Essential Guide to Blood Coagulation

by Blomback, Margareta; Antovic, Jovan

• ISBN13: 9781405196277
• ISBN10: 1405196270
• Format: Paperback
• Copyright: 2010-01-19
• Publisher: Wiley-Blackwell

Summary

This concise, practical guide covers all the essentials for managing thrombotic and bleeding disorders, distilling the most clinically, up-to-date and relevant material, and including treatment strategies for key conditions and diseases. The latest antithrombotic and newest anticoagulant drugs are included, along with coverage of special patients (e.g. those infected with HIV) and complications.

Table of Contents

List of contributors	p. ix
Preface	p. xi
Abbreviations	p. xiii
General hemostasis
Schematic presentation of the hemostatic system	p. 3
Proposals for sampling instructions	p. 6
Points to note prior to sampling	p. 6
Sampling time and patient preparation	p. 7
Referrals for coagulation analyses	p. 8
Sampling	p. 8
Laboratory investigations	p. 11
Nomenclature	p. 11
Reference intervals for laboratory investigations	p. 13
Screening analyses	p. 13
Special analyses	p. 18
Markers of coagulation activation (hypercoagulation markers)	p. 24
DNA analyses	p. 25
Global hemostatic assays and bedside methods	p. 27
Useful components in research studies	p. 28
Other nonhemostatic variables of importance	p. 32
Bleeding disorders
Hereditary bleeding disorders	p. 37
General remarks about hemophilia A and B	p. 37
General remarks about von Willebrand's disease	p. 38
Factor concentrates used for treatment of hemophilia A and B and VWD in Sweden in 2009	p. 39
Treatment strategy in severe forms of hemophilia and VWD	p. 41
Surgery in patients with bleeding disorders	p. 43
Tooth extraction in a hemophilia patient	p. 44
Caution in patients with bleeding disorders	p. 44
Treatment principles for different types of bleeding disorders (severe, moderate and milder forms of hemostatic defects)	p. 46
Severe platelet function defect, e.g. Glanzmann's thrombasthenia	p. 48
Mild hemostatic defects	p. 48
Blood sampling in bleeding disorders	p. 50
Bleeding risk charts	p. 51
Critical bleedings	p. 52
Introduction	p. 52
Massive bleeding	p. 52
Transfusion coagulopathy	p. 53
Treatment	p. 53
Complicating factors	p. 56
Ongoing treatment with platelet-inhibiting and antithrombotic drugs	p. 57
Investigations of increased bleeding tendency	p. 58
Introduction	p. 58
Diagnosis	p. 58
Reasons for pathologic screening analyses and further actions	p. 60
Causes of thrombocytopenia	p. 60
Causes of prolonged activated partial thromboplastin time	p. 61
Causes of elevated PT(INR)	p. 62
Investigation of bleeding tendency-practical aspects	p. 62
Thromboembolic disorders
Venous thrombosis and pulmonary embolism	p. 67
Introduction	p. 67
Incidence of thrombosis in different clinical materials	p. 67
Venous thrombosis	p. 68
Pulmonary embolism	p. 71
Drug treatment in deep vein thrombosis and pulmonary embolism	p. 75
Treatment of acute deep vein thrombosis and pulmonary embolism	p. 75
Drug treatment in deep vein thrombosis and pulmonary embolism	p. 77
Action to take to avoid the risk of thrombosis	p. 86
Primary prophylaxis against deep vein thrombosis and pulmonary embolism	p. 88
New anticoagulants: focus on currently approved oral factor Xa and factor Ila inhibitors	p. 91
Introduction	p. 91
Rivaroxaban	p. 91
Dabigatran	p. 95
Ongoing clinical studies and other therapeutic indications	p. 100
Possibility of and need for therapeutic monitoring of new anticoagulants	p. 100
Arterial thromboembolism	p. 103
Ischemic heart disease	p. 103
Thrombolysis	p. 104
Percutaneous coronary intervention	p. 105
Cardiac arrhythmias (atrial fibrillation)	p. 106
Stroke and transient ischemic attack (TIA)	p. 109
Investigation of thromboembolic tendency	p. 112
Introduction	p. 112
Venous thromboembolism	p. 113
Arterial thromboembolism	p. 114
Disseminated intravascular coagulation	p. 114
Special hemostasis
Hemostasis in obstetrics and gynecology	p. 119
Thrombosis during pregnancy	p. 119
Heart disease: treatment of women with mechanical heart valve prostheses	p. 126
Thromboprophylaxis in obstetrics and gynecology	p. 126
Blood sampling in children of women with severe forms of thrombophilia	p. 132
Obstetric epidural / spinal analgesia (anethesia)	p. 133
Complications during pregnancy	p. 134
Postpartum bleeding	p. 140
Thromboprophylaxis in legal and spontaneous abortions	p. 141
Thromboprophylaxis in gynecologic surgery	p. 141
Oral contraceptives, hormone substitution	p. 142
Investigation prior to artificial insemination	p. 145
Investigation in repeated miscarriages	p. 145
Investigation in menorrhagia	p. 146
Hemostasis defects in children	p. 147
Bleeding disorders in children	p. 147
Thromboembolic disorders in children	p. 154
Emergency conditions associated with coagulation activation	p. 161
Disseminated intravascular coagulation	p. 161
Heparin-induced thrombocytopenia	p. 167
Thrombotic microangiopathies (TTP and HUS)	p. 169
Index	p. 171
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