Utilizing Plasma Composition Data to Help Determine Procoagulant Dynamics in Patients with Thermal Injury: A Computational Assessment. (Record no. 12535)

MARC details
000 -LEADER
fixed length control field 05829nam a22006137a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 190521s20192019 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 0026-4075
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1093/milmed/usy397 [doi]
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 5418659 [pii]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 30901410
245 ## - TITLE STATEMENT
Title Utilizing Plasma Composition Data to Help Determine Procoagulant Dynamics in Patients with Thermal Injury: A Computational Assessment.
251 ## - Source
Source Military Medicine. 184(Suppl 1):392-399, 2019 03 01.
252 ## - Abbreviated Source
Abbreviated source Mil Med. 184(Suppl 1):392-399, 2019 03 01.
253 ## - Journal Name
Journal name Military medicine
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2019
Manufacturer FY2019
265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE]
Publication status ppublish
266 ## - Date added to catalog
Date added to catalog 2019-05-21
501 ## - WITH NOTE
Local holdings Available in print through MWHC library: 1999 - 2005
520 ## - SUMMARY, ETC.
Abstract CONCLUSIONS: Thrombin and FXa generation are increased in burn patients at admission compared to mean physiological simulations. Over the first 48 hours, burn survivors became more procoagulant while non-survivors became less procoagulant. Differences between survivors and non-survivors appear to be present in the underlying dynamics that contribute to FXa dynamics. Understanding how the individual specific balance of procoagulant and anticoagulant proteins contributes to thrombin and FXa generation could ultimately guide therapy and potentially reduce burn injury-related morbidity and mortality.
520 ## - SUMMARY, ETC.
Abstract Copyright (c) Association of Military Surgeons of the United States 2019. All rights reserved. For permissions, please e-mail: [email protected].
520 ## - SUMMARY, ETC.
Abstract INTRODUCTION: The development of methods that generate individualized assessments of the procoagulant potential of burn patients could improve their treatment. Beyond its role as an essential intermediate in the formation of thrombin, factor (F)Xa has systemic effects as an agonist to inflammatory processes. In this study, we use a computational model to study the FXa dynamics underlying tissue factor-initiated thrombin generation in a small cohort of burn patients.
520 ## - SUMMARY, ETC.
Abstract MATERIALS AND METHODS: Plasma samples were collected upon admission (Hour 0) from nine subjects (five non-survivors) with major burn injuries and then at 48 hours. Coagulation factor concentrations (II, V, VII, VIII, IX, X, TFPI, antithrombin (AT), protein C (PC)) were measured and used in a computational model to generate time course profiles for thrombin (IIa), FXa, extrinsic tenase, intrinsic tenase and prothrombinase complexes upon a 5 pM tissue factor stimulus in the presence of 1 nM thrombomodulin. Parameters were extracted from the thrombin and FXa profiles (including max rate (MaxRIIa and MaxRFXa) and peak level (MaxLIIa and MaxLFXa)). Procoagulant potential was also evaluated by determining the concentration of the complexes at select times. Parameter values were compared between survivors and non-survivors in the burn cohort and between the burn cohort and a simulation based on the mean physiological (100%) concentration for all factor levels.
520 ## - SUMMARY, ETC.
Abstract RESULTS: Burn patients differed at Hour 0 (p < 0.05) from 100% mean physiological levels for all coagulation factor levels except FV and FVII. The concentration of FX, FII, TFPI, AT and PC was lower; FIX and FVIII were increased. The composition differences resulted in all nine burn patients at Hour 0 displaying a procoagulant phenotype relative to 100% mean physiological simulation (MaxLIIa (306 +/- 90 nM vs. 52 nM), MaxRIIa (2.9 +/- 1.1 nM/s vs. 0.3 nM/s), respectively p < 0.001); MaxRFXa and MaxLFXa were also an order of magnitude greater than 100% mean physiological simulation (p < 0.001). When grouped by survival status and compared at the time of admission, non-survivors had lower PC levels (56 +/- 18% vs. 82 +/- 9%, p < 0.05), and faster MaxRFXa (29 +/- 6 pM/s vs. 18 +/- 6 pM/s, p < 0.05) than those that survived; similar trends were observed for all other procoagulant parameters. At 48 hours when comparing non-survivors to survivors, TFPI levels were higher (108 +/- 18% vs. 59 +/- 18%, p < 0.05), and MaxRIIa (1.5 +/- 1.4 nM/s vs. 3.6 +/- 0.7 nM/s, p < 0.05) and MaxRFXa (13 +/- 12 pM/s vs. 35 +/- 4 pM/s, p < 0.05) were lower; similar trends were observed with all other procoagulant parameters. Overall, between admission and 48 hours, procoagulant potential, as represented by MaxR and MaxL parameters for thrombin and FXa, in non-survivors decreased while in survivors they increased (p < 0.05). In patients that survived, there was a positive correlation between FX levels and MaxLFXa (r = 0.96) and reversed in mortality (r= -0.91).
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Burns/bl [Blood]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Burns/pp [Physiopathology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Coagulants/an [Analysis]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Analysis of Variance
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Area Under Curve
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Blood Coagulation Tests/mt [Methods]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Burns/en [Enzymology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Coagulants/bl [Blood]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Cohort Studies
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Factor Xa/an [Analysis]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Humans
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Pilot Projects
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element ROC Curve
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Thrombin/an [Analysis]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Time Factors
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Health Research Institute
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Washington Hospital Center
656 ## - INDEX TERM--OCCUPATION
Department Firefighters' Burn and Surgical Research Laboratory
656 ## - INDEX TERM--OCCUPATION
Department Surgery/Burn Services
657 ## - INDEX TERM--FUNCTION
Medline publication type Journal Article
657 ## - INDEX TERM--FUNCTION
Medline publication type Research Support, U.S. Gov't, Non-P.H.S.
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors McLawhorn, Melissa M
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Moffatt, Lauren T
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Shupp, Jeffrey W
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Tejiram, Shawn
790 ## - Authors
All authors Bravo MC, Brummel-Ziedins KE, Jett-Tilton M, McLawhorn MM, Moffatt LT, Orfeo T, Pusateri AE, Shupp JW, Tejiram S
856 ## - ELECTRONIC LOCATION AND ACCESS
DOI <a href="https://dx.doi.org/10.1093/milmed/usy397">https://dx.doi.org/10.1093/milmed/usy397</a>
Public note https://dx.doi.org/10.1093/milmed/usy397
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Journal article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 05/21/2019   30901410 05/21/2019 05/21/2019 Journal Article

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