor-1 [PAI-1]) and coagulation activation markers (D-dimer [DD]) in 30 patients (pts) undergoing PVI. Heparin was administered continuously after double transseptal puncture in all pts. Concentrations of vWf and t-PA were significantly increased after accomplishing PVI compared to the baseline values, and elevated levels persisted 24 hours later ( p < 0.01). PAI-1 levels decreased following PVI compared to the baseline levels ( p = 0.02). PAI-1 levels normalized 24 hours after the procedure. DD increased continuously during the procedure with the peak following PVI ( p < 0.01). Higher DD concentrations persisted 24 hours later ( p = 0.02). In a multivariate analysis, total procedure time correlated significantly with the peak vWf and DD concentrations, while total RF energy dose correlated only with peak vWf ( r = 0.82). Time to heparin administration correlated with DD levels prior to the first RF pulse ( r = 0.83, p < 0.01) as well as after PVI ( r = 0.75, p < 0.01). A group of patients heparinized within the first hour of the PVI procedure had normal preablation DD levels and significantly mitigated DD levels following PVI compared to the group of patients heparinized later ( p < 0.01). CONCLUSIONS: Pulmonary vein ablations cause an increased systemic procoagulant state as reflected by fibrin turnover, fibrinolysis activation and endothelial perturbation. The activation of the coagulation cascade could be decreased by early heparin administration.

• MeSH
• atrioventrikulární nodální reentry tachykardie krev   chirurgie   MeSH
• biologické markery krev   MeSH
• biotransformace účinky léků   fyziologie   MeSH
• dospělí MeSH
• echokardiografie transezofageální MeSH
• endotel metabolismus   patologie   MeSH
• fibrilace síní krev   chirurgie   MeSH
• fibrin-fibrinogen - produkty degradace účinky léků   metabolismus   MeSH
• fibrinolytika terapeutické užití   MeSH
• fibrinolýza účinky léků   fyziologie   MeSH
• hemostáza účinky léků   fyziologie   MeSH
• heparin terapeutické užití   MeSH
• inhibitor aktivátoru plazminogenu 1 krev   MeSH
• katetrizační ablace * MeSH
• lidé středního věku MeSH
• lidé MeSH
• peroperační komplikace krev   etiologie   MeSH
• statistika jako téma MeSH
• tkáňový aktivátor plazminogenu krev   účinky léků   MeSH
• venae pulmonales diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• von Willebrandův faktor účinky léků   metabolismus   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• srovnávací studie MeSH
• Názvy látek
• biologické markery MeSH
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH
• fibrinolytika MeSH
• heparin MeSH
• inhibitor aktivátoru plazminogenu 1 MeSH
• tkáňový aktivátor plazminogenu MeSH
• von Willebrandův faktor MeSH

Platelet fibrin(ogen) adhesive interactions were investigated in whole citrated blood using the rectangular perfusion chamber at wall shear rates of 300 and 1600 s(-1) with regard to the amount and structure of immobilized protein. Only single platelets adhered to adsorbed fibrinogen at both low and high surface fibrinogen concentrations and at 1600 s(-1) almost no adhesion was observed. When using spray-immobilized protein, platelet adhesion was significantly higher than to adsorbed protein. Conversion of adsorbed fibrinogen to fibrin monomer resulted in the formation of pronounced platelets aggregates and with the elevation of wall shear rate 50% decrease of adhesion took place. Degree of platelet adhesion to fibrin monomer was significantly influenced by immobilized protein concentration at both shear rates. However, the morphology (small and dense platelet aggregates) and extent of platelets adhered to fibrin pentamer was nearly the same at both shear rates. Starting with surface-bound fibrinogen and alternating addition of thrombin and fibrinogen fibrin pentamer was prepared using the stepwise synthesis. This methodology is based on the observation that at low concentration immobilized fibrin monomer binds fibrinogen in 1:1 molar ratio. The gradually formed fibrin of a defined size and composition can be a useful tool in the further understanding of the role of fibrin architecture in the pathophysiology of thrombosis.

• MeSH
• adhezivita trombocytů * MeSH
• adsorpce MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• fibrin metabolismus   MeSH
• fibrinogen metabolismus   MeSH
• hemostáza fyziologie   MeSH
• lidé MeSH
• sklo MeSH
• techniky in vitro MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• fibrin-fibrinogen - produkty degradace MeSH
• fibrin MeSH
• fibrinmonomer MeSH Prohlížeč
• fibrinogen MeSH

More than half of 33 children with HUS were less than a year old, 90% less than five. A constant laboratory finding was the presence of FDP in the blood and urine, and of the remaining tests the presence of erythrocyte fragments. The absence of thrombocytopenia does not eliminate HUS. Antiplatelet treatment was given to 94% of children, heparin to 94%, thrombolysis to 27% Precise evaluation of treatment would require a controlled prospective multicentre study.

• MeSH
• dipyridamol terapeutické užití   MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• hematologické testy MeSH
• hemolyticko-uremický syndrom diagnóza   farmakoterapie   MeSH
• hydrokortison terapeutické užití   MeSH
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• streptokinasa terapeutické užití   MeSH
• vyšetření krevní srážlivosti MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• dipyridamol MeSH
• fibrin-fibrinogen - produkty degradace MeSH
• hydrokortison MeSH
• streptokinasa MeSH

The effect of static magnetic field of induction 0.005 T, 0.12 T and 0.3 T applied in daily rhythm (one hour every day) for the period of 2 weeks and 4 weeks produces an increase of FDP level in the serum. Especially, the effect elicited by the magnetic field applied 2 weeks prior to experimental thrombosis development. The range of changes was related to the duration of the exposure to the magnetic field. No dependence of the degree of induction of the magnetic field was established.

• MeSH
• fibrin-fibrinogen - produkty degradace metabolismus   MeSH
• fibrinolýza * MeSH
• králíci MeSH
• magnetismus * MeSH
• trombóza krev   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fibrin-fibrinogen - produkty degradace MeSH