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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 | The reflection of guided waves from circumferential notches in pipes 显示文摘 | Alleyne D N Lowe M J S Cawley P | 1998 | Trans ASME J of Appl Mech1998，65，： | 2 |
| 3 | Nutrient removal from eutrophic lake water by wetland filtration显示文摘 | Stites D L Lowe E F | 2002 | Ecological Engineering2002，19，2： | 1 |
| 4 | Identification of severe acute respiratory syndrome in Canada显示文摘 | Poutanen S M Low D E Henry B | 2003 | N Engl J Med2003，348，20： | 1 |
| 5 | Invasive infection due to Streptococcus iniae: a new or previously unrecognized disease显示文摘 | WEINSTEIN M R LOW D E McGeer A | 1996 | Ontario CCDR1996，22，： | 1 |
| 6 | Infiltration and physical character istics of functionally graded alumina/ calcium- hexaluminate composites 显示文摘 | Asmi D Low I M | 2001 | Journal of Materials Processing Technology2001，118，： | 1 |
| 7 | High-dose cytarabine (24 g/m2) in combination with idarubicin (HiDAC-3) results in high first-cycle response with limited gastrointestinal toxicity in adult acute myeloid leukaemia显示文摘 | Low M Lee D Coutsouvelis J | 2013 | Intern Med J2013，43，3： | 1 |
| 8 | Defect detection in pipes using guided waves 显示文摘 | Lowe M Alleyne D Cawley P | 1998 | Ultrasonics1998，36，： | 1 |
| 9 | Oxidative injury and apoptosis of dorsal ganglion neurons in chronic experimental diabetic neuropathy显示文摘 | Schmeichel A M Schmeizer J D Low P A | 2003 | Diabetes2003，52，： | 1 |
| 10 | Non-destructive testing of rock bolts using guided ultrasonic waves显示文摘 | Beard M D Lowe M J S | 2003 | Intl Journal of Rock Mechanics & Mining Science2003，40，： | 1 |
| 11 | Defect detection in pipes using guided waves显示文摘 | LOWE M J S ALLEYNE D N CAWLEY P | 1998 | Ultrasonics1998，36，： | 1 |
| 12 | The relative importance of non-sea-salt sulphate and sea-salt aerosol to the marine cloud condensation nuclei population:Animproved multi-component aerosol-cloud droplet parametrization显示文摘 | O'Dowd C D Lowe J A Smith M H | 1999 | Quart J Roy Meteor Soc1999，125，556： | 1 |
| 13 | Anessentiat role for A adeninemet hylation in bacterial virulence显示文摘 | Heithoff D M Sinsheimer R L Low D A | 2000 | Trans R Soc Lond B Biol Sci2000，355，1397： | 1 |
| 14 | Thermal expansion coefficient of titanium casting 显示文摘 | Low D Sumii T Swain M | 2001 | J Oral Rehabil2001，28，3： | 1 |
| 15 | An Exploration of the Technical Feasibility of Achieving CO2 Emission Reductions in Excess of 60% Within the UK Housing Stock by the Year 2050显示文摘 | Johnston D Lowe R Bell M | 2005 | Energy Policy2005，83，： | 1 |
| 16 | Identification of severe acute respiratory syndrome in Canada显示文摘 | Poutanen S M Low D E Henry B | 2003 | N Engl J Med2003，13，： | 1 |
| 17 | Intra-prostatic uriuary reflux:an aetological factor in abacterial prostatitis显示文摘 | KIRBY R S LOWE D BULTITUDE M I | 1982 | Urol1982，54，6： | 1 |
| 18 | Determination of the isotopic composition of atmospheric methane and its application in the Antarctic显示文摘 | Lowe D C Brenninkmeijer C A M Tyler S C | 1991 | Journal of Geophysical Research1991，96，15： | 1 |
| 19 | Relation between extent of coronary artery disease and blood viscosity显示文摘 | LOWE G D DRUMMOND M M LORIMER A R | 1980 | Br Med J1980，280，3： | 1 |
| 20 | Automatic panoramic image stitching using invariant features显示文摘 | Brown M Lowe D G | 2007 | International Journal of Computer Vision2007，74，1： | 1 |
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