Thrombophilia
Inherited thrombophilia contributes to a developed predisposition to thrombotic activities. The dangers of thrombophilia activities are increased when patients are hypercoagulable (Benedetto et al., 2015). Even though thrombophilia increases the hazards to the patients, the effect is not high because many of the patients having this complication does not invest a clothing action. However, at the time of pregnancy, the raised dangers might be substantial and warrant considerations since the thrombosis is recognized as the chief source of mortality at pregnancy periods. Furthermore, during pregnancy, 50% of the affected people with thrombosis will be found to have an underlying thrombophilia. Factor II and V Leiden is the highest known inherited thrombophilia (Aracic et al., 2016, 1031). Due to technology, a lot of new information with the inclusiveness of upcoming evaluations have considerably recognized for much modest association. Based on the starting of the advancement care, the working standard of outdated coagulometers was massively utilized as a foundation of the enhancement of reduced strategies.
Presently, there are relatively various concepts of precaution coagulation strategies that have commercially available for decades, making the affected people accept other prevention towards the treatment of thrombophilia of technology. The idea of precaution strategies for assessing anticoagulation depends mainly on clothing time examinations, factor-specific essays, various platelet function examinations based on immunoassay, among others (Roganović et al. 2016, p.489). The strategy have driven by the existing anticoagulant medications with the failure of clothing exams centered on accurately identifying numerous thrombotic syndromes. Modern technology in the POC coagulation development assessing technologies has assisted majorly with the treatment mechanism to the growth of inherited thrombophilia. Also, studies have evaluated for their potential upcoming clinical diagnostics (Roganović et al. 2016, p.490).
Moreover, the availability of point of care coagulation technologies has become essential as the central laboratories were not capable of delivering results in time frames needed to let for the fast turnaround, which was to enable timely interference based on anticoagulant therapy (King et al. 2016, p.73). However, it was equally for the patients who required dosage adjustment in the times of emergency procedures or for those outpatients who allowed dosage adjustment before they leave the clinic. The improvements were essential to improve the satisfaction of the patient as well as improving clinical outcomes. In the current review, the effects of point of care coagulation testing based on the rate of perioperative transfusion of allogeneic blood products, clinical results, and occurrence of hemostatic treatment have been assessed (Li, Han, Pauletti and Steckl, 2018).
While the treatment of POC may be limited, such program implementation can potentially lower the transfusion rates as well as reducing the costs related to chemotherapy. Improvements have been experiential in clinical actions apart from the clinical results (Whiting et al., 2015). A comparable trend has also been found based on studies for cardiac markers within the emergency department settings, wherever the span of stay for patients is meaningfully decreased despite the slight enhancement in clinical outcomes (Hegener et al., 2017).
The drive for the point of care coagulation has driven substantially the technological resolutions that may function within the microscale, as well as many innovations been implemented within the availability of commercial technologies. Improved point of care testing devices has absorbed on the expansion of low-cost and reduced tools. The research claims that current materials like nanostructure, the current striking properties based on the development of reduced biodevices like the adaptable chemical composition, and the controllable size-dependent properties have been assessed (Bilici et al. 2018, p.2). With coagulation assay technology, the devices have progressed significantly to such a point of allowing individuals to evaluate their clotting status by comforting on their own homes.
The quality and the range of POC coagulation testing have significantly increased, and that has allowed for measures on clotting period, factor activity, platelet function, and concentration to be improved hence the management of inherited thrombophilia. The tests have progressively increased alongside the understanding of those procedures being included in the hemostasis, as well as for the development of anticoagulant drug therapies (Bilici et al. 2018, p.4). Today, there are numerous points of care coagulation due to technology and facilitates the rapid and convenient measures of clotting status in clinical scenarios. For example, emergency rooms, operating theatres, outpatient settings, and in-patient settings in the management of massive evets of disorders form a diagnosis of genetic coagulation syndromes. Also, the treatment is essential perioperative anticoagulation centered on thrombosis management and the prophylactic control of a huge selection of thrombophilia conditions.
