Hypercoagulable and IV Access Projects

HYPERCOAGULABLE AND IV ACCESS PROJECTS  

Briefly:  Patients with GI Motility Disorders appear to have a much higher than expected incidence of hyper-coagulable disorders. The etiology of these may be multifactorial.

History: Patients with luminal gut failure, or severe gastrointestinal motility disorders not infrequently require intravenous (IV) access. Clinical observations, when dealing with large numbers of motility patients, are that those with IV access often have thrombosis. In addition, in certain conditions, such as diabetes mellitus, other circulatory disorders, such as pulmonary emboli, myocardial infarctions and strokes, appear to occur more often than in patients without diabetes mellitus.

Projects: Projects have involved: incidence and occurrence of hypercoagulable disorders, possible pathophysiology of these abnormalities, and possible ways to treat them.

Original Publications, chronologically:

Lobrano A., Blanchard K., Abell T. L., Minocha A., Boone W., Wyatt-Ashmead J., Fratkin J., Subramony C., Wee Jr. A., Di Nardo G., Barbara G., Stanghellini V., De Giorgio R. Postinfectious Gastroparesis Related to Autonomic Failure: A Case Report. Neurogastroenterology and Motility, Volume 18, Issue 2, Page 162-167, Feb 2006.

Lobrano A., Blanchard K., Rock W., Johnson W., Schmeig B., Borman K., Araghizadeh F., Minocha A., Abell T.L., Assessing Thrombosis Risk in patients with Idiopathic, Diabetic, and Postsurgical Gastroparesis. Advances in Therapy. 23 (5), 750-768, September/October 2006.

Creel B; Abell TL; Lobrano A; Deitcher SR; Dugdale M; Smalley D, Johnson WD. To Clot of Not To Clot: Are There Predictors of Clinically Significant Thrombus Formation in Patients with Gastroparesis and  Prolonged IV Access? Dig Dis Sci 53: 1532-1536, 2008.

Abstracts (numerous—available on request—some listed below)

Amy Lobrano, Anil Minocha, and Thomas Abell, William Rock, William Johnson. The Presence of Overlap Syndromes in Patients with Gastroparesis and Correlation with Hypercoagulable States in Gastroparesis.  Neurogastroenterology and Motility 18 (8), A288: August 2006.

Bradley Creel, Amy Lobrano, William Rock, David Smalley, William D Johnson, Anil Minocha, Thomas L Abell. Correlation of Immune Markers, Overlap Symptoms and Hypercoagulable Measures in Patients with Gastroparesis: Can We Predict Which Patients Will Clot?  Neurogastroenterology and Motility 18 (8), A322: August 2006.

Bradley Creel, Anil Minocha, Amy Lobrano, Thomas Abell, William Johnson. To Clot or Not to Clot: Are there Predictors of Thrombosis in Patients with Gastroparesis and Prolonged IV Access?  Am J of Gastroenterol 101 (9), A1219: September 2006

Creel W.B., Minocha A., Lobrano A., Deitcher S., Dugdale M., Smalley D., Abell T.L.. To Clot or Not To Clot: Are There Predictors of Clinically Significant Thrombus Formation in Patients with Gastroparesis and Prolonged Intravenous Access? Journal of Investigative Medicine 55 (Supp. 1) S299, A310: February 2007

Creel B, Abell TL, Rock W, Minocha A. Can Thrombosis be predicted in Patients with Gastroparesis? Am J Gastroenterolo. 2007:102 (S2) S506 [E1059].

Inflammatory and Hematologic Disorders are Associated With GI Symptoms in Diabetic Gastroparesis.  Shabnam Sarker, Naveed Ahmad, Archana Kedar, Danielle C. Spree, Michael Griswold, Christopher J. Lahr, Thomas L. Abell, William A. Rock, Gailen D. Marshall. AGA abstract, GE, T2063, May 2010.

Follow-up: A number of other investigations have been ongoing, with the determination that patients with GI Motility Disorders may have better outcomes if given anticoagulation peri-operatively. Also, motility patients with ongoing IV access might do better with anti-coagulation therapy when an IV access is in place.

[updated  18 June 2014 by TLAbell]

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