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interpretation of coagulation test

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https://www.readbyqxmd.com/read/29758989/the-double-hazard-of-bleeding-and-thrombosis-in-hemostasis-from-a-clinical-point-of-view-a-global-assessment-by-rotational-thromboelastometry-rotem
#1
Olga Meltem Akay
Hemostasis is a complex dynamic process involving bleeding and thrombosis as two end-points. Conventional coagulation tests which are measured in plasma examine only isolated portions of the coagulation cascade, thereby giving no information on important interactions essential to the clinical evaluation of hemostatic function. Thromboelastography (TEG), originally described in 1948 has improved over the decades and become a valuable tool of coagulation testing because of the limitations of standard coagulation tests...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29741250/how-i-investigate-for-bleeding-disorders
#2
REVIEW
C P M Hayward
INTRODUCTION: Laboratory investigations for bleeding disorders are warranted when an individual has a personal and/or family history of bleeding, and/or laboratory findings that suggest the possibility of an inherited or acquired bleeding disorder. METHODS: This review summarizes author's experience with ordering and reporting on diagnostic investigations for common and rare bleeding disorders, with consideration of recent articles on diagnosing bleeding disorders...
May 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29708898/activated-partial-thromboplastin-time-derivative-curves-helpful-diagnostic-tool-in-mixing-test-interpretation
#3
Sevim Esmedere Eren, Cigdem Karakukcu, Mehmet Z Ciraci, Yasemin Ustundag, Musa Karakukcu
: The mixing test is used to evaluate whether prolonged activated partial thromboplastin time (APTT) is due to an inhibitor or a factor deficiency. The coagulation reaction is demonstrated with APTT derivative curves on the ACL TOP series. We aimed to determine the utility of APTT derivative curves in the mixing test process. The plasma of a patient was mixed with normal plasma in a 1 : 1 ratio and APTT assay was performed with SynthASil reagent. We observed roughness, biphasic and shoulder patterns in derivative curves during the mixing test...
April 27, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29548924/measurement-uncertainty-in-laboratory-reports-a-tool-for-improving-the-interpretation-of-test-results
#4
Andrea Padoan, Laura Sciacovelli, Ada Aita, Giorgia Antonelli, Mario Plebani
BACKGROUND: Measurement uncertainty (MU) estimation has been introduced by ISO 15189 for the accreditation of clinical laboratories. Although MU reporting is not required, its inclusion in medical reports is of potential assistance to physicians in results interpretation. METHODS: MU reporting was evaluated with respect to different test purposes, namely comparison with reference intervals (RI), patient monitoring or comparison with clinical decision limits. Clinical Biochemistry, Hematology, Coagulation and Clinical Immunology measurands were used as examples...
March 13, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29469043/viscoelastic-testing-in-liver-disease
#5
Jessica P E Davis, Patrick G Northup, Stephen H Caldwell, Nicolas M Intagliata
Long thought to be hypocoagulable, new evidence suggests cirrhosis patients have "rebalanced" coagulation in the setting of decreased synthesis of both pro- and anti-coagulant factors. Traditional testing like PT/INR reflects only the decreased synthesis of pro-coagulant factors and thus does not correspond to bleeding or clotting risk in this population. In this review, we discuss the use of viscoelastic testing (VET), an assay of global hemostasis in cirrhosis patients. We describe the technique and interpretation of commercially available VET and assess the application of VET in both transplant and non-transplant cirrhosis populations...
