Hemostatic Potential Research Articles

Pharmacological Correction of Cisplatin-Induced Hemostatic Disorders.

A single intraperitoneal administration of cisplatin in the MTD to outbred female mice disturbed hemostasis and formed the procoagulant phenotype of hemostatic potential on days 7-10 culminating in a pronounced hypocoagulation on day 15. Hemostasis was corrected with warfarin and an extract containing furocoumarins composed of isopimpinellin (42.97%), bergapten (35.18%), and xanthotoxin (15.41%). The extract was standardized with gas chromatography-mass spectrometry, thin-layer chromatography, and HPLC. Furocoumarins and reference drug warfarin were administered intragastrically during 4 days starting on day 6 after the administration of cisplatin. Both furocoumarins and warfarin corrected hypercoagulation on days 7-10. On day 10, furocoumarins normalized coagulation, whereas warfarin resulted in hypocoagulation. On days 15-30, no effects of warfarin were observed. furocoumarins corrected hypocoagulation on days 15-20 with prolongation of this effect up to experimental day 30.

Purification, characterization and fibrino(geno)lytic activity of cysteine protease from Tabernaemontana divaricata latex.

Protease was isolated and purified from Tabernaemontana divaricata latex and its hemostatic potential was analyzed. Crude latex enzyme was purified through ion exchange and gel filtration chromatography. Purified protease was characterized and its thrombin-like (coagulant assay, fibrinogen polymerizing, and fibrinogenolytic activity) and plasmin-like (blood and plasma clot lysis) activities were assessed accordingly. The homogeneous nature of protease was confirmed with the identification of a single band approximately at 25-kDa molecular weight position. The purified enzyme showed an enhancement of 77.32% in clot inducing ability and 89.86% improvement in blood clot lysis in comparison to that by the crude enzyme. All three subunits (Aα, Bβ and γ chains) of human fibrinogen were hydrolyzed by the purified enzyme. PAGE results of the fibrinolytic activity and blood clot lytic effect by the purified enzyme indicated the plasmin-like activity. The study lays a foundation for the development of enzyme-based approaches for pharmaceutical innovations, in which plant latex proteases can be utilized as a potential natural agent for wound healing applications.

Berberine-Coated Biomimetic Composite Microspheres for Simultaneously Hemostatic and Antibacterial Performance.

Biomimetic microspheres containing alginate/carboxymethylcellulose/gelatin and coated with 0%, 1%, 3%, and 6% berberine (BACG, BACG-1B, BACG-3B, BACG-6B) were prepared by the oil-in-water emulsion method combined with spray drying. Through a series of physicochemical parameters and determination of hemostatic properties in vitro and in vivo, the results indicated that BACG and BACG-Bs were effective in inducing platelet adhesion/aggregation and promoting the hemostatic potential due to their biomimetic structure and rough surface. In addition, BACG-6B with high berberine proportion presented better hemostatic performance compared with the commercial hemostatic agent compound microporous polysaccharide hemostatic powder (CMPHP). BACG-6B also showed strong antibacterial activity in the in vitro test. The hemolysis test and cytotoxicity evaluation further revealed that the novel composite biomaterials have good hemocompatibility and biocompatibility. Thus, BACG-6B provides a new strategy for developing a due-functional (hemostat/antibacterial) biomedical material, which may have broad and promising applications in the future.

The prehospital use of younger age whole blood is associated with an improved arrival coagulation profile.

