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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 | Two Graph Searching Techniques for Boundary Finding in White Blood Cell Image显示文摘 | J M Lester H A Williams B A Weintraub | 1978 | Computers in Biology and Medicine1978，，8： | 1 |
| 3 | Temperature dependence of performance of In-GaN/GaN MQW LEDs with different indium compo-sitions显示文摘 | Huh Chul Schaff William J Eastman Lester F | 2004 | IEEE Electron Device Letters2004，25，2： | 1 |
| 4 | Efficient online index maintenance for text retrieval systems 显示文摘 | Lester N Zobel J Williams H E | 2006 | Information Processing & Management2006，42，4： | 1 |
| 5 | Type Ⅱ estrogen binding site agonist:synthesis and biological evaluation of the enantiomers of methyl-para-hydroxyphenyllactate (MeHPLA)显示文摘 | Roy Williams Mark Elliott | 2003 | Chirality2003，15，： | 1 |
| 6 | Metal accumulation with in salt marsh environment : a review 显示文摘 | WILLIAMS T P BUBB J M LESTER J M | 1994 | Mar Pollut Bull1994，28，5： | 1 |
| 7 | Controlling emissions from motor vehicles显示文摘 | Lester Lave William Wecker Reis | 1990 | Environmental Science Technology1990，24，8： | 1 |
| 8 | Efficient online index maintenance for contiguous inverted lists 显示文摘 | LESTER N ZOBEL J WILLIAMS H | 2006 | Infor- mation Processing Management2006，42，4： | 1 |
| 9 | Metal accumulation within salt marsh environments: A review显示文摘 | WILLIAMS T P BUBB F M LESTER J N | 1994 | Marine Pollution Bulletin1994，28，5： | 1 |
| 10 | 查看详情显示文摘 | Fred L. C Michael R B Michael J. G Kevin C.G Chi S.L Lester A.D Eric P.S William W Wade J.A Janice M.F Charles W.F Gary E.Z | | 0，，： | 1 |
| 11 | Efficient on-line index maintenance for contiguous inverted lists 显示文摘 | LESTER N ZOBEL J WILLIAMS H E | 2006 | Systems Information Processing and Management2006，42，4： | 1 |
| 12 | Two graph searching techniques for boundary finding in white blood cell images 显示文摘 | LESTER J M WILLIAMS H A WEINTRAUB B A | 1979 | Computers in Biology and Medicine1979，8，4： | 1 |
| 13 | Metal accumulation within salt marsh environments: A review 显示文摘 | WILLIAMS T P BUBBJ M LESTER J N | 1994 | Marine Pollution Bulletin1994，28，5： | 1 |
| 14 | The impact of psychological contract fulfillment on the performance of in-role and organizational citizenship behaviors显示文摘 | WILLIAM H TURNLEY MARK C BOLINO SCOTT W LESTER & JAMES M BLOOD GOOD | 2003 | Journal of Management2003，29，2： | 1 |
| 15 | Monoamines and the EEG stages of sleep显示文摘 | Williams HL Lester BK Coulter JD | 1969 | Act Nerv Super (Praha)1969，11，3： | 1 |
| 16 | Metal accumulation within salt marsh environments: A review 显示文摘 | WILLIAMS T P BUBB J M LESTER J N | 1994 | Marine Pollution Bulletin1994，28，5： | 1 |
| 17 | Metal accumu- lation within salt marsh environments= A review显示文摘 | WILLIAMS T P BUBB J M LESTER J N | 1994 | Marine Pollution Bulletin1994，28，5： | 1 |
| 18 | Efficient online index maintenance for contiguous inverted lists 显示文摘 | Lester N Zobel J Williams H | 2006 | Information Processing and Management2006，42，7： | 1 |
| 19 | Metal accumulation within salt marsh environments: a Review 显示文摘 | Williams T P Bubb J M Lester J N | 1994 | Marine Pollution Bulletin1994，28，5： | 1 |
| 20 | Metal accumulation within salt marsh environments:a review显示文摘 | William T P Bubb J M Lester J N | 1994 | Marine Pollution Bulletin1994，28，5： | 1 |
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