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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 | Measurement tools used in the study of eccentric contraction-induced injury显示文摘 | Warren GL Lowe DA Armstrong RB | | 0，，： | 1 |
| 3 | Thrombolysis for ischemic stroke in the United States:data fromNationa l Hospital Discharge Survey 1999-2001显示文摘 | Suri MF Nasar A He W Kirmani JF Divani AA PrestiqiacomoCJ Low RB | 2005 | Neurosurgery2005，57，65： | 1 |
| 4 | A force reproduc- tion analysis of two recording sensors of two recording sen- sors of a computerized occlusal analysis system 显示文摘 | Kerstein RB Lowe M Harty M | 2006 | Cranio2006，24，1： | 1 |
| 5 | Excitation-contraction uncoupling: major role in contraction-induced muscle injury显示文摘 | Warren GL Ingalls CP Lowe DA Armstrong RB | 2001 | Exerc Sport Sci Rev2001，29，2： | 1 |
| 6 | A force reproduction analysis of two recording sensors of two recording sensors of a computerized ocelusal analysis system 显示文摘 | Kerstein RB Lowe M Harry M | 2006 | Cranio2006，24，1： | 1 |
| 7 | Preliminary report on the use of the percluder occluding aortic balloon in human beings 显示文摘 | Low RB Longmore W Rubinstein R | 1986 | Ann Emerg Med1986，15，： | 1 |
| 8 | Altered myosin isozyme pattern from pressure-overloaded and thyrotoxic hypertrophied rabbit hearts显示文摘 | Martin BJ Low RB | 1982 | Circ Res1982，50，： | 1 |
| 9 | Toward developing a complete understanding:a social science research agenda for marine protected areas显示文摘 | Christie P McCay BJ Miller ML Lowe C White AT Stoffle R Fluharty DL McManus LT Chuenpagdee R Pomeroy C Suman DO Blount BG Huppert D Eisma RV Oracion E Lowry K Pollnac RB | | 0，，12： | 1 |
| 10 | Epidemiological support for an hypothesis for melanoma induction indicating a role for UVA radiation 显示文摘 | Moan J Dahl back A Set low RB | 1999 | Photoche Photobiol1999，70，： | 1 |
| 11 | Serum and bronchoalveolar lavage (BAL) N-terminal procollagen peptides (PCP) correlatewith disease activity in idiopathic pulmonary fibrosis(IPF)显示文摘 | King TE Low RB Davis GS | 1990 | Am Rev Respir Dis1990，141，： | 1 |
| 12 | Endocrine secretory granules and neuronal synaptic vesicles have three integral membrane proteins in common显示文摘 | Lowe AW Madeddu L Kelly RB | 1988 | J Cell Biol1988，106，1： | 1 |
| 13 | Full-thicknes skin wound healing using autologous keratinocytes and dermal fibroblasts with fibrin: bilayered versus single-layered substitute 显示文摘 | Idrus RB Rameli MA Low KC | 2014 | Adv Skin Wound Care2014，27，4： | 1 |
| 14 | Excitation - contraction uncoupling : major role in contraction - induced muscle injury 显示文摘 | Warren GL Ingalls CP Lowe DA and Armstrong RB | 2001 | Exerc Sport Sci Rev2001，29，： | 1 |
| 15 | Determination of opiates in urine by capillary electrophoresis显示文摘 | Taylor RB Low AS Reid RG | 1996 | J Chromatogr B1996，675，： | 1 |
| 16 | Effect of physical forces on lung structure, function, and metabolism显示文摘 | Riley DJ Rannels DE Low RB | 1990 | Am Rev Respir Dis1990，142，： | 1 |
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