Recent in vitro data have shown that the hemostatic profile of whole blood (WB) degrades significantly after 14 days, yet the optimal storage remains debated. We hypothesized that arrival coagulation studies would be improved in patients receiving younger WB in the prehospital setting. This study was approved by our institutional institutional review board. We evaluated all trauma patients who received prehospital blood products by our helicopter service between July 2017 and July 2019. "Young" WB was defined as 14 days or less. Patients who received at least 1 U of young WB were classified as YOUNG, while the remainder was classified as OLD. Continuous data are presented as medians (25th-75th interquartile range) with comparisons performed using Wilcoxon rank sum. Assessments of clinical hemostatic potential included arrival platelet cell count and rapid thrombelastography. Multivariate regression analysis was also performed (Stata 12.1; College Station, TX). A total of 220 patients received prehospital WB during the study period. Of these, 153 patients received YOUNG WB, while 67 were transfused only OLD WB units. There were no differences in demographics, prehospital or arrival physiology, or Injury Severity Score among the two groups. The measures of clot initiation (activated clotting time) and kinetics (k time) were improved, as were the measures of clot acceleration/fibrinogen function (angle) and platelet function (maximum amplitude). As well, arrival platelet count was higher in the YOUNG cohort. No significant differences in postarrival transfusion were noted (p = 0.220). Multivariate analysis showed the greatest differences in maximum amplitude and α angle but failed to reach significance. Previous in vitro data have suggested deterioration of platelet function in cold-stored WB after 14 days. The current study demonstrated decreased global hemostasis by clinically available laboratory tests, especially related to fibrinogen and platelet interactions on univariate, but not multivariate analysis. This did not translate into increased transfusion requirements. Further studies are needed to determine the optimal storage duration for cold-stored WB for transfusion in the bleeding trauma patient, as well as rule out the presence of confounding variables. Therapeutic, level IV.

In Vivo Investigation of Noncontact Rapid Photothermal Hemostasis on Venous and Arterial Bleeding.

Endoscopic surgical procedures rigorously underscore the significance of rapid hemostasis for unavoidable intraoperative bleeding, requiring advancement of the immediate hemostatic interventions for favorable clinical outcomes. Here, we report the efficacy of a new optical treatment with dual-wavelengths to develop an endoscopic hemostasis method. we combine visible (20-W 532 nm at 1.1 kW/cm2) and near-infrared (40-W 980 nm at 2.2 kW/cm2) wavelengths for facilitating noncontact thermal hemostasis on venous and arterial bleeders in in vivo leporine models. Simultaneous irradiation of 60-W dual-wavelengths allows for an increased irradiance of 3.3 kW/cm2, involving both rapid light absorption by hemoglobin and deep thermal penetration. The collective thermal effects from the combined wavelengths contribute to a significant reduction in coagulation time and a high success rate of complete hemostasis for both venous and arterial bleeders. The enhanced hemostatic potential of the dual-wavelengths treatment accompanies minimal hemorrhage, reduces inflammatory responses, and facilitates re-epithelialization. The proposed dual-wavelengths method can achieve rapid and complete hemostasis for endoscopic procedures. We present the high-irradiance photothermal treatment using the dual-wavelengths as a novel method to regulate venous and arterial bleeding and potentially as a rapid noncontact hemostasis option to mitigate the risk associated with significant blood loss.

Haemostatic Potential of Medicinal Plants and Their Phytochemicals

Haemorrhage associated with traumatic injury is responsible for over 35% of pre-hospital deaths and over 40% of deaths within the first 24 hours.Some important pharmacological aspects of plants such as haemostatic potential remain underexplored due to lack of scientific validation for the medical use of plant extracts/active compounds in bleeding control. In this study, an ethnobotanical survey of medicinal plants, which are used to stop bleeding, was done. Information was gathered from local herbalists, elderly people, literature search through various books and previously reported research papers in scientific databases (Pubmed, Science Direct, Scopus, Chem Spider, PubChem). Information about plants used to treat bleeding, plant parts used, mode of preparation, possible compounds and mechanism of action and dosage was collected and recorded. The collected information revealed 92 medicinal plants belonging to 59 families which are used against bleeding. Members of the Asteraceae family (12%) were the most prominent, followed by Moraceae (6%), Poaceae (5%) and Euphorbiaceae (4%). Leaves and underground plant parts were reported to be the most commonly used plant parts. The most prominent methods of herbal administration used were intravenous and as an ointment on the body surface. These plant extracts can be used efficiently and in a managed proportion to develop an effective remedy for bleeding/haemorrhages.

