Rationale : Cardiac remodeling and subsequent heart failure remain critical issues after myocardial infarction despite improved treatment reperfusion strategies. Recently, cardiac regeneration has been demonstrated in fish newborn mice apex resection or infarctions. Two key to translate findings model organisms future therapies humans: what is the mechanism can indeed occur humans? Objective To assess whether human neonatal hearts functionally recover infarction. Methods Results Here, we...

To explore whether disturbed fibrin polymerization is the main problem underlying dilutional coagulopathy and can be reversed by fibrinogen administration, we conducted a prospective study using modified thrombelastography (ROTEM).Sixty-six orthopedic patients randomly received gelatin solution, hydroxyethyl starch 130/0.4, or exclusively Ringer lactate solution. ROTEM analysis was performed, concentrations of coagulation factors markers thrombin generation were measured. Fibrinogen...

Sugammadex reverses the neuromuscular blocking effects of rocuronium by chemical encapsulation. The efficacy, safety, and pharmacokinetics sugammadex for reversal profound rocuronium-induced blockade were evaluated.Ninety-eight male adult patients randomly assigned to receive (1, 2, 4, 6, or 8 mg/kg) placebo at 3, 5, 15 min after 0.6 mg/kg rocuronium. Patients anesthetized with propofol fentanyl. primary endpoint study was time achieve a recovery train-of-four ratio 0.9. Neuromuscular...

High-molecular-weight (HMW) von Willebrand factor (vWF) multimers are crucial for primary hemostasis. Increased shear stress from ventricular assist devices can provoke premature degradation of HMW vWF multimers. Whether similar loss occurs during extracorporeal membrane oxygenation (ECMO) is not clear.We conducted a prospective observational study in clinical cohort patients who required ECMO intractable cardiac and/or respiratory failure. The end point was the quantity and quality multimer...

Colloids and crystalloids are usually administered as treatment for hypovolemia in severely injured patients. However, dilution of clotting factors platelets together with impaired fibrinogen polymerization associated fluid therapy may aggravate hemorrhage, thus worsening final outcome these We investigated, an vitro model, whether the addition to diluted blood samples can reverse dilutional coagulopathy. Blood from 5 healthy male volunteers was by 60% using lactated Ringer's solution, 4%...

In Brief BACKGROUND: During craniosynostosis repair, massive blood loss, consumption and dilution of clotting factors often result in coagulopathy, for which cryoprecipitate, fresh frozen plasma (FFP), platelets are recommended treatment. However, cryoprecipitate is not available most European countries, the efficacy FFP correcting fibrinogen deficiency limited. We report our experience with human concentrate (Hemocomplettan®) used to improve impaired polymerization children. METHODS:...

In Brief BACKGROUND: We determined whether whole blood impedance aggregometry using the Multiplate® detects effects of antiplatelet drugs as reliably does classical light transmission (LTA) or platelet function analyzer PFA-100®. METHODS: Multiplate (M) assays, measuring changes in electrical resistance aggregation units over time (AU*min), and LTA assays induced by collagen (COL), adenosine diphosphate (ADP) arachidonic acid (AA) PFA-100 testing, epinephrine (PFA100-EPI) ADP (PFA100-ADP)...

<i>Objectives:</i> Coronary artery bypass grafting (CABG) is associated with long rehabilitation periods and slow quality of life (QOL) improvement. Totally endoscopic coronary (TECAB) can be performed using robotic technology remote access perfusion. The aim this study was to evaluate whether TECAB leads accelerated QOL improvement as compared standard CABG. <i>Methods:</i> We included 120 patients who had received robotically assisted CABG, 56 whom were operated on...

The purpose of our study was to evaluate planimetry the aortic valve area with 64-slice CT in comparison transthoracic echocardiography (TTE) and transesophageal (TEE) patients stenosis.Thirty-six disease referred for coronary angiography were examined. Planimetry compared TTE using Doppler continuity equation calculation planimetric measurement TEE.Planimetry (1.11 +/- 0.42 cm2) showed a good correlation (1.05 (r = 0.88, p < 0.001) 32 TEE (1.41 1.61 0.99, 0.0001) 10 patients. mean maximum...

Previous investigations have shown that increasing fibrinogen concentration improves dilution-dependent impairment of clot formation. We conducted an in vitro study to explore whether substitution with fibrin-stabilizing factor XIII (FXIII) combined promotes further improvement formation, and administration as concentrate or fresh frozen plasma (FFP) results comparable effects.Blood from six healthy donors was diluted by 60% using lactated Ringer's solution. Aliquots blood samples were...

In this study, we explored whether antiplatelet medications impair whole blood impedance aggregometry after cardiac surgery and cardiopulmonary bypass (CPB) compared with classical light transmission (LTA).Multiplate (M) assays measuring changes in electrical resistance as aggregation units over time, LTA (% aggregation) induced by collagen (COL), adenosine diphosphate (ADP), or arachidonic acid were performed simultaneously using arterial samples obtained before induction of anesthesia, 15...

Our goal of this study was to determine whether protamine's effects on coagulation can be detected and differentiated from those heparin when using thrombelastometry (ROTEM).To reverse the after cardiopulmonary bypass (CPB), 22 consecutive patients undergoing aortocoronary graft surgery were included. According clinical routine, all received a first dose protamine calculated total amount given; additional (70 U/kg) administered with activated clotting time (ACT) above baseline signs diffuse...

Patients requiring extracorporeal membrane oxygenation (ECMO) have a well-known bleeding risk and the potential for experiencing possibly fatal thromboembolic complications. Risk factors predictors of transfusion requirements during ECMO support remain uncertain. The authors hypothesized that compromised organ function immediately before will influence requirements.A prospective observational study.A tertiary, single-institutional university hospital.The study included 40 adult patients...

Small-volume resuscitation using hypertonic saline/hydroxyethyl starch 200/0.62 (HS-HES) has been shown to be an effective alternative the administration of crystalloids or colloids in trauma patients. All i.v. fluids cause dose-related dilutional coagulopathy and show intrinsic effects on hemostatic system, but only few data refer functional consequences after small-volume resuscitation.Using thrombelastometry (ROTEM), we studied 30 pigs (weighing 35-45 kg) withdrawal 60% blood volume [1484...

Background: Volume resuscitation is one of the primary therapeutic goals in hemorrhagic shock, but data on microcirculatory effects different colloidal fluid regimen are sparse. We investigated sublingual mucosal parameters during hemorrhage and after with gelatin, hydroxyethyl starch, or hypertonic saline starch pigs. Methods: To induce 60% calculated blood volume was withdrawn. Microvascular flow assessed by laser Doppler velocimetry. Microcirculatory hemoglobin oxygen saturation measured...