Hemostasis and Thrombosis

21st Annual NATA Symposium

21st Annual NATA Symposium, Athens 2020The 21st Annual NATA Symposium on Patient Blood Management, Haemostasis and Thrombosis will take place on April 23-24, 2020 in Athens, Greece.

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21st Annual Symposium General Information

News from the Industry

New clinical data support efficacy of fibrinogen concentrate (fibryga®) in treating acquired fibrinogen deficiency and lead to label extension in Europe

Fibrinogen replacement is widely accepted as an approach to managing acquired fibrinogen deficiency (AFD) in patients with critical bleeding, despite a lack of evidence until now from controlled clinical studies. Data from two comparative studies with Octapharma's highly-purified, dual pathogen-inactivated fibrinogen concentrate fibryga® have recently been published, and provide robust clinical support for this treatment approach.

The outcomes of a randomised, controlled clinical trial investigating approaches to bleeding control during cytoreductive surgery in 55 patients with pseudomyxoma peritonei were presented at the ISTH 2019 Congress in July. Fibrinogen replacement was effective for treatment of AFD in all cases, as measured by overall haemostatic efficacy. The results demonstrated non-inferiority of fibryga® (n = 22) compared with cryoprecipitate (n = 23) (p < 0.0095 for non-inferiority).

More recently, data from the first large multicentre, randomised controlled trial in AFD were published (JAMA, 2019). In a study of 827 patients undergoing cardiac surgery, fibryga® met the non-inferiority endpoint compared with cryoprecipitate (p < 0.001 for non-inferiority). Safety profiles of fibryga® and cryoprecipitate were comparable. Based on these clinical data, fibryga® received approval in the European Union for treatment of acquired fibrinogen deficiencies.

Read more at www.fibrinogendeficiency.com.

Focused Update: European Society of Anesthesiology Guidelines on the Management of Severe Perioperative Bleeding

European Society of Anesthesiology (ESA) guidelines on the management of severe perioperative bleeding (POB) were published recently.

In a Nataonline Focused Update, Prof. Kozek-Langenecker, Department of Anesthesia and Intensive Care, Evangelical Hospital Vienna, Vienna, Austria, and first author of the article published in the European Journal of Anaesthesiology, provides an overview of the recommendations.

The basis of clinical questions covered in the ESA guidelines is wide, she explains. POB management is not restricted to procoagulant strategies in overt POB but also includes patient optimization before, during and after bleeding. A web-app summarizing the key messages of the guidelines is available on the ESA website.

Read more on this


From the Literature

Dec 12, 2019

Published: Nov 2019

CRASH-3 trial collaborators

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial.
Lancet 2019;394:1713-1723.

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NATA REVIEW:
Tranexamic acid administered within 3 hours of injury in patients with head trauma reduces death. I...
REVIEW by:
B. H. Hunt

Published: Nov 2019

Harenberg J, Beyer-Westendorf J, Crowther M, et al.

Accuracy of a rapid diagnostic test for the presence of direct oral factor Xa or thrombin inhibitors in urine – a multicenter trial.
Thromb Haemost 2019; Nov 8 [Epub ahead of print].

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NATA REVIEW:
Harenberg et al. have developped a rapid colorimetric point-of-care test using patient urine sample...
REVIEW by:
C.-M. Samama

Published: Nov 2019

Chaudhury P, Gadre S, Schneider E, et al.

Impact of multidisciplinary pulmonary embolism response team availability on management and outcomes.
Am J Cardiol 2019;124:1465-1469

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NATA REVIEW:
Chaudhury et al. retrospectively analysed the outcomes of 769 consecutive adult patients with pulmonary...
REVIEW by:
J. M. Cholette

Published: Nov 2019

Raphael J, Mazer CD, Subramani S, et al.

Society of Cardiovascular Anesthesiologists clinical practice improvement advisory for management of perioperative bleeding and hemostasis in cardiac surgery patients.
J Cardiothorac Vasc Anesth 2019;33:2887-2899.

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NATA REVIEW:
Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood...
REVIEW by:
J. M. Cholette

Published: Nov 2019

Bonnet A, Gilquin N, Steer N, et al.

The use of a thromboelastometry-based algorithm reduces the need for blood product transfusion during orthotopic liver transplantation: A randomised controlled study.
Eur J Anaesthesiol 2019;36:825-833.

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NATA REVIEW:
Orthotopic liver transplants have come a long way over the past several decades. While we have solved a myriad...
REVIEW by:
E. Adams

Published: Oct 2019

Roy A, Stanford S, Nunn S, et al.

Efficacy of fibrinogen concentrate in major abdominal surgery – a prospective, randomized, controlled study in cytoreductive surgery for pseudomyxoma peritonei.
J Thromb Haemost 2019; Oct 26 [Epub ahead of print].

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NATA REVIEW:
This European single-centre trial randomised patients undergoing cytoreductive surgery with hyperthermic intraperitoneal...
REVIEW by:
J. H. Levy