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dc.contributor.authorLawrence, Matthew J.
dc.contributor.authorKumar, Sendhil
dc.contributor.authorHawkins, Karl
dc.contributor.authorRutt, Harvey
dc.contributor.authorMills, Gavin
dc.contributor.authorSabra, Ahmed
dc.contributor.authorMorris, Keith
dc.contributor.authorDavidson, Simon J.
dc.contributor.authorBadiei, Nafieseh
dc.contributor.authorBrown, Martin R.
dc.contributor.authorWilliams, Phylip R.
dc.contributor.authorEvans, Phillip A.
dc.date.accessioned2016-03-16T13:32:47Z
dc.date.available2016-03-16T13:32:47Z
dc.date.issued2014-10-10
dc.identifier.citationLawrence, M.J., Kumar, S., Hawkins, K., Boden, S., Rutt, H., Mills, G., Sabra, A., Morris, R.H.K., Davidson, S.J., Badiei, N., Brown, M.R., Williams, P.R. & Evans, P.A. (2014) 'A new structural biomarker that quantifies and predicts changes in clot strength and quality in a model of progressive haemodilution', Thrombosis research, 134(2), pp.488-494.en_US
dc.identifier.issn0049-3848
dc.identifier.issn1879-2472 (ESSN)
dc.identifier.urihttp://hdl.handle.net/10369/7776
dc.descriptionThis article was published in Thrombosis Research on 7 June 2014 (online), available at http://dx.doi.org/10.1016/j.thromres.2014.05.039en_US
dc.description.abstractWe investigated the effect of progressive haemodilution on the dynamics of fibrin clot formation and clot microstructure using a novel rheological method. The technique measures clotting time (TGP), clot strength (G`GP), and quantifies clot microstructure (df) at the incipient stages of fibrin formation. We use computational modelling to examine the relationship between structure and mass, as well as helium ion microscopy (HIM) to compare morphological changes in the fully formed clot to that of the incipient clot. Methods This is an in vitro study; 90 healthy volunteers were recruited with informed consent and a 20 ml sample of whole blood obtained from each volunteer. Five clinically relevant dilutions were investigated using 0.9w.v isotonic saline (0, 10, 20, 40 and 60%, n = 18 for each dilution). The rheological method of assessing structural clot changes was compared against conventional coagulation screen and fibrinogen estimation. Results Fractal dimension (df) and final clot microstructure both decreased with progressive dilution (significant at a dilution of 20%) with similar relationships observed for final clot characteristics in HIM images. Significant correlations were observed between df and G`GP (clot strength) (0.345, p = 0.02), as well as clotting time (PT: − 0.690, p > 0.001; APTT: − 0.672, p > 0.001; TGP: − 0.385, p = 0.006). Conclusions This study provides new insight into the effects of haemodilution by isotonic saline on clotting time (TGP), clot strength (G′GP) and clot microstructure (df). Previous studies have attempted to link clot microstructure to clot quality/strength, however this study provides a significant step in quantifying these relationships. Abbreviations df, fractal dimension; GP, gel point; TGP, time to gel point; G`GP, clot strengthen_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofseriesThrombosis research
dc.rightsNon-Commercial
dc.rightsCreative Commons Attribution Non-Commercial No Derivatives License
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/3.0/
dc.subjectdilutionen_US
dc.subjectfluid resuscitationen_US
dc.subjectmicrostructureen_US
dc.subjectfractal dimensionen_US
dc.titleA new structural biomarker that quantifies and predicts changes in clot strength and quality in a model of progressive haemodilutionen_US
dc.typeArticleen_US
dc.identifier.doihttp://dx.doi.org/10.1016/j.thromres.2014.05.039
dc.date.dateAccepted2014-09-20


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