Anticoagulation and Hemostasis in Neurosurgery by Christopher M. Loftus PDF

By Christopher M. Loftus

ISBN-10: 3319273256

ISBN-13: 9783319273259

ISBN-10: 3319273272

ISBN-13: 9783319273273

​This booklet is an updated reference on all facets of anticoagulation and hemostasis in neurosurgery. After a gap part on uncomplicated ideas and drug periods in present use, precise attention is given to coagulation matters proper to all sufferers, not only neurosurgical ones. The insurance contains, for instance, deep vein thrombosis, pulmonary embolism, and disseminated intravascular coagulation. a number of vital concerns particular to neurosurgical perform are then addressed, and a precis of present guidance and most sensible practices is equipped. via bringing jointly the most recent wisdom from around the self-discipline, this publication will function a valid foundation for proficient selection making in surgical perform. will probably be of day-by-day price for neurosurgeons and trainees around the world and also will be of curiosity to emergency room physicians, surgeons often, serious care physicians, neurologists, and medical institution medication specialists.

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40 Fig. 5 Direct thrombin inhibitor effect. Both soluble and bound thrombins are inactivated by DTIs. These drugs directly bind to thrombin without AT and block its subsequent effects clotting time (ECT) are more quantitative for DTI activity but the former is oversensitive and the latter is not often available in many hospitals in the USA [42]. 2 for further details. 3 % per year for the 110 mg and 150 mg groups, respectively) compared to warfarin. Adverse Effects Reversal As with other forms of anticoagulation, major bleeding is the most serious side-effect of DTIs.

The NSAIDs limit or eliminate the aggregation and secretion responses to arachidonic acid and collagen. Thienopyridines suppress aggregation and secretion responses to ADP. The Accumetrics VerifyNow System (San Diego, CA) measures platelet activity by agglutination of fibrinogen-coated microbeads. Response to aspirin therapy is determined using arachidonic acid as the test reagent; response to P2Y12 inhibitor treatment is determined using ADP as the test reagent; and response to GP IIb/ IIIa inhibitor treatment (abciximab, tirofiban, eptifibatide) is determined using TRAP as the test reagent.

There are numerous plasma D-dimer immunoassays. Sensitivity varies depending on the avidity of the monoclonal anti-D-dimer and the detection method. The quantitative D-dimer assay is used to ruleout ischemic stroke, acute myocardial infarction, or venous thromboembolic disease in patients with low pretest probability, and is required for detecting and monitoring DIC. D-dimer assays have negative predictive values of 90–95 %. Chronic or acute inflammation is accompanied by elevated D-dimer concentrations.

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Anticoagulation and Hemostasis in Neurosurgery by Christopher M. Loftus


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