Hemostasis in the Lab, Approaching to the Correct Diagnosis in the Coagulopathies
American Journal of Pediatrics
Volume 6, Issue 2, June 2020, Pages: 98-104
Received: Oct. 2, 2019;
Accepted: Feb. 24, 2020;
Published: Mar. 6, 2020
Views 354 Downloads 88
Lopez S N, Pediatric Hematologists, Hematology Department, National Institute of Pediatrics, Mexico City, Mexico
Cortina DLR E, Laboratory of Thrombosis, Fibrinolysis and Platelet Function, National Institute of Cardiology, Ignacio Chavez, Mexico City, Mexico
Gonzalez P M, Pediatric Hematologists, Hematology Department, National Institute of Pediatrics, Mexico City, Mexico
Nunez T M, Pediatric Hematologists, Hematology Department, National Institute of Pediatrics, Mexico City, Mexico
Follow on us
Coagulation is the result of a coordinated interaction of blood proteins, circulating cells, endothelium cells and extracellular matrix proteins in the vessel wall. This process works in conjunction with other mechanisms that have to keep the blood in an effective flow, without hemorrity when damage occurs or without a thrombus when clotting begins. Most of the time, there is not so much information that a clotting test gives us, however, in the face of a real clinical scenario that concurrent with a personal haemorrhage, this is essential to take action. In addition, there is a thrombophilic scenario that has to be investigated. In all of them, it is important to note that doctors have to take into account that the pre-analytical phase plays a fundamental role, so it is very important to look around any situation that may impact the patient's results. There is a wide range of laboratory tests to evaluate different mechanisms of hemostasis, according to the history and characteristic of the clinical patient. With this in mind, there is a right time to ask for the right test, to get a better result for diagnosis and treatment. Analytical quality is the set of actions that are carried out in the laboratory with the aim of obtaining an accurate result, reflecting the real situation of the patient. Grossly, platelets, clotting factors and the fibrinolytic system could be studied, not all patients need all tests, they could be solved with a simple test, but may require a deep focus; that is why the patient with a history of mucocutaneous bleeding has to be studied for thrombocytopaties or VWD; a patient with muscle or joint bleeding has to be a factor deficiency test. We propose an initial approach to detecting the pathological situations essential to make decisions. Each person has different symptoms and different approaches, which is why identification and the right tests give us the greatest opportunity to get the right diagnosis.
Blood Coagulation, Hemostasis, Blood Test, Clinical Laboratory, Coagulopathty
To cite this article
Lopez S N,
Cortina DLR E,
Gonzalez P M,
Nunez T M,
Hemostasis in the Lab, Approaching to the Correct Diagnosis in the Coagulopathies, American Journal of Pediatrics.
Vol. 6, No. 2,
2020, pp. 98-104.
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Izaguirre R, De Micheli A. 2005. Evolución del conocimiento sobre la sangre y su movimiento. Parte II. El saber sobre su composición. Iatroquímica de la sangre. Rev Invest Clin.; 57: 85-97.
Kordich L. 2006. Fundamentos para el manejo practico en el laboratorio de Hemostasia. Grupo CATH.
Zamora-González. 2012. Pruebas del coagulograma y componentes de la hemostasia. Utilidad para diagnosticar las diátesis hemorrágicas Revista Cubana Hematología, Inmunología y Hemoterapia; 28 (2): 141-150.
Zimring JC. 2009. Introduction to coagulation testing. Transfusion Medicine and hemostasis, Clinical and laboratory aspects. Chirstopher D Hillyer, Beth H Shaz, James C Zimring, Thomas C Abshire Editors, Elsevier, New York USA., pp|601-605.
Jae-Lim Choi, Shuhua Li, and Jin-Yeong Han. 2014. Platelet Function Tests: A Review of Progresses in Clinical Application. BioMed Research International Volume, Article ID 456569, 7 pages.
Martha Sola-Visne. 2012. Platelets in the neonatal period: developmental differences in platelet production, function, and hemostasis and the potential impact of therapies. ASH, Hematology; 506-511.
Baker-Groberg S, Lattimore S. 2016. Assessment of neonatal platelet adhesion, activation, and aggregation., et al J Thromb Haemost. April; 14 (4): 815–827.
Michelson, A. D., 2006. Evaluation of platelet function by flow cytometry. Pathophysiol Haemost Thromb,. 35 (1-2): p. 67-82.
Malays J Med Sci. 2013; 20 (2): 62-66. New Horizons in Platelets Flow Cytometry. Malays J Med Sciv. 20 (2).
Elisabeth Mahla. 2009. Point-of-Care Platelet Function Analysis. Journal of the American College of Cardiology. Vol. 53, No. 10.
Paniccia R, Priora R, Alessandrello Liotta A, Maggini N, Abbate. 2014. Assessment of platelet function: Laboratory and point-ofcare Methods. World J Transl Med August 12; 3 (2): 69-83.
Oh Joo Kweon, Yong Kwan Lim, Bohyun Kim, et al. 2019. Effectiveness of Platelet Function Analyzer-100 for Laboratory Detection of Anti-Platelet Drug-Induced Platelet Dysfunction. Ann Lab Med; 39: 23-30 https://doi.org/10.3343/alm.2019.39.1.23.
Hoffman M. Remodeling the blood coagulation cascade. 2003. J Thromb Thrombolysis. 16 (1-2): 17-20.
Tripodi A, Lippi G, Plebani M. 2016. How to report results of prothrombin and activated partial thromboplastin times. Clin Chem Lab Med; 54 (2): 215–222.
Byun JH, Jang IS, Kim JW, Koh EH. 2016. Stablishing the heparin therapeutic range using aPTT and anti-Xa measurements for monitoring unfractionated heparin therapy. Blood Res; 51: 171-4.
Evi Stavrou and Alvin H. Schmaier. 2010. Factor XII: What Does It Contribute To Our Understanding Of The Physiology and Pathophysiology of Hemostasis & Thrombosis. Thromb Res.; 125 (3): 210–215. doi: 10.1016/j.thromres.2009.11.028.
Kitchen S, Geisen U, Kappelmayer J, Quehenberger P, et al. 2018. Evaluating the analytical performance of four new coagulation assays for the measurement of fibrinogen, D-dimer and thrombin time. Int J Lab Hematol; 40: 637–644.
Jennings I, Kitchen DP, Woods TA, Kitchen S, Walker ID. 2009. Differences between multifibrin U and conventional Clauss fibrinogen assays: data from the UK National External Quality Assessment scheme. Blood Coagul Fibrinolysis; 20: 388–90.
Lowe G, Rumbley A, Mackie IA. 2004. Review Article. Plasma Fibrinogen. Ann clin Biochem; 41: 430-440.
Olson JD et al. 2015. D-dimer: An Overview of Hemostasis and Fibrinolysis, Assays, and Clinical Applications. Adv Clin Chem. Volume 69, Pages 1-46.
López MS. 2018. Tromboelastografía y tromboelastometría para el monitoreo del tratamiento en pacientes con sangrado en distintos escenarios clínicos. HEMATOLOGÍA, Volumen 22 Número Extraordinario, XIII Congreso del Grupo CAHT: 278-291.
Milind Thakur, Aamer B Ahmed. 2012. A Review of Thromboelastography. International Journal of Perioperative Ultrasound and Applied Technologies. 1 (1): 25-29.