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Informationen zum Autor Edited by Jovan P. Antovic and Margareta Blombäck Department of Molecular Medicine and Surgery, Coagulation Research, Karolinska Institutet; Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden Klappentext Thrombotic and bleeding disorders affect at least 10 million people in the US alone. There has also been a great deal of concern over travel-related deep vein thrombosis and therefore much more interest and research into the field of blood clotting. This new and concise practical guide will cover all the essentials one needs to know when managing thrombotic and bleeding disorders. The field of haematology is undergoing major advances in thrombosis research, including significant additions to recommended treatment protocols. The Essential Guide to Coagulation will distil the most clinically, up-to-date and relevant material from the literature for all those working in the field.Faced with a bleeding patient, it may be difficult to discern whether blood loss is due to a local factor or secondary to an underlying haemostatic defect. There are a range of simple and specialized laboratory texts which can be performed to further define the cause of bleeding in a patient. Since the first edition there have been many developments in the field including many new anticoagulant drugs. These new classes of "direct thrombin inhibitors" slow the coagulation cascade by directly binding to thrombin, a clotting factor essential in the clotting process. If thrombin is blocked, clot formation is delayed. A key component of this guide will be the latest treatment strategies available for patients. "This book would be useful to those wanting an introduction to coagulation disorders. More experienced practitioners will likely find its treatment of coagulation disorders too superficial for their needs." ( Doody's , 23 August 2013) Zusammenfassung A guide to laboratory diagnosis and treatment of hemostatic disorders. It distils the clinically up-to-date information on thrombotic and bleeding disorders, including the treatment strategies, for key conditions and diseases. It covers both the stable and the acute stages of hereditary and acquired bleeding and thrombotic disorders. Inhaltsverzeichnis List of contributors, x Preface, xii Abbreviations, xiii PART 1: GENERAL HEMOSTASIS 1 Schematic presentation of the hemostatic system, 3 Nils Egberg 2 Proposals for sampling instructions, 6 Margareta Blombäck and Nils Egberg Points to note prior to sampling, 6 Sampling time and patient preparation, 7 Referrals for coagulation analyses, 8 Sampling, 8 Technique, 9 For DNA investigation (genetic analyses), 10 3 Laboratory investigations, 11 Jovan P. Antovic, Liselotte Onelöv, and Nils Egberg Nomenclature, 11 Reference intervals for laboratory investigations, 13 Screening analyses, 13 Special analyses, 20 Markers of coagulation activation (hypercoagulation markers), 29 DNA analyses, 29 Global hemostatic assays and bedside methods, 31 Useful components in research studies, 32 Platelet-activating predictors, 35 PART 2: BLEEDING DISORDERS 4 Hereditary bleeding disorders, 41 Margareta Holmström and Lars Göran Lundberg General remarks about hemophilia A and B, 41 General remarks about von Willebrand disease, 42 Factor concentrates used for treatment of hemophilia A and B and VWD in Sweden in 2012, 43 Treatment strategy in severe forms of hemophilia and VWD, 44 Recommendations for desired initial plasma concentrations at different types of bleedings, 45 Surgery in patients with bleeding disorders, 47 Tooth extraction in a hemophilia patient, 47 Cauti...
Inhaltsverzeichnis
List of contributors, x
Preface, xii
Abbreviations, xiii
PART 1: GENERAL HEMOSTASIS
1 Schematic presentation of the hemostatic system, 3
Nils Egberg
2 Proposals for sampling instructions, 6
Margareta Blombäck and Nils Egberg
Points to note prior to sampling, 6
Sampling time and patient preparation, 7
Referrals for coagulation analyses, 8
Sampling, 8
Technique, 9
For DNA investigation (genetic analyses), 10
3 Laboratory investigations, 11
Jovan P. Antovic, Liselotte Onelöv, and Nils Egberg
Nomenclature, 11
Reference intervals for laboratory investigations, 13
Screening analyses, 13
Special analyses, 20
Markers of coagulation activation (hypercoagulation markers), 29
DNA analyses, 29
Global hemostatic assays and bedside methods, 31
Useful components in research studies, 32
Platelet-activating predictors, 35
PART 2: BLEEDING DISORDERS
4 Hereditary bleeding disorders, 41
Margareta Holmström and Lars Göran Lundberg
General remarks about hemophilia A and B, 41
General remarks about von Willebrand disease, 42
Factor concentrates used for treatment of hemophilia A and B and VWD in Sweden in 2012, 43
Treatment strategy in severe forms of hemophilia and VWD, 44
Recommendations for desired initial plasma concentrations at different types of bleedings, 45
Surgery in patients with bleeding disorders, 47
Tooth extraction in a hemophilia patient, 47
Caution in patients with bleeding disorders, 48
Treatment principles for different types of bleeding disorders (severe, moderate, and milder forms of hemostatic defects), 49
Rare bleeding disorders, 51
Blood sampling in bleeding disorders, 54
Bleeding risk charts, 54
5 Critical bleeding, 56
Maria Bruzelius, Anna Ågren, and Hans Johnsson
Introduction, 56
Defi nition of massive bleeding, 56
Transfusion coagulopathy, 56
Recommendations to obtain optimal hemostasis, 57
Choice of plasma, 58
Local procedures, 59
Additional treatment, 59
Fibrinogen concentrate, 59
Prothrombin-complex concentrate (PCC), 59
Recombinant factor VIIa, 59
Concentrates of other coagulation factors, 60
Cryoprecipitates, 60
Tranexamic acid, 60
Desmopressin, 60
Local hemostatic drugs, 60
Complicating factors, 61
Ongoing treatment with antiplatelet, and anticoagulant drugs, 61
6 Investigation of increased bleeding tendency, 62
Margareta Holmström and Lars Göran Lundberg
Introduction, 62
Diagnosis, 62
Reasons for pathologic screening analyses and further actions, 64
Causes of thrombocytopenia, 64
Causes of prolonged activated partial thromboplastin time, 65
Causes of elevated PT(INR), 66
Investigation of bleeding tendency: practical aspects, 66
PART 3: THROMBOEMBOLIC DISORDERS
7 Venous thrombosis and pulmonary embolism, 71
Anders Carlsson
Introduction, 71
Venous thrombosis, 72
Pulmonary embolism, 75
Primary prophylaxis against VTE, 91
8 Investigations of thromboembolic tendency, 94
Margareta Holmström
Introduction, 94
Venous thromboembolism, 95
Arterial thromboembolism, 96
Disseminated intravascular coagulation, 96
9 Heart disease, 97
Håkan Wallen and Rickard Linder
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Bericht
"Nevertheless, this book could one day become the 'oxford handbook' - equivalent for coagulation." (The Haem Trainee, 1 August2013)
"This book would be useful to those wanting an introduction to coagulation disorders. More experienced practitioners will likely find its treatment of coagulation disorders too superficial for their needs." (Doody's, 23 August 2013)