Hypercoagulable Changes in Fibrin Generation and Fibrinolysis in Patients With Cardiac Risk Factors From the BioHEART-CT Cohort

We investigated the thrombin generation and fibrin generation profiles of patients with cardiovascular risk factors using the overall haemostatic potential (OHP) and calibrated automated thrombin (CAT) assays.

HEMOSTATIC POTENTIAL ASSESSMENT OF PATIENTS WITH LIVER CIRRHOSIS AND ATRIAL FIBRILLATION BY LOW-FREQUENCY PIEZOELECTRIC THROMBOELASTOGRAPHY

The aim: Our aim was to assess the hemostatic potential of patients with liver cirrhosis and atrial fibrillation by LPTEG global coagulation assay, to investigate changes in LPTEG parameters according to the stage of liver cirrhosis and compare results with liver cirrhosis group. Materials and methods: We performed a prospective cross-sectional study including 70 patients with liver cirrhosis and atrial fibrillation, 36 patients with liver cirrhosis and 20 healthy individuals. LPTEG parameters were measured using ARP-01M "Mednord" in order to assess coagulation abnormalities. Results: t1 and Intensity of contact coagulation didn't differ (p>0,05), Constant of thrombin activity was increased (47.53±0.8vs.34.51±1.88, p<0.001), t3 was reduced (5,0±0.1vs.6.7±0.36 p<0.001), Intensity of coagulation drive was increased (52.8±1.8vs.38.55±1.54, p = 0.001), Intensity of clot polymerization was increased (19.66±0.28vs.16.29±0.28,p<0.001), time t5 was reduced (32.94±0.36 vs. 36.8±1.30, p<0.01), Maximum amplitude was increased (655.7±9.19 vs. 547±19.38, p<0.001), Intensity of total coagulation was increased (19.41±0.34vs.15,09±0.56, p<0.001), Intensity of clot retraction and lysis was increased (4.1±0.07vs.3±0.15, p<0.001) and Coefficient of total anticoagulant activity was increased (2.81±0.05 vs. 2.48 ± 0.06, p<0.001) compared to liver cirrhosis. Conclusions: In patients with liver cirrhosis and atrial fibrillation the hemostatic potential is significantly shifted towards hypercoagulation with a gradual worsening of coagulation disorders, starting from the compensated stage of liver cirrhosis.

Ultra-small gold nanoclusters assembled on plasma polymer-modified zeolites: a multifunctional nanohybrid with anti-haemorrhagic and anti-inflammatory properties.

Hemostatic agents are pivotal for managing clinical and traumatic bleeding during emergency and domestic circumstances. Herein, a novel functional hybrid nanocomposite material consisting of plasma polymer-modified zeolite 13X and ultra-small gold nanoclusters (AuNCs) was fabricated as an efficient hemostatic agent. The surface of zeolite 13X was functionalised with amine groups which served as binding sites for carboxylate terminated AuNCs. Protein corona studies revealed the enhanced adsorption of two proteins, namely, coagulation factors and plasminogen as a result of AuNCs immobilization on the zeolite surface. The immune response studies showed that the hybrid nanocomposites are effective in reducing inflammation, which combined with a greater attachment of vitronectin, may promote wound healing. The hemostatic potential of the nanocomposite could be directly correlated with their immunomodulatory and anti-haemorrhagic properties. Together, the hybrid nanoengineered material developed in this work could provide a new avenue to tackle life-threatening injuries in civilian and other emergencies.

