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Coagulation01:06

Coagulation

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Colloidal solids are solid particles suspended in solution. They are usually negatively charged, attracting a compact primary layer of positively charged ions, which attract more counterions to form an electrical double layer. Electrostatic repulsion between the charged double layers prevents the particles from colliding, stabilizing the colloids. These solids are often undesirable because they can contain toxins that are difficult to remove. Coagulation is a technique that helps aggregate and...
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Coagulation01:09

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The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
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Ecarin based coagulation testing.

Robert C Gosselin1, Jonathan Douxfils2

  • 1Davis Health System, Thrombosis and Hemostasis Center, University of California, Sacramento, California.

American Journal of Hematology
|May 1, 2020
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Summary
This summary is machine-generated.

Ecarin-based assays offer a reliable method for monitoring direct thrombin inhibitors like dabigatran. These tests, derived from Echis carinatus venom, are valuable for assessing anticoagulant effects in clinical settings.

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Area of Science:

  • Coagulation science
  • Pharmacology
  • Clinical laboratory diagnostics

Background:

  • Ecarin, derived from Echis carinatus venom, activates prothrombin to meizothrombin, leading to clot formation.
  • Ecarin-based assays have a long history but were traditionally limited to specialized laboratories.
  • Initially used for monitoring direct thrombin inhibitors unaffected by heparinoids.

Purpose of the Study:

  • To review the current status and utility of ecarin-based assays for monitoring dabigatran.
  • To highlight the potential of these assays for assessing other parenteral direct thrombin inhibitors.

Main Methods:

  • Review of existing literature and clinical applications of ecarin-based assays.
  • Analysis of assay performance in the context of direct thrombin inhibitor monitoring.

Main Results:

  • Ecarin-based assays gained prominence with the advent of dabigatran etexilate.
  • These assays are considered a preferred method for assessing dabigatran's anticoagulant effect.
  • The methodology is also applicable to parenteral direct thrombin inhibitors like argatroban and bivalirudin.

Conclusions:

  • Ecarin-based assays are a valuable tool for monitoring direct oral thrombin inhibitors, particularly dabigatran.
  • These assays provide a reliable method for assessing anticoagulant activity in clinical practice.
  • Their application extends to parenteral direct thrombin inhibitors, offering broad utility.