Coagulation articles 2017-2019 Flashcards
JVIM 2019 What abnormalities of hemostatic testing correlated with anti Xa assay increase
Prolonged R and PT correlated with anti Xa assay increase
JVECC 2018 How do phospholipid emulsions alter clot formation when added ex vivo
hemolysis and accelerated clot formation with increase dose and inflammatory leukogram
NEJM 2019 AVERT tiral: In ambulatory cancer patients how did apixaban perform
Xa inhibitor
Reduced venous thromboembolism, but had 2x risk of bleeding over placebo
JVECC 2018 How did in vitro acidemia effect coagulation
hypocoagulable (decreased MA and Alpha angle)
No change in PT and PTT
JVECC 2018 at what dilutional percentage was changes in the PT, PTT, and TEG noted
40%
Vet Journal 2017 Oral rivaroxaban to healthy dogs how did this alter hemostatic coagulation testing
Inter-individual variability on coagulation with 2x daily dosing
TEG= increase R, Increase PT, PTT
AJVR 2017 What TEG and Platelet testing findings for dogs with CKD versus healthy controls
Increase MA, G-value; closure time
Decrease clotting time
JVECC 2018 What as the findings to develop multicenter in vitro TEG/ROTEM standardization
Variation within and between centers Significant.
Use same machine for testing
JVIM 2018 what were the coagulation changes in hemorrhaged dogs between 6% tetrastarch and LRS
Dilutional coagulopathy in both
HES may interefere with FXIII
JVECC 2018 In a retrospective DIC scoring system what factors had increased specificity and sensitivity to diagnosis DIC
PT, PTT, fibrinogen, antithrombin, d-dimer, plt count
JVECC 2017 what was the mechanism for prolonged coagulation with HES
decrease circulating VWF and FVIII
JVECC 2017 what TEG abnormalities were noted with HES and 0.9% saline due to dilution
Decreased MA, Alpha angle, and G
NEJM 2019 CASSINI How did rivaroxaban in ambulatory advanced metastatic cancer patients perform to prevent thromboembolism
Reduced thromboembolism but not stat significant
No difference in major bleeding
AJVR 2018 In rattle snake envenomination what was the abnormal TEG Findings and what was noted in dogs with concurrent PT/PTT
Hypocoagulable - increased G value
12/14 had < 25% of clot strength as control
1/5 dogs had abnormal PT valvue (did not correlate with bleeding)
VetJournal 2017 What was found to be useful for a screening tool for canine PTE
D-Dimers okay, but rapidly decreases within 24 hrs of embolism
NEJM 2018 DAWN tiral: what were the findings for a thrombectomy after stroke at 6-24 hrs
Better outcome at 90 days for thrombecty after stroke (6-24 hrs)
JVECC 2017 How did Yunnan baiyo perform for recurrence of signs with right atrial masses
No difference in survival or recurrence of mass.
AJVR 2018 What were the side effects of TXA infusion and how is it mediated
Vomiting/nausea mediated by Tachykin neurokin 1 receptor
JVECC 2019 How did Yunnan baiyo affect the TEG of healthy cats when give twice daily for 1 week
No change to TEG parameters
Decreased HCT significant but not outside reference range
JVIM 2018 What was found for aspirin and clopidogrel to evaluate for palatelet analysis in healthy dogs
All platelet analyzers able to detect treatment effect
Both have resistance in some dogs.
Clopidogril attributable to MDR1
JVECC 2017 How are clot retractions prevented in modern TEG/ROTEM
Used plastic cups in place of metal cups
JVECC 2018 What was noted to rebound after treatment with UFH in healthy dogs after 4 days
Increase in thrombin at 12 hrs, but resolved at 30 hrs
JAVMA 2020 What was found in dogs after splenectomy for splenic masses in evaluation of coagulation
Higher MA/G with malignant masses
Became thrombocytosis
JFMS 2018 in the diagnosis of FATE how was infrared thermography used
Difference of 2.4 C between ipsalateral affected vs non affected limbs
VetJournal 2017 What led to hyperfibrinolysis in dogs with ascites and which dogs were at highest risk
highest in dogs with increased hydrostatic pressure and transudate
JVIM 2017 What hemostatic findings were detected in astic fluid from dogs
Evidence of coagualtion and fibrinolysis by ascitic fluid by FDPs and D-dimers
Occurs indipendent of underlying mechanism of fluid
JVIM 2018 How did immunosuppressive agents change hemostatic variables in normal dogs
No change to platelet aggremetry, VCM, PT, PTT
Thromboxane increased with cyclosporine but no change in coagulability
JVIM 2018 what immunsuppressive had antiplatelet activity
Lefonamide
NEJM 2018 MARINER How did rivaroxaban for thromboprolyphylaxis after hospitalization for medical illneses work
No significant lower risk for thromboembolism
Dose adjusted for decreased renal creatinine clearance
JFMS 2019 What was the influence of needle gauge for jugular venipuncture of hemostatitc measures in cats
No clinically meaningful change between 22 ga and 25 ga
Stat singinficant higher PT with 25 ga vs 20 ga
JFMS 2019 What was the influence of needle gauge for jugular venipuncture on TEG in cats