Влияние экзогенного фибрин-мономера на гемостатический потенциал и фибринообразование в области дозированной травмы печени на фоне введения гепарина в эксперименте

Актуальность. В проведенных ранее исследованиях на «гепариновой» модели посттравматической кровопотери был продемонстрирован гемостатический эффект экзогенно вводимого фибрин-мономера (ФМ) (доза 0,25 мг/кг), сопоставимый по выраженности с применением протамина сульфата (ПС), что не получило своего объяснения из-за отсутствия данных морфологического исследования в зоне травмы печени. Цель. Сопоставить гемостатические, гемостазиологические и морфологические последствия использования ФМ, при его внутривенном введении в дозе 0,25 мг/кг, у гепаринизированных животных, после дозированной травмы печени. Материалы и методы. На 77 здоровых кроликах породы «Шиншилла» моделировали гипокоагуляцию нефракционированным гепарином (НГ) в/в в дозе 150 ед/кг. Профилактику интраоперационных кровотечений осуществляли введением ФМ в/в в дозе 0,25 мг/кг, за один час до травмы, и ПС в/в в дозе 1,5 мг/кг за 10 мин до травмы. После нанесения дозированной травмы печени кровопотерю оценивали в % от объема циркулирующей крови. Исследовали также содержание тромбоцитов в крови, активированное парциальное тромбопластиновое время (АПТВ), уровень фибриногена и количество D-димера, параметры калиброванной тромбографии. Ткани печени в области раневой поверхности для гистологических исследований получали после спонтанной остановки кровотечения. Результаты. Гепаринизированным животным была свойственна повышенная кровопотеря на фоне выраженной гипокоагуляции и снижении генерации тромбина. Применение антидота НГ - ПС, минимизировало потерю крови (снижение кровопотери в 4,0 раза по сравнению с плацебо) и приводило к восстановлению гемостатического потенциала. Согласно морфологическим исследованиям, это достигалось увеличением толщины тромботических масс (в 15,1 раза по сравнению с плацебо). В не меньшей степени гемостатический эффект был достигнут при замене ПС на ФМ (уменьшение кровопотери в 5,1 раза по сравнению с плацебо). Данные эффекты не сопровождались коррекцией гипокоагуляционного сдвига и восстановлением генерации тромбина. В последнем случае определено меньшее по выраженности фибринообразование в зоне травмы (толщина фибрина 55,2 мкм против 201,8 мкм при применении ПС; р &lt; 0,001). Еще одной отличительной особенностью явилось отсутствие фибриллярной структуры фибрина и наличие в тромботических массах многочисленных тромбоцитов, тогда как их число в просветах сосудов рядом с раневой поверхностью было минимальным. Заключение. Приведенные данные позволяют обозначить возможные механизмы и пути остановки постравматического кровотечения при использовании гепарина. Background. In previous studies using the heparin model of post-traumatic blood loss, a hemostatic effect of exogenous fibrin monomer (FM) (0.25 mg/kg) was observed, which was comparable in intensity to the effect of protamine sulfate (PS) and remained unexplained due to the lack of morphological study data for the area of liver injury. Aim. To compare hemostatic, hemostasiological, and morphological consequences of intravenous administration of FM 0.25 mg/kg following controlled liver injury in heparinized animals. Methods. Hypocoagulation was simulated by i.v. administration of unfractionated heparin (UFH) 150 U/kg to 77 healthy Chinchilla rabbits. Intraoperative bleeding was prevented by i.v. administration of FM 0.25 mg/kg one hour prior to the injury or PS 1.5 mg/kg 10 minutes prior to the injury. After the controlled liver injury, blood loss was measured and expressed in % of the circulating blood volume. Blood platelet count, activated partial thromboplastin time (APTT), fibrinogen concentration, D-dimer concentration, and data of calibrated thrombography were also studied. Samples of liver tissue from the wound surface area were collected for histology after spontaneous arrest of bleeding. Results. Heparinized animals were characterized by increased blood loss due to pronounced hypocoagulation and decreased thrombin production. The use of the UFH antidote, PS, minimized the blood loss (by 75% compared to placebo) and resulted in restoration of the hemostatic potential. According to results of the morphological study, this effect was due to increased thickness of thrombotic masses (15.1 times compared to placebo). At least equal hemostatic effect was obtained when PS was replaced with FM (80% decrease in blood loss compared to placebo). These effects were not associated with correction of the hypocoagulation shift or recovery of the thrombin generation. In this process, fibrin formation in the injury area was less pronounced (fibrin thickness 55.2 µm vs 201.8 µm with PS; p &lt; 0.001). Another distinctive feature was the absence of the fibrillar structure of fibrin and the presence of numerous platelets in thrombotic masses while the platelet number in the lumen of blood vessels near the wound surface was minimal.