Numerous upcoming skills have been put in place in improving and polishing for the ability to accomplish coagulation assessments at the POC that is mainly being absorbed generally on better structures decrease and necessary incorporation (Harris et al. 2018, p.203). Similarly, with the use of technology, the point of care implementation structures is not essential without several main problems such as underlying cost, regulatory approval, property concerns that are intellectual, clinical acceptance, quality, and robustness. A lot of technological advancement has dramatically been majorly incremental (Harris et al. 2018, p.203). Indeed, the coagulation examination is expressively so pressured based on improvements of drug management that have demanded not to desire assessment.
The treatment concerning this inherited thrombophilia requires new technological improvement to maintain on being inexpensive, quicker, and more straightforward (Harris et al. 2018, p.204). People affected with thrombophilia and containing the pregnancy background result is recognized as a sensitive field as several doctors have not approved the actual management. Therefore, they pause for increased anxieties from such patient’s interferences that presently has pushed for POV availability coagulation nursing knowledge (Harris et al. 2018, p.204). Furthermore, the contemporary study employed on whether women that contain inherited thrombophilia and the selected pregnancy condition, have gained from anticoagulant treatment centered on increasing the likelihood of active pregnancy.
Managing thrombophilia
The patient management containing an inherited thrombophilia relies on numerous aspects such as one’s personal and thrombotic family account, the site centered on thrombosis and current of various prothrombotic threat issues. With the adequate on the point of care coagulation, it has turned promising to convey several particular measures constructed on the treatment of their situations (Hegener et al. 2017, p.64).
Point of care coagulation monitoring technology
Presently, many skills are utilized on the POC for anticoagulation checking using the outpatient anticoagulation, particularly the thrombophilia. Skills have formed examinations of inherited thrombophilia very manageable constructed on the coexisting framework, and that atmosphere influences on danger (Vashist et al. 2015, p.692). The point of care has, at the same time, created observing and testing of inherited thrombophilia condition much manageable. The anticoagulation initiation forum through advancement gives strong management concerning thrombophilia examination in various terms such as unprovoked venous thromboembolism, regarding women of those parents affected by thrombosis centered on their prenatal period (Hegener et al. 2017, p.64). The supervision provided is concerning thrombophilia examination timing. The examination employing contemporary mechanisms have gained the chosen people that might have stopped containing the anticoagulation.
Apart from the availability of the point of care coagulation monitoring technologies, there have been some educations performed by nurses themselves towards patients. The current use of the anticoagulants has helped in the management of this inherited thrombophilia (Mallett & Armstrong 2015, p.73). Patients with this kind of thrombophilia have no much knowledge about the condition, and that is why patients have turned out in large masses to educate them on the risk factors as well as managing for the state. It is recommended that the initial management of thrombosis include five days of the anticoagulation treatment with the unfractionated weight heparin with the use of anticoagulant for only six months.
Also, seeking some medication attention in case of a blood clot is helpful for management cases (Vashist et al. 2015, p.694). The significant improvement has been due to the use of anticoagulants, although there are limitations to decrease those risks based on inappropriate bleeding. It is an advanced point of care coagulation analyzer technology that is used to perform testing on inherited thrombophilia.
The POC allows for quick patients interventions due to technology (Harris et al., 2018). They have provided a wide range of advantages as a management and decision tool for both out and in the hospital. They have been helping to produce immediate and actionable results hence easing the management process. Their availability has also improved in expediting patients’ management in a wide range of settings as diverse as the outpatient clinics (Levy et al. 2019, p.837). The device testing mechanisms are very accurate hence helping for the precise treatment process. Another advantage of the device is that of being able to assess the viscoelastic properties for the patient’s whole blood in the body. Currently, things are much more comfortable as there are significant measures that have been set for the clotting process for which thrombosis is all about.
