Hamostaseologie最新文献_第5页

Integration of Extracorporeal Membrane Oxygenation into the Management of High-Risk Pulmonary Embolism: An Overview of Current Evidence. 将体外膜肺氧合纳入高危肺栓塞治疗：当前证据概述。

IF 2.7 4区医学

Hamostaseologie Pub Date : 2024-06-01 Epub Date: 2024-03-26 DOI: 10.1055/a-2215-9003

Romain Chopard, Raquel Morillo, Nicolas Meneveau, David Jiménez

{"title":"Integration of Extracorporeal Membrane Oxygenation into the Management of High-Risk Pulmonary Embolism: An Overview of Current Evidence.","authors":"Romain Chopard, Raquel Morillo, Nicolas Meneveau, David Jiménez","doi":"10.1055/a-2215-9003","DOIUrl":"10.1055/a-2215-9003","url":null,"abstract":"High-risk pulmonary embolism (PE) refers to a large embolic burden causing right ventricular failure and hemodynamic instability. It accounts for approximately 5% of all cases of PE but contributes significantly to overall PE mortality. Systemic thrombolysis is the first-line revascularization therapy in high-risk PE. Surgical embolectomy or catheter-directed therapy is recommended in patients with an absolute contraindication to systemic thrombolysis. Extracorporeal membrane oxygenation (ECMO) provides respiratory and hemodynamic support for the most critically ill PE patients with refractory cardiogenic shock or cardiac arrest. The complex management of these individuals requires urgent yet coordinated multidisciplinary care. In light of existing evidence regarding the utility of ECMO in the management of high-risk PE patients, a number of possible indications for ECMO utilization have been suggested in the literature. Specifically, in patients with refractory cardiac arrest, resuscitated cardiac arrest, or refractory shock, including in cases of failed thrombolysis, venoarterial ECMO (VA-ECMO) should be considered, either as a bridge to percutaneous or surgical embolectomy or as a bridge to recovery after surgical embolectomy. We review here the current evidence on the use of ECMO as part of the management strategy for the highest-risk presentations of PE and summarize the latest data in this indication.","PeriodicalId":55074,"journal":{"name":"Hamostaseologie","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pulmonary Embolism: Don't Start Me to Talkin'. 肺栓塞：别让我开始说话。

IF 2.7 4区医学

Hamostaseologie Pub Date : 2024-06-01 Epub Date: 2024-07-01 DOI: 10.1055/s-0044-1780534

Stefano Barco, Riccardo Mario Fumagalli

引用次数: 0

Intensive Care Treatment of Pulmonary Embolism: An Update Based on the Revised AWMF S2k Guideline. 肺栓塞的重症监护治疗：基于修订版 AWMF S2k 指南的更新。

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-04-01 Epub Date: 2024-03-18 DOI: 10.1055/a-2237-7428

Uwe Janssens

{"title":"Intensive Care Treatment of Pulmonary Embolism: An Update Based on the Revised AWMF S2k Guideline.","authors":"Uwe Janssens","doi":"10.1055/a-2237-7428","DOIUrl":"10.1055/a-2237-7428","url":null,"abstract":"Acute pulmonary embolism (PE) remains a significant cause of morbidity and requires prompt diagnosis and management. The prognosis of affected patients depends on the clinical severity. Therefore, risk stratification is imperative for therapeutic decision-making. Patients with high-risk PE need intensive care. These include patients who have successfully survived resuscitation, with obstructive shock or persistent haemodynamic instability. Bedside diagnostics by means of sonographic procedures are of outstanding importance in this high-risk population. In addition to the treatment of hypoxaemia with noninvasive and invasive techniques, the focus is on drug-based haemodynamic stabilisation and usually requires the elimination or reduction of pulmonary vascular thrombotic obstruction by thrombolysis. In the event of a contraindication to thrombolysis or failure of thrombolysis, various catheter-based procedures for thrombus extraction and local thrombolysis are available today and represent an increasing alternative to surgical embolectomy. Mechanical circulatory support systems can bridge the gap between circulatory arrest or refractory shock and definitive stabilisation but are reserved for centres with the appropriate expertise. Therapeutic strategies for patients with intermediate- to high-risk PE in terms of reduced-dose thrombolytic therapy or catheter-based procedures need to be further evaluated in prospective clinical trials.","PeriodicalId":55074,"journal":{"name":"Hamostaseologie","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Aktueller Bericht der BDDH über die aktuellen gesundheitspolitischen Entwicklungen mit politischer Einordnung. BDDH 关于当前卫生政策发展的最新报告，并进行了政治分类。