Dynamics of perioperative changes in hemostatic potential according to low-frequency piezoelectric thromboelastography data in open transvesical prostatectomy under epidural analgesia

Background. The anesthetic technique of choice for urological surgeries is a controversial issue, especially for transvesical prostatectomy for patients with benign prostatic hyperplasia (BPH). Often, epidural anesthesia and analgesia are considered as the methods of choice. However, the effect of an anesthetic support on perioperative changes in hemostatic potential has been poorly studied.&#x0D; Aim. The aim of the study was to demonstrate the dynamics of changes in the system of the aggregate blood state regulation by using an instrumental method, a low-frequency piezoelectric thromboelastography (LFPTEG), in the perioperative period for patients with BPH who will undergo transvesical prostatectomy.&#x0D; Material and methods. The state of the hemostatic system in a group of 71 patients with confirmed BPH who required a transvesical prostatectomy was evaluated by the APC ARP-01M Mednord device at the time of the admission, 30 min after the effect of an epidural anesthesia, an hour after the end of a surgery and a day after a surgery.&#x0D; Results. A perioperative dynamic monitoring of the state of a hemostatic balance showed that a preoperative hypercoagulation, compensated by an increased fibrinolysis, was replaced by a normocoagulation at the moment of a surgery, which was observed in the first hour after the end of a surgery and retained until the end of the first day.&#x0D; Conclusion. Hypercoagulation was found out for patients with BPH before a transvesical prostatectomy that was masked by an activation of the fibrinolytic system. The hemostatic potential assumed values identical to the reference values that should be taken into account prescribing a postoperative thromboprophylaxis against the background of a prolonged epidural blockade. The APC ARP-01M Mednord device allows you to assess all parts of a hemocoagulation at each stage of a perioperative treatment quickly and without high material costs.

Значимость персонифицированного мониторинга гемостатического потенциала у пациентки с сочетанием комбинированной тромбофилии и тромбоцитопатии в повышении эффективности экстракорпорального оплодотворения

Значимость персонифицированного мониторинга гемостатического потенциала у пациентки с сочетанием комбинированной тромбофилии и тромбоцитопатии в повышении эффективности экстракорпорального оплодотворения

Assessment of Chromolena odorata potential ability of hemostasis in patients with and without Haemophilia A Inhibitors

Haemophilia is a chronic bleeding illness that causes several difficulties in the patient's daily life in various aspects. Inhibitor development is presently the most important treatment complication observed in patients with hemophilia. Treatment modalities of Haemophilia A with either plasma or recombinant FVIII regimes results in the development of inhibitors and the risk of complications in patients. Hence, newer treatment strategies involving innovative hemostatic therapy are warranted for better management of hemophilia patients. The aim and objective of this study was to assess the efficacy of Chromolena odorata mediated hemostasis in patients with hemophilia A inhibitors. It was a cohort study constituting 147 clinically diagnosed hemophilic A patients. All the patients underwent treatment with FVIII A regimes (specific or multiple). The severity of hemophilia and clotting time was assessed by standard FVIII and aPTT assays, respectively. Modified Bethesda assay method was used to detect FVIII inhibitors. The hemostatic capacity of Chromolena odorata was evaluated by pooling the patient’s plasma with Chromolena extract concentrate. Younger age group (15-30) were more prevalent (56.4%) among hemophilia pathogenesis. Hemarthrosis was the significant co-morbidity observed in 58.5% of patients. Majority of the patients (72.7%) were diagnosed with severe hemophilia A. We identified 10 clinically evident patients to possess inhibitors for FVIII. Evaluation of Chromolena odorata hemostatic potential showed the improvement of clotting capacity with optimal concentrations of extract in patients with inhibitors. The findings of the study revealed the hemostatic properties of Chromolena odorata that can be recommended in the treatment strategies of Haemophilia patients.

