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| 1 | Heparin resistance in severe thermal injury:a prospective cohort study显示文摘Background:Low molecular-weight heparin(LMWH)is routinely administered to burn patients for thromboprophylaxis.Some studies have reported heparin resistance,yet the mechanism(s)and prevalence have not been systematically studied.We hypothesized that nucleosomes,composed of histone structures with associated DNA released from injured tissue and activated immune cells in the form of neutrophil extracellular traps(NETs or NETosis),neutralize LMWH resulting in suboptimal anticoagulation,assessed by reduction in anti-factor Xa activity.Methods:Blood was sampled from>15%total body surface area(TBSA)burn patients receiving LMWH on days 5,10 and 14.Peak anti-factor Xa(AFXa)activity,anti-thrombin(ATIII)activity,cellfree DNA(cfDNA)levels and nucleosome levels were measured.Mixed effects regression was adjusted for multiple confounders,including injury severity and ATIII activity,and was used to test the association between nucleosomes and AFXa.Results:A total of 30 patients with severe burns were included.Mean TBSA 43%(SD 17).Twentythree(77%)patients were affected by heparin resistance(defined by AFXa activity<0.2 IU/mL).Mean peak AFXa activity across samples was 0.18 IU/mL(SD 0.11).Mean ATIII was 81.9%activity(SD 20.4).Samples taken at higher LWMH doses were found to have significantly increased AFXa activity,though the effect was not observed at all doses,at 8000 IU no samples were heparin resistant.Nucleosome levels were negatively correlated with AFXa(r=−0.29,p=0.050)consistent with the hypothesis.The final model,with peak AFXa as the response variable,was adjusted for nucleosome levels(p=0.0453),ATIII activity(p=0.0053),LMWH dose pre-sample(p=0.0049),drug given(enoxaparin or tinzaparin)(p=0.03),and other confounders including severity of injury,age,gender,time point of sample.Conclusions:Heparin resistance is a prevalent issue in severe burns.Nucleosome levels were increased post-burn,and showed an inverse association with AFXa consistent with the hypothesis that they may interfere with the anticoagulant effect of heparin in vivo and contribute to heparin resistance.Accurate monitoring of AFXa activity with appropriate therapy escalation plans are recommended with dose adjustment following severe burn injury. | Liam D Cato Benjamin Bailiff Joshua Price Christos Ermogeneous Jon Hazeldine William Lester Gillian Lowe Christopher Wearn Jonathan RB Bishop Janet M Lord Naiem Moiemen Paul Harrison | 2021 | Burns & Trauma2021，9，1： | 3 |
| 2 | Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: systematic review and meta-analysis显示文摘 | Juan P Casas Weiliang Chua Stavros Loukogeorgakis Patrick Vallance Liam Smeeth Aroon D Hingorani Raymond J MacAllister | 2005 | The Lancet2005，，9502： | 1 |
| 3 | Dynamic characteristics of a base isolated building from ambient vibration measurements and low level earthquake shaking 显示文摘 | Ventura C E Liam F W D Lord J F | 2003 | Soil Dynamics and Earthquake Engineering2003，23，4： | 1 |
| 4 | Dynamic characteristics of a base isolated building from ambient vibration measurements and low level earthquake shaking显示文摘 | Ventura C E Liam Finn W D Lord J F | 2003 | Soil Dynamics and Earthquake Engineering2003，23，： | 1 |
| 5 | Mortality from pandemic A/ H1N1 2009 influenza in England:public health surveillance study 显示文摘 | Liam J Donaldson Paul D Rutter | 2009 | BMJ2009，339，： | 1 |
| 6 | Root hairs as a model system for studing plant cell growth显示文摘 | Julia F Liam D | 2001 | Annals of Botany2001，88，： | 1 |
| 7 | Seismic re- sponse analysis of pile foundations 显示文摘 | Thavaraj T Liam Finn W D Wu Guoxi | 2010 | Journal of Geotechnical and Geoenvironmental Engineering2010，28，12： | 1 |
| 8 | Fundamentals of liquefaction under cyclic loading 显示文摘 | Martin R Geoffrey W D Liam Finn H Bolton Seed | 1975 | Journal of the Geotechnical Engineering Division1975，1975，： | 1 |
| 9 | Parallel and distributed state estimation显示文摘 | Falcao D M Felix F Wu Liam Murphy | 1995 | IEEE Trans on Power Systems1995，10，2： | 1 |
| 10 | Analysis of ground motions at Treasure Island site during the 1989 Loma Prieta earthquake 显示文摘 | Liam F W D Ventura Carlos E Wu Guo-xi | 1993 | Soil Dynamics and Earthquake Engineering1993，12，7： | 1 |
| 11 | Response of seafloor to ocean waves显示文摘 | Liam Finn W D Siddharthan R Martin G R | 1983 | Journal of Geotechnical Engineering ASCE1983，109，4： | 1 |
| 12 | Hemodilution and whole body oxygen balance during normothemic cardiopulmonary bypass in dogs 显示文摘 | Liam BL Plochl W Cook D J | 1998 | J Thorac Cardiovasc Surg1998，115，5： | 1 |
| 13 | Applications of limit plasticity in mechanics 显示文摘 | Finn W D Liam | | Journal0，，： | 1 |
| 14 | Dynamic nonlinear of pile foundations using finite element method in the time domain 显示文摘 | Guoxi Wu Liam Finn W D | 1997 | Canadian Geotechnical Journal1997，34，： | 1 |
| 15 | Clean care is safe care:The first global challenge of the WHO world alliance for patient safety显示文摘 | Didier P Liam D | | 0，，11： | 1 |
| 16 | Homocysteine and stroke: evidence on a causal link from mendelian randomisation显示文摘 | Juan P Casas Leonelo E Bautista Liam Smeeth Pankaj Sharma Aroon D Hingorani | 2005 | The Lancet . 2005 (9455)2005，，9455： | 1 |
| 17 | Clean care is safer care:The first global challenge of the WHO World alliance for patient safety显示文摘 | Didier P Liam D | 2005 | Infection Control and Hospital Epidemiology2005，26，11： | 1 |
| 18 | Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods 显示文摘 | MACKINNON D P LOCKWOOD C M WIL- LIAMS J | 2004 | Multivariate Behavioral Research2004，39，1： | 1 |
| 19 | Identification and expression of a cDNA for human glycolate oxidase 显示文摘 | Wi|liams E Cregeen D Rumsby G | 2000 | Biochimica et Biophysica Acta2000，1493，1： | 1 |
| 20 | The human bone marrow response to acute air pollution caused by forest fires显示文摘 | TAN W C QIU D LIAM B L | 2000 | Am J Respir Crit Care Med2000，161，41： | 1 |
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