345 Spicing up the Edmonton Anticoagulation protocol: interference of dietary curcumin on coagulation status during mechanical circulatory support with berlin heart LVAD
Bibliographic record
Abstract
<h3></h3> In patients with implanted Berlin Heart EXCOR® Ventricular Assist Device, appropriate anticoagulation and antiaggregation within pre-defined values are essential for proper device function, and vital in order to avoid complications such as thromboembolic events and/or bleeding. Important factors that contribute to achieve the desired coagulation control are patient’s pharmacogenomics, liver status with nutritional status and interactions with other medications and supplements given to the patient during treatment. Bleeding or clotting issues that could occur are addressed according to aetiology, site of the incident, laboratory and clinical parameters. We describe a 3-year-old female patient with restrictive cardiomyopathy and acute heart failure subjected to implantation of Berlin Heart EXCOR® paediatric Left Ventricular Assist Device mechanical support as bridge therapy to cardiac transplantation. After device implantation, anticoagulation and antiaggregation were started and maintained according to the Edmonton Anticoagulation and Platelet Inhibition Protocol. Achievement of appropriate anticoagulation was compromised due to a non-disclosed addition of turmeric in her dietary regimen by parents. Curcumin, a polyphenol responsible for the yellow colour of turmeric, possesses anticoagulant properties, prolongs aPTT and PT significantly and inhibits thrombin and FXa activities. As a result, unexpected oscillations in the coagulation profile occurred, which represented a substantial management challenge. The aim of this report is to analyse and discuss the factors that could have been contributed to the difficult control of anticoagulation in our patient, with emphasis on the potential danger of undetected compounds deriving from sub-optimal control of paediatric patients during parental presence in PICU.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".