The Impact of Rapid Infuser Use on the Platelet Count, Platelet Function, and Hemostatic Potential of Whole Blood

BackgroundRapid infusion pumps employing filters, roller pumps, and heat exchangers for the administration of blood products are not approved for platelets or cryoprecipitate. This technology may decrease platelet count and degrade coagulation proteins. The effect of rapid infusers on the hemostatic potential of whole blood is unknown. MethodsFive units of low titer O+ whole blood were obtained from anonymous donors. Each unit was subjected to infusion by five different techniques: (1) gravity infusion without a filter, (2) gravity infusion with a filter, (3) Belmont rapid infuser at 70 mL/min, (4) Belmont at 100 mL/min, and (5) pressurized infusion with a pneumatic pressure bag and filter. After infusion, platelet count, platelet function, thrombin generation, and hemostatic potential were measured for each aliquot. Infusion techniques were compared, using gravity infusion without a filter as the control. ResultsThere was a significant decrease in platelet count from baseline (168,000) in the BELMONT70 (97,000) and BELMONT100 (94,000) groups (P < 0.05). However, there were no differences in platelet function (all P > 0.20). While there were no differences in thromboelastography parameters between control and infusion models (all P > 0.20), there were significant increases in thrombin generation parameters by CAT in both the BELMONT70 and BELMONT100 groups (all P < 0.05). ConclusionsThe use of a rapid infuser decreases the platelet count of WB but does not decrease platelet function or overall hemostatic potential. In fact, thrombin generation and thrombin potential are actually increased. Rapid infusers are safe for the transfusion of WB.

The state of hemostasis in patients with CKD VD stage with some comorbid conditions

Annotation. Clinical observations indicate that one of the rather important mechanisms in the pathogenesis of complications in CKD stage VD are disorders in the hemostatic system leading to the development of thrombophilia. Comorbidity in this category of patients significantly worsens the prognosis due to the potentiation of hypercoagulation, which, as a comorbid syndrome, accelerates morphological changes in the kidneys, contributes to the deposition of fibrin in the glomeruli and the development of thrombosis. The aim of the study was to study the indices of the main links of hemostasis depending on some comorbid conditions (acute inflammation, secondary hyperparathyroidism, hepatitis B and C). The study involved 52 men and 36 women with CKD stage VD, who were on programmed hemodialysis, in whom the levels of soluble fibrin, D-dimer, fibrinogen, protein C, indicators of hemostatic potential in these comorbid conditions were determined. Statistical processing of materials was performed using the methods of variation statistics.It was determined that the presence of a fast phase of inflammation enhances the processes of hypercoagulability, and a high level of parathyroid hormone (˃800 pg/ml) in combination with hyperphosphoremia slightly increases the level of fibrinogen. Infection with hepatitis C significantly increases the level of soluble fibrin, and infection with hepatitis B decreases the level of protein C. The study and implementation of a comprehensive assessment of the state of hemostasis in patients with CKD stage VD complicated by comorbid diseases makes it possible to identify imbalances in the pro- and anticoagulation system.

Factor VIII–driven changes in activated factor IX explored by hydrogen-deuterium exchange mass spectrometry