Monitoring of clotting and bleeding risk should be known to be essential components l for patient’s care. Should either be abnormal or excessive bleeding in clotting, which could have severe and visible results based on well-being and health as well as several co-morbidities. The presence of standard hemostasis management has been with checking of time that it takes to activate the models for clotting (Roganović et al., 2016). All the convenient methods have been moved from the initial laboratory tests towards the point of care technologies, and this has allowed for much more effective management as well as their treatment. Though the techniques have highly been limited to the information, they offer based on clotting or status of bleeding. With the use of the methods currently, there has been having development for the point of care applications.
Management of inherited thrombophilia in pregnancy
Adverse pregnancy outcomes like pre-escapism usually are located within the thrombotic mechanism as well as thrombophilia. The antithrombotic interventions, especially the little molecular weight heparin, have been researched in and recognized in women (Stevens et al. 2017, p.156). There is a need for research to better for the understanding of disease processes as well as to determine the biomarkers and then more of homogeneous groups based on the targeted treatment.
With the development of the targeted as well as effective preventive interventions is an essential issue for obstetric care. Most of the inherited thrombophilia is the factor V and factor II, and they usually affect three to eleven percent based on the population (Stevens et al. 2016, p.157). There is less common thrombophilia, such as protein c, antithrombin, and protein s. However, there was data conducted from the retrospective case-control and cohort studies and showed that inherited thrombophilia is mainly related not only with the VTE. Also, the adverse pregnancy results, such as gestational vascular and recurrent miscarriage complications.
Diagnosis and treatment of inherited thrombophilia
The inherited thrombophilia has been determined to be caused by thrombotic diathesis, which is caused mainly by several abnormalities within the anticoagulant factors. They include antithrombin, protein S, and protein C; sometimes, the thrombosis recurs despite the anticoagulant therapy. Currently, there are better assessments on clinical implications based on inherited thrombophilia. It is based on the framework for the coexisting risk factors which are involved within the multifactorial pathogenesis of the VTE (Jain & Acharya 2018, p.705). This kind of considerations needs to be taken into account, especially when assessments are done for modalities of secondary and primary thromboprophylaxis for those patients having the inherited thrombophilia traits.
The widespread use of the prophylactic anticoagulant, as well as the antiplatelet therapy for those with thrombophilia, has overridden for the lack of data that supports for its treatment. Lacking evidence could lead to reflecting the multifactorial nature of the complications, having inadequate stratification in the studies. Clinicians and the patients have direction based on the management of the situations with the present evidence with pursuing clinical trials in the treatment area (Nimjee & Lonser, 2018). There is a need for some better research targeting the treatment which could guide clinical decision making in this vital and controversial area.
The randomized trials based on interventions are targeted with specific disease processes that would accumulate the creation for sound evidence by better informing the affected area. Those patients having inherited thrombophilia always present the individual clinical episodes for the venous thromboembolism (Wun & Brunson 2018, p.642). It manifests with a deep vein thrombosis of directly pulmonary thromboembolism in young individuals. The congenital thrombophilias are highly related to the loss of pregnancy. Evidence supporting anticoagulation to improve for the disease outcome has been tabled by several researchers. With today’s advancement with the technology sector, the disease has been easier to control due to the use of individual devices based on technology. The management of inherited thrombophilia has been improved from patient to patient as studies from clinician’s reports.
Moreover, thrombotic events are highly recognized as an essential source by morbidity and mortality. Only the hereditary thrombophilia results due to an inherited factor like the antithrombin or deficiency of protein c, needs the interaction of the components which are typically inherited or need before the onset of the clinical disorders. The availability of these technologies could be said to have helped so much with the management process of the inherited thrombophilia (Palareti 2018, p.236). Many clinics have now been modernized with the required instruments that are necessary to do accurate testing and provide actual data across patients. There are heparin and Warfarin, which are the best anti-clotting medicines used today by many clinics to treat and prevent the disease (Levy et al. 2019, p.840). They are the best-known anticoagulants known currently. They usually interfere with the clotting process, and that is the reason why they are used in preventing the DVT as well as pulmonary embolism. Clinicians may prescribe patients for warfarin if one requires the anticoagulant to prevent and clot another one from happening.