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-04-01 Epub Date: 2024-04-30 DOI: 10.1055/a-2239-5959

Jürgen Koscielny, Günther Kappert, Christoph Sucker

引用次数: 0

Erratum: Aktueller Bericht der BDDH über die aktuellen gesundheitspolitischen Entwicklungen mit politischer Einordnung. 勘误：目前 BDDH 关于当前卫生政策发展的报告，含政治分类。

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-04-01 Epub Date: 2024-05-21 DOI: 10.1055/s-0044-1787122

Jürgen Koscielny, Günther Kappert, Christoph Sucker

引用次数: 0

Diagnosis and Therapy of Visceral Vein Thrombosis: An Update Based on the Revised AWMF S2k Guideline. 内脏静脉血栓的诊断和治疗:基于修订的AWMF S2k指南的更新。

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-04-01 Epub Date: 2023-11-22 DOI: 10.1055/a-2178-6670

Katja S Mühlberg

{"title":"Diagnosis and Therapy of Visceral Vein Thrombosis: An Update Based on the Revised AWMF S2k Guideline.","authors":"Katja S Mühlberg","doi":"10.1055/a-2178-6670","DOIUrl":"10.1055/a-2178-6670","url":null,"abstract":"Splanchnic or visceral vein thromboses (VVTs) are atypical thrombotic entities and include thrombosis of the portal vein, hepatic veins (Budd-Chiari syndrome), mesenteric veins, and splenic vein. All VVTs have in common high 30-day mortality up to 20% and it seems to be difficult to diagnose VVT early because of their rarity and their wide spectrum of unspecific symptoms. VVTs are often associated with myeloproliferative neoplasia, thrombophilia, and liver cirrhosis. VVT is primarily diagnosed by sonography and/or computed tomography. In contrast to venous thromboembolism, D-dimer testing is neither established nor helpful. Anticoagulation is the first-line therapy in patients with stable circulation and no evidence of organ complications. Anticoagulation improves significantly recanalization rates and stops the progress of thrombosis. Low-molecular-weight heparin, vitamin K antagonists, as well as direct-acting oral anticoagulants are possible anticoagulants, but it is noteworthy to be aware that all recommendations supporting the off-label use of anticoagulants are based on poor evidence and consist predominantly of case series, observational studies, or studies with small case numbers. When choosing a suitable anticoagulation, the individual risk of bleeding and thrombosis must be weighted very carefully. In cases of bleeding, bowel infarction, or other complications, the optimal therapy should be determined on a case-by-case basis by an experienced multidisciplinary team involving a surgeon. Besides anticoagulation, there are therapeutic options including thrombectomy, balloon angioplasty, stenting, transjugular placement of an intrahepatic portosystemic shunt, liver transplantation, and ischemic bowel resection. This article gives an overview of current diagnostic and therapeutic strategies.","PeriodicalId":55074,"journal":{"name":"Hamostaseologie","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cancer-Associated Venous Thromboembolism-Diagnostic and Therapeutic Considerations: An Update Based on the Revised AWMF S2k Guideline. 癌症相关静脉血栓栓塞——诊断和治疗考虑:基于修订的AWMF S2k指南的更新

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-04-01 Epub Date: 2023-11-22 DOI: 10.1055/a-2178-6508

Hanno Riess, Jan Beyer-Westendorf, Uwe Pelzer, Robert Klamroth, Birgit Linnemann

{"title":"Cancer-Associated Venous Thromboembolism-Diagnostic and Therapeutic Considerations: An Update Based on the Revised AWMF S2k Guideline.","authors":"Hanno Riess, Jan Beyer-Westendorf, Uwe Pelzer, Robert Klamroth, Birgit Linnemann","doi":"10.1055/a-2178-6508","DOIUrl":"10.1055/a-2178-6508","url":null,"abstract":"Patients with cancer are prone to develop venous thromboembolism (VTE) with negative impact on quality of life, morbidity, and mortality. Treatment of established VTE is often complex in patients with cancer. Treatment of cancer-associated VTE (CAT) basically comprises initial and maintenance treatment, for 3 to 6 months, secondary preventions, and treatment in special situations. Therapeutic anticoagulation is the treatment of choice in CAT. In addition to the efficacy and safety of low-molecular-weight heparin (LMWH) that had been recommended for decades, direct oral anti-factor Xa inhibitors, a subgroup of direct oral anticoagulants (DOACs), demonstrated their advantages along with the accompanying concerns in several randomized controlled treatment trials of CAT. The latest guidelines, such as the German AWMF-S2k Guideline \"Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism,\" agree with each other on most aspects with respect to the treatment of CAT. Encompassing recent clinical studies, and meta-analyses, as well as the focus on some special management aspects of CAT, the objective of this review is to present a current overview and recommendations for the treatment of CAT.","PeriodicalId":55074,"journal":{"name":"Hamostaseologie","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-Pulmonary Embolism Syndrome: An Update Based on the Revised AWMF-S2k Guideline. 肺栓塞后综合征：基于修订版 AWMF-S2k 指南的更新。