AbstractThe assembly of the enzyme-activated factor IX (FIXa) with its cofactor, activated factor VIII (FVIIIa) is a crucial event in the coagulation cascade. The absence or dysfunction of either enzyme or cofactor severely compromises hemostasis and causes hemophilia. FIXa is a notoriously inefficient enzyme that needs FVIIIa to drive its hemostatic potential, by a mechanism that has remained largely elusive to date. In this study, we employed hydrogen–deuterium exchange-mass spectrometry (HDX-MS) to investigate how FIXa responds to assembly with FVIIIa in the presence of phospholipids. This revealed a complex pattern of changes that partially overlaps with those changes that occur upon occupation of the substrate-binding site by an active site-directed inhibitor. Among the changes driven by both cofactor and substrate, HDX-MS highlighted several surface loops that have been implicated in allosteric networks in related coagulation enzymes. Inspection of FVIIIa-specific changes indicated that 3 helices are involved in FIXa–FVIIIa assembly. These are part of a basic interface that is also known as exosite II. Mutagenesis of basic residues herein, followed by functional studies, identified this interface as an extended FVIIIa-interactive patch. HDX-MS was also applied to recombinant FIXa variants that are associated with severe hemophilia B. This revealed that single amino acid substitutions can silence the extended network of FVIIIa-driven allosteric changes. We conclude that HDX-MS has the potential to visualize the functional impact of disease-associated mutations on enzyme–cofactor complexes in the hemostatic system.

Influence of means of prevention of adverse effects of space flight on the plasma component of the system of regulation of the aggregate state of human blood

Introduction. It is known that the factors of space flight shift the coagulation balance of blood in the direction of procoagulant. The effect of space flight factors on the hemostatic potential of human blood with the simultaneous effect of preventive measures and compensation for their adverse effects has not been practically studied. The aim of study was to study the effect of physical exertion, electromyostimulation, mechanical stimulation of the foot, and blood-substituting solutions on the main indicators of the human hemostasis system in experiments with 21-hour antiorthostatic hypokinesia, 7-day "dry" water immersion, and 120-day isolation in a hermetic volume. Materials and methods. Concentrations of fibrinogen, plasminogen, soluble fibrin-monomer complexes, D-dimer, antithrombin III, protein C, and α2-antiplasmin were determined in citrate plasma; values of thrombin time, activated partial thromboplastin time, and prothrombin time. Results. It was found that the infusion of blood-substituting colloidal solution "venofundin" prevents the tendency to increase the level of soluble fibrin-monomer complexes observed during 21-hour antiorthostatic hypokinesia. Electromyostimulation leads to increased levels of fibrinogen and D-dimer during 7-day immersion. The complex of physical activities used in the experiment with 120-day isolation helps to reduce the level of D-dimer. Conclusions. The results indicate that when modeling the impact of space flight factors, a favorable hypocoagulation effect is provided by an infusion of venofundin, as well as a complex of balanced physical activities.

Autoplasma as a Hemostatic Agent for Endoscopic Surgery of Hollow Organs

Introduction. To maximize the effectiveness of hemostatic technologies, it is necessary to optimize local hemostasis through hybrid and controlled approaches, as well as to improve the conditions for tissue surgical dissection preventing perforation of hollow organs. This study is aimed at assessing the efficacy of stopping bleeding and the safety of resection of digestive hollow organs in experimental models of trauma to abdominal organs in laboratory animals.Materials and methods. Experiments were carried out in vivo on 20 rabbits. All animals were divided into 4 experimental groups (5 animals each): I — the control group, in which no methods for stopping bleeding were used; II — the group, in which infiltration of the wall of a hollow organ with saline solution was used; III — the group, in which physical hemostasis was applied using an electrosurgical unit and an argon plasma coagulation apparatus; IV — the group, animals in which underwent controlled local biological hemostasis using autoplasma. Prior to laparotomy, 2–3 ml of whole blood was taken from the rabbit’s ear for preliminary preparation of autoplasma. The prepared autoplasma was introduced into the area of resection or other operation of the mucous membrane of the rabbit’s digestive tract.Results and discussion. Although no statistical difference in the time of stopping bleeding was observed between the control (I) and saline (II) groups, one more episode of bleeding was noted in group II. Preventive local administration of autoplasma (group IV) was established to have a high hemostatic potential. As expected, electrocoagulation was more effective than saline; however, hemostasis achieved by means of argon plasma coagulation is characterized by rapid formation of a necrotic zone, which may lead to undesirable consequences in the long-term period.Conclusion. Preventive local administration of autoplasma and recombinant human protein has a high hemostatic potential in animals. In comparison, electrocoagulation is less effective due to the rapid filling of the pathological focus with blood.