No difference between 21 and 22 ga butterfly in TEG variables
JFMS 2017 in Cats with congenital PSS how did PT and PTT relate to clinical bleeding
None of the cats with increased PT or PTT had significant bleeding post operatively
Vet Surgery 2018 What was the effect of surgery on D-dimers
Increased D-Dimers after neutering but not TTA or long bone fracture
In Curative what were considered at risk populations
Dogs: IMHA, PLN
Cats: Cardiomyopathy & Hx of ATE/LA dilation/ Spontaneous echocontrast/ reduced LA appendage flow velocity
Dogs/Cats with > 1 disease /risk factor (sepsis with pancreatitis, HAC and steroid use; necrotizing pancreatitis
In Curative what was the recommended treatments for arterial vs venous clots
arterial lots of platelets: antiplatelets
Venous low platelets: anticoagulation In people have shown that anti platelets help based on cell based model
In Curative what was the recommendation for warfarin
Against due to narrow theraputic range and inter individual variation
In Curative what monitoring was considered
Aspirin: Platelet aggregometry (may be considered)
Warafin: if used PT (INR)
UFH: Anti Xa activity
NEJM 2014 Triss Trial: What was found between the two thresholds of blood transfusions in septic patients
No difference in mortality etc. Only higher threshold for transfusion received more tranfusion
NEJM Lifenox: What was the difference of enoxaparin and stocking vs stockings alone on mortality
LMWH
Did not decrease the rate of in hospital deaths in acutely ill patients
AJVR 2009 How does platelet concentration alter TEG
People < 66K before MA and K to be abnormal
Would not expect it to strongly influence R (CT) because value represents the initiation phase
AJVR 2009 How does clotting deficiencies alter TEG
FVII, FVIII, or FIX hypocoagulable
AJVR 2009 How does HCT alter TEG
Increased HCT = hypocoagulability
Decreased HCT= Hypercoagulability
more coag factors as less RBCs to ‘dilute’ sample therefore increase coag
JAVMA 2017 In dogs and cats with liver lobectomies what led to increased transfusion rates
Dogs: perioperative anemia
Cats: Post operative anemia
JAVMA 2017 What eicosanoids were increased in pRBCs during storage and use
TXB2, PGF2Alpha, 6-Keto-PGF1a, LTB4
JVIM 2017 What as associated with an increased need for transfusion in cats receiving dialysis
Number of dialysis treatments
JVIM 2017 In dogs what increased mortality in dogs receiving dialysis
Blood product administered
JAVMA 2017 What changed in dogs that were crossmatched prior to transfusion
Higher mean HCT post tranfsuion
12.5 vs. 9
JVIM 2017 How did leukoreduction alter eicosanoids in pRBCs
Did not alter 6-Keto-PGF1 alpha
JVECC2017 How did storage affect chance of hemolytic reaction
Every additional day of storage age increased likely hood of hemolytic significantly
JVECC 2017 How was blood product age associated with mortality
Wasn’t
JVECC 2017 What was found to increase complications with
Increase dose of product
Longer duration of administration
Immune mediated diease
JVIM 2017 After transfusion with DEA 1 matched blood products what percentage of dogs were incompatible with the donor after transfusion
44%
NEJM 2017 TRANSFUSE: How did the age of the transfused pRBCs affect mortality
Did not affect mortatlity at 90 days in among critically ill adults
JVECC 2019 What were the 4 variables in the HeLP score and what is it used for
Body weight, admission total protein, admission platelet count, thoracic rad findings
JVECC 2019 How did leukoreduction of pRBC affect mortatlity in critically ill dogs
No change in mortality, inflammation, or TF rx
AJVR 2019 in Dogs how did a microaggregate filter alter RBC fragility
Did not change, Morphology was noted to have changed
JVECC 2019 At the level of the iliac how did the cadual vena cava diameter or ratio to aorta change in greyhounds after donating 1 unit of blood
No change in diameter or ratio to aorta
JVECC 2019 How did greyhounds cryopreciptate factors alter the quality of product
Was stastically less in VWF and fibrinogen, but still met human quality standards
JVIM 2019 How are cobalamine and folate related to anemia in dogs
Not
2019 JVIM How did cryopoor precipitated change albumin with a CRI
Increased albumin with increased rate of CRI
(1.8 ml/kg/hr)
Content of CPP= FFP
JVECC 2019 What was associated with transfusion in cats with pelvic injury
Lower PCV, Increased ATT, Longer length of Hosp
SI luxations/pubic factures
JVIM 2018 in cats with blood type compatible blood how did crossmatch affect the outcome
Crossmatching did not change transfusion reactions or improve post PCV significantly
JAVMA 2018 What percentage of animals (cats vs Dogs) developed hospital acquired anemia at 48 hours.
70% of cats and 43% of dgos
JAVMA 2018 What increased the risk of developing hospital acquired anemia
Cumulative phelbotomy of > 3% total blood volume; Surgery; increased volume of crystalloid fluids
