Werfen: A History of Partnership in Hemostasis E. El Bouchi
Blood Components Separate Blood RBC from Cryo- Circulation Plasma precipitate 1628 1930 1960s Blood Coagulation Coagulation Groups Factors Cascade 1901 1964 1954
Bleeding Disorders Life Expectancy «Royal Disease» Severe Hemophilia Queen Victoria <20y Desmopressin 1837 1960 1977 Von Factor First Willebrand Concentrate Recombinant Disease Factor 1970s aproved Finland 1992 1926
Thrombophilia Germany Rudolph US Virchow Protein C Def APS 1856 1981 1980s Norway US FV Leiden 1994 Olav Egeberg Protein S Def Antithrombin 1984 Deficiency 1965
Oral Anticoagulants Bleeding Cows Rat Poison Dwight Mouldy Warfarin Eisenhower Sweet Clover 1941 1955 Dicoumarol Clinical Use PT-INR 1939 Coumadin 1980s 1954 2008: DOACs
Tests Prothrombin Time ACT and «Quick» aPTT Heparin 1935 1953 1975 Viscoelastic ACT VT and Testing Transfusion 1966 Algorithms 1948 1980/90s
Heparin and ECC Extra Coronary Corporeal Heparin Artery Membrane discovered Bypass Graft Oxygenation 1916 1964 1972 1953 Heart LMWH Transplant 1° Cardiac 1990s Surgery 1967 Heart Lung Machine
Antiaggregation Meadow Acetyl 1° trials in Sweet salicylic Neuro Acid Spiraea Vascular ulmaria Bayer Diseases 2000 BC 1897 1978 German 1° trials in Clopidogrel Cardio Johann 1997 Vascular Buchner Prasugrel Diseases Salicin 2009 1974 1828
Aggregometers 1960s: Light Transmission Aggregometry with Agonists
General screening Anticoagulant testing Heparin-Induced Thrombocytopenia VTE exclusion (with PTP Score) Disseminated Intravascular Coagulation Thrombophilia investigation Antiphospholipid Syndrome Hemophilia and VWD Fibrinolytic disorders Identification of coagulopathies Anticoagulant testing Antiplatelet therapy management
History of 1st HIT, VWF CB and ADAMTS13 Act Liquid PT Coagulation Workcell Fully Automated APS Solution D-Dimer with VTE Exclusion Claims True Instrument Family Platform Automated D-Dimer (1988) Automated Coagulometer (1985)
Laboratory Portfolio of Tests General Screening D-Dimer HIT VWD ✓ PT ✓ D-Dimer HS 500 ✓ HIT Ab (PF4-H) ✓ vWF: Ag ✓ APTT ✓ D-Dimer 500 ✓ HIT Ab (IgG) ✓ vWF Activity ✓ Fib-C/QFA ✓ D-Dimer HS ✓ vWF:Rco ✓ D-Dimer ✓ Thrombin Time ✓ vWF: CB ADAMTS13 Thrombophilia ✓ ADAMTS13 Activity Lupus Anticoagulants ✓ Antithrombin Factors ✓ dRVVT Screen/Confirm ✓ Protein C ✓ Intrinsic Factors ✓ SCT Screen/Confirm ✓ ProClot ✓ Extrinsic Factors ✓ Free Protein S ✓ FXIII Antigen Antiphospholipid Antibodies ✓ PS Activity ✓ aCL IgG ✓ APC-R V ✓ aCL IgM Fibrinolysis ✓ Homocysteine ✓ Plasminogen ✓ B2GPI IgG ✓ Plasmin ✓ B2GPI IgM UF/LMW Heparin ✓ B2GPI Domain 1 Inhibitor ✓ Anti-Xa (1 stage) ✓ FDP DOACs Chemiluminescence Assay ✓ DTI: Dabigatran Available as CL or Latex ✓ Anti-Xa: Rivaroxaban ✓ Anti-Xa: Apixaban 14
Hemostasis Management in Point-of-Care Settings Viscoelastic testing for the rapid evaluation of coagulopathies to optimize patient treatment decisions in major surgeries and traumatic bleeding ACT testing for anticoagulant dose optimization during cardiovascular procedures and extracorporeal life support Platelet function testing for individualized antiplatelet therapy management, pre-and post-cardiovascular and neurointerventional procedures 15
Cardiac Patient Post Partum Neuro Vascular Pregnancy Extra Corporeal Surgery Circulation Transplant Coagulopathies
General screening Anticoagulant testing Heparin-Induced Thrombocytopenia VTE exclusion (with PTP Score) Disseminated Intravascular Coagulation Thrombophilia investigation Antiphospholipid Syndrome Hemophilia and VWD Fibrinolytic disorders Identification of coagulopathies Anticoagulant testing Antiplatelet therapy management
Hemostasis Diagnostic Management 18
Partnership outside the hospital Advanced Hemostasis Seminars IL webinars Sponsored Webinars Studies Workshops
Bambini Cardiopatici nel Mondo • http://www.bambinicardiopatici.it/en/ • Italy based NGO Hospital Group San Donato • Every month the Association organizes hope missions in different Countries • In the 5 days of the mission they diagnose around 250 children, about a dozen of whom they operate and the others they treat • Werfen EEMEAI will match the donations made by Employees and Partners to fund 2 upcoming Missions 20
Thank You!
Recommend
More recommend