Abstract 16324: The Overall Haemostatic Potential: A Novel Coagulation Measure Associated With Sex-specific Differences in Early Atherosclerosis and Metabolic Dysfunction

Introduction &amp; Aim: Plaque micro-ruptures and associated thrombosis are a contributor to the progression of coronary artery disease (CAD). We sought to determine if disorders of haemostasis detectable by a global coagulation assay was a novel risk factor for CAD, or if hypercoagulation was associated with any of the traditional cardiac risk factors. Methods: Using the BioHEART biobank of clinical data, imaging data and pathology specimens, a cohort of patients (mean age 62.9 +/- 9.9 years, n=103 female, 103 male) had platelet poor plasma assessed by the overall haemostatic potential (OHP) assay. This assay measures the integrated effect of procoagulant, anticoagulant and fibrinolytic factors via calculation of area under a fibrin time curve. All patients had CT coronary angiograms scored; calcified plaque was identified by the coronary artery calcium score, and non-calcified plaque burden by a soft plaque score (SPS). Analysis was segregated by sex because of baseline differences in coagulation between males and females. Results: The OHP was found to be elevated in male patients who had non-calcified CAD [SPS&gt;0 - 10.4 +/- 0.6 (n=62) vs SPS=0 - 8.78 +/- 0.5 (n=41), p=0.04], male patients with obesity [BMI &gt;= 30 - 12.6 +/- 1.1 (n=26) vs BMI &lt; 30 - 8.8 +/- 0.4 (n=77), p&lt;0.01] and in female patients with hyperlipidaemia [hyperlipidaemic 11.8 +/- 0.6 (n=63) vs normolipidaemic 9.2 +/- 0.6 (n=40), p&lt;0.01]. No differences were seen in OHP with calcified CAD, hypertension, diabetes mellitus, current or previous smoking history, or significant family history of CAD. Conclusions: These results indicate that hypercoagulation is associated with more biologically active non-calcified plaque, and that disordered coagulation is associated with two significant cardiac risk factors in a sex-discrepant manner. These findings underscore the importance of global coagulation assessments as potential novel, sex-specific biomarker for subclinical atherosclerosis.

Assessing maternal clotting function with novel global coagulation assays: A prospective pilot study.

Women are at higher risk of venous thromboembolism (VTE) during pregnancy and the puerperium. Global coagulation assays (GCAs), including thromboelastography (TEG), thrombin generation using the calibrated automated thrombogram (CAT) and fibrin generation using the overall haemostatic potential assay (OHP), provide a more comprehensive assessment of the coagulation process than conventional coagulation assays. We aimed to evaluate the ability of these GCAs to analyse the coagulability among pregnant women of varying VTE risk profile. Women undergoing term elective caesarean delivery provided a single predelivery blood sample for conventional and novel coagulation testing (TEG, CAT and OHP). Data from 47 healthy nonpregnant women aged 18-45years were used as controls. Sixty women with term singleton pregnancies were included. Samples from pregnant women were hypercoagulable on most GCA parameters compared to nonpregnant controls, demonstrating increased maximum amplitude (clot strength) (71.5 vs 60.6mm, P<.001) on whole blood TEG and increased endogenous thrombin potential (1895.22 vs 1399.33nmol/L·min, P<.001) and overall coagulation potential (fibrin generation) (57.58 vs 36.21 units, P<.001) on platelet-poor plasma. Pregnant women with booking BMI≥30kg/m2 had significantly higher maximum amplitude compared to pregnant women of normal BMI (18.5-25kg/m2 ) (73.2 vs 66.1mm, P<.001). Global coagulation assays reliably detect the physiological hypercoagulability of pregnancy. Thromboelastography in particular appears to correlate with obesity in the pregnant population. GCAs may be potential adjuncts to risk factor-based criteria to guide VTE thromboprophylaxis during pregnancy and the puerperium.