Essential Guide to Blood Coagulation

Edited byJovan P. Antovic and Margareta BlombäckDepartment of Molecular Medicine and Surgery, Coagulation Research, Karolinska Institutet; Clinical Chemistry, Karolinska University Hospital,Stockholm, Sweden

“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)

• List of contributors, xPreface, xiiAbbreviations, xiiiPART 1: GENERAL HEMOSTASIS1 Schematic presentation of the hemostatic system, 3Nils Egberg2 Proposals for sampling instructions, 6Margareta Blombäck and Nils EgbergPoints to note prior to sampling, 6Sampling time and patient preparation, 7Referrals for coagulation analyses, 8Sampling, 8Technique, 9For DNA investigation (genetic analyses), 103 Laboratory investigations, 11Jovan P. Antovic, Liselotte Onelöv, and Nils EgbergNomenclature, 11Reference intervals for laboratory investigations, 13Screening analyses, 13Special analyses, 20Markers of coagulation activation (hypercoagulation markers), 29DNA analyses, 29Global hemostatic assays and bedside methods, 31Useful components in research studies, 32Platelet-activating predictors, 35PART 2: BLEEDING DISORDERS4 Hereditary bleeding disorders, 41Margareta Holmström and Lars Göran LundbergGeneral remarks about hemophilia A and B, 41General remarks about von Willebrand disease, 42Factor concentrates used for treatment of hemophilia A and B and VWD in Sweden in 2012, 43Treatment strategy in severe forms of hemophilia and VWD, 44Recommendations for desired initial plasma concentrations at different types of bleedings, 45Surgery in patients with bleeding disorders, 47Tooth extraction in a hemophilia patient, 47Caution in patients with bleeding disorders, 48Treatment principles for different types of bleeding disorders (severe, moderate, and milder forms of hemostatic defects), 49Rare bleeding disorders, 51Blood sampling in bleeding disorders, 54Bleeding risk charts, 545 Critical bleeding, 56Maria Bruzelius, Anna Ågren, and Hans JohnssonIntroduction, 56Definition of massive bleeding, 56Transfusion coagulopathy, 56Recommendations to obtain optimal hemostasis, 57Choice of plasma, 58Local procedures, 59Additional treatment, 59Fibrinogen concentrate, 59Prothrombin-complex concentrate (PCC), 59Recombinant factor VIIa, 59Concentrates of other coagulation factors, 60Cryoprecipitates, 60Tranexamic acid, 60Desmopressin, 60Local hemostatic drugs, 60Complicating factors, 61Ongoing treatment with antiplatelet, and anticoagulant drugs, 616 Investigation of increased bleeding tendency, 62Margareta Holmström and Lars Göran LundbergIntroduction, 62Diagnosis, 62Reasons for pathologic screening analyses and further actions, 64Causes of thrombocytopenia, 64Causes of prolonged activated partial thromboplastin time, 65Causes of elevated PT(INR), 66Investigation of bleeding tendency: practical aspects, 66PART 3: THROMBOEMBOLIC DISORDERS7 Venous thrombosis and pulmonary embolism, 71Anders CarlssonIntroduction, 71Venous thrombosis, 72Pulmonary embolism, 75Primary prophylaxis against VTE, 918 Investigations of thromboembolic tendency, 94Margareta HolmströmIntroduction, 94Venous thromboembolism, 95Arterial thromboembolism, 96Disseminated intravascular coagulation, 969 Heart disease, 97Håkan Wallen and Rickard LinderIschemic heart disease, 97Atrial fibrillation, 102Cardiac valve prosthesis, 103New oral anticoagulants in the treatment of heart disease, 10410 Antiplatelet drug therapy and reversal of its effects, 105Håkan Wallen, Hans Johnsson, and Bo-Michael BellanderIntroduction, 105ASA, 105ADP (P2Y12) receptor antagonists, 106GPIIb/IIIa receptor antagonists, 106Phosphodiesterase inhibitors and other antiplatelet compounds, 108Combined antithrombotic treatment, 108Benefi t–risk assessment, 108Platelet transfusion, 10911 New oral anticoagulants: Focus on currently approved oral factor Xa and Thrombin inhibitors, 111Rickard E. Malmström and Hans JohnssonClinical pharmacology of NOACs, 111Possibility of and need for therapeutic monitoring of NOACs, 114Clinical aspects of NOACs, 114Results of clinical trials, 116Some characteristics of the individual NOACs, 118Considerations to be taken when using NOACs in some emergency situations12 Stroke and transient ischemic attack, 121Nils Wahlgren and Mia von EulerAntithrombotic secondary stroke prevention, 121Atrial fibrillation and TIA or stroke, 122Thrombolysis in stroke, 122Cerebral venous thrombosis and dissection of precerebral arteries, 123Recurrent TIA, 124Prophylactic treatment against DVT and PE, 12413 Peripheral artery surgery, 125Jesper SwedenborgProphylaxis against reocclusion in peripheral vascular surgery or percutaneous transluminal angioplasty (PTA), 125Peri- and postoperative treatment, 125Thrombolysis in acute ischemia, 126PART 4: SPECIAL HEMOSTASIS14 Hemostasis in obstetrics and gynecology, 129Katarina BremmeIntroduction, 129Thrombosis during pregnancy, 131Heart disease: treatment of women with mechanical heart valve prostheses, 139Thromboprophylaxis in obstetrics and gynecology, 140Blood sampling in children of women with severe forms of thrombophilia, 148Obstetric epidural/spinal analgesia (anesthesia), 148Complications during pregnancy, 150Postpartum bleeding, 155Thromboprophylaxis in legal and spontaneous abortions, 156Thromboprophylaxis in gynecologic surgery, 156Investigation prior to artificial insemination (IVF), 160Investigation in repeated miscarriages, 160Investigation in menorrhagia (for treatment see Chapter 4), 16115 Hemostasis in children, 162Susanna Ranta and Pia PetriniIntroduction, 162Bleeding disorders in children, 166Thromboembolic disorders in children, 17216 Emergency conditions associated with coagulation: DIC, HIT and TTP/HUS, 182Jovan P. Antovic and Margareta HolmströmDisseminated intravascular coagulation, 182Heparin-induced thrombocytopenia, 188Thrombotic microangiopathies, 190Index, 191