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-04-01 Epub Date: 2024-03-26 DOI: 10.1055/a-2229-4190

F Joachim Meyer, Christian Opitz

{"title":"Post-Pulmonary Embolism Syndrome: An Update Based on the Revised AWMF-S2k Guideline.","authors":"F Joachim Meyer, Christian Opitz","doi":"10.1055/a-2229-4190","DOIUrl":"10.1055/a-2229-4190","url":null,"abstract":"In survivors of acute pulmonary embolism (PE), the post-PE syndrome (PPES) may occur. In PPES, patients typically present with persisting or progressive dyspnea on exertion despite 3 months of therapeutic anticoagulation. Therefore, a structured follow-up is warranted to identify patients with chronic thromboembolic pulmonary disease (CTEPD) with normal pulmonary pressure or chronic thromboembolic pulmonary hypertension (CTEPH). Both are currently understood as a dual vasculopathy, that is, secondary arterio- and arteriolopathy, affecting the large and medium-sized pulmonary arteries as well as the peripheral vessels (diameter < 50 µm). The follow-up algorithm after acute PE commences with identification of clinical symptoms and risk factors for CTEPH. If indicated, a stepwise performance of echocardiography, ventilation-perfusion scan (or alternative imaging), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level, cardiopulmonary exercise testing, and pulmonary artery catheterization with angiography should follow. CTEPH patients should be treated in a multidisciplinary center with adequate experience in the complex therapeutic options, comprising pulmonary endarterectomy, balloon pulmonary angioplasty, and pharmacological interventions.","PeriodicalId":55074,"journal":{"name":"Hamostaseologie","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Vonicog Alpha and Acquired von Willebrand Syndrome, a New Approach: A Case Report. 使用 Vonicog Alpha 和获得性 von Willebrand 综合征，一种新方法：病例报告。

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-03-22 DOI: 10.1055/a-2266-7984

Adeline Blandinières, Sophie Combe, Noémie Chanson, Olivier Lambotte, Cécile Lavenu-Bombled

引用次数: 0

Novel Perspectives on Thrombopoietin Receptor Agonists Applications. 血小板生成素受体激动剂应用的新视角。

IF 3.2 4区医学

Hamostaseologie Pub Date : 2024-03-18 DOI: 10.1055/a-2250-9369

Christos Stafylidis, Dimitra Vlachopoulou, Stavroula Syriopoulou, Sevastianos Chatzidavid, Nora-Athina Viniou

{"title":"Novel Perspectives on Thrombopoietin Receptor Agonists Applications.","authors":"Christos Stafylidis, Dimitra Vlachopoulou, Stavroula Syriopoulou, Sevastianos Chatzidavid, Nora-Athina Viniou","doi":"10.1055/a-2250-9369","DOIUrl":"https://doi.org/10.1055/a-2250-9369","url":null,"abstract":"Second-generation thrombopoietin receptor agonists (TPO-RAs), romiplostim, eltrombopag, and avatrombopag, have been proved to be significant stimulators of megakaryopoiesis and, in the last decade, they have been incorporated in the treatment options against refractory immune thrombocytopenia in children and adults that do not respond to conventional therapy. Additionally, given their beneficial impact on hematopoiesis, they have successfully been applied in cases of non-immune thrombocytopenia, such as aplastic anemia, HCV-related thrombocytopenia, chronic liver disease, and most recently acute radiation syndrome. During the past years, a wide variety of clinical studies have been performed, in regard to the use of TPO-RAs in various thrombocytopenic settings, such as malignant hematology and hematopoietic stem cell transplantation, hereditary thrombocytopenias, and chemotherapy-treated patients with solid organ tumors. Although data indicate that TPO-RAs may be an effective and safe option for managing disease- or treatment-related thrombocytopenia in these patients, further research is needed to determine their efficacy and safety in these settings. Furthermore, recent studies have highlighted novel properties of TPO-RAs that render them as potential treatment candidates for reducing tumor burden or fighting infections. Herein, we discuss the potential novel applications of TPO-RAs and focus on data regarding their efficacy and safety in these contexts.","PeriodicalId":55074,"journal":{"name":"Hamostaseologie","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0