March 1, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29465204/-diagnostic-value-of-the-homeostasis-parameters-in-sepsis-detecting-in-patients-with-infectious-inflammatory-complications-during-the-postoperative-period
#6
O V Dymova, A A Eremenko, V V Nikoda, O N Vasilieva, A V Bondarenko, N S Bogomolova, Yu E Mikhailov
Purpose of the study was to define the diagnostic value of clinical and laboratory criteria of sepsis during the postop- erative period Methods. The results of 269 blood tests (biochemical, coagulation, hematology and microbiology) which were per- formed in 115 patients in the early postoperative period (starting from the first postoperative day) and in the late post- operative periods were analyzed. RESULTS: Presepsin and procalcitonin have a similar diagnostic sensitivity in detection of sepsis - 89% (Psp>328...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29453814/preclinical-evaluation-of-a-semi-automated-and-rapid-commercial-electrophoresis-assay-for-von-willebrand-factor-multimers
#7
Marika Pikta, Galina Zemtsovskaja, Hector Bautista, Georges Nouadje, Timea Szanto, Margus Viigimaa, Valdas Banys
BACKGROUND: The von Willebrand factor (VWF) multimer test is required to correctly subtype qualitative type 2 von Willebrand disease (VWD). The current VWF multimer assays are difficult, nonstandardized, and time-consuming. The purpose of this study was to evaluate the clinical utility of the commercial VWF multimer kit by Sebia (Lisses, France), an electrophoresis technique yielding same-day results. METHODS: Ten healthy volunteer plasma samples, in-house reference plasma (IRP) and commercial normal plasma (CNP) samples, 10 plasma samples from patients with a known VWD type, 1 hemophilia A plasma sample, and 7 external quality assurance (EQA) samples were analyzed using the commercial VWF multimer kit...
February 17, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29360254/intravenous-thrombolysis-for-acute-ischaemic-stroke-in-patients-on-direct-oral-anticoagulants
#8
E Touzé, Y Gruel, I Gouin-Thibault, E De Maistre, S Susen, P Sie, L Derex
BACKGROUND AND PURPOSE: Whereas intravenous thrombolysis (IVT) is allowed for acute ischaemic stroke in patients on vitamin K antagonists with international normalized ratio ≤1.7, there are no similar recommendations for patients on direct oral anticoagulants (DOACs), notably due to the lack of coagulation tests to assess the therapeutic effects. Although the literature is scarce, consisting of small case series and retrospective studies, considering the frequency of this situation the French Vascular Neurology Society and the French Study Group on Haemostasis and Thrombosis have worked on a joint position paper to provide a practical position regarding the emergency management of ischaemic stroke in patients on DOACs...
May 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29193737/laboratory-testing-in-patients-treated-with-direct-oral-anticoagulants-a-practical-guide-for-clinicians
#9
REVIEW
J Douxfils, W Ageno, C-M Samama, S Lessire, H Ten Cate, P Verhamme, J-M Dogné, F Mullier
Click to hear Dr Baglin's perspective on the role of the laboratory in treatment with new oral anticoagulants SUMMARY: One of the key benefits of the direct oral anticoagulants (DOACs) is that they do not require routine laboratory monitoring. Nevertheless, assessment of DOAC exposure and anticoagulant effects may become useful in various clinical scenarios. The five approved DOACs (apixaban, betrixaban, dabigatran etexilate, edoxaban and rivaroxaban) have different characteristics impacting assay selection and the interpretation of results...
February 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29076371/ammonia-concentrations-in-canine-whole-blood-edta-anticoagulated-whole-blood-and-plasma-measured-by-use-of-a-point-of-care-ammonia-meter
#10
Adesola Odunayo, Karen M Tobias, Chika C Okafor, Bente Flatland
OBJECTIVE To investigate the use of canine whole blood (WB) for measurement of ammonia concentration by use of a point-of-care ammonia meter and to compare results of measuring ammonia concentrations in WB, EDTA-anticoagulated WB, and plasma. ANIMALS 40 client-owned dogs. PROCEDURES A blood sample (2 mL) was obtained from each dog. One drop of WB was immediately applied to a test strip for evaluation with an ammonia meter. The remainder of the blood sample was placed in an EDTA-containing tube, and 1 drop of EDTA-anticoagulated WB was applied to a test strip...
November 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29043982/preanalytical-influence-of-pneumatic-tube-delivery-system-on-results-of-routine-biochemistry-and-haematology-analysis
#11
Morgane Petit, Louis Mine, Tiffany Pascreau, Chantal Brouzes, Sandrine Majoux, Delphine Borgel, Jean-Louis Beaudeux, Dominique Lasne, Carole Hennequin
Pneumatic tube delivery system (PTS) enables to reduce considerably turnaround times. The aim of the study was to assess the influence of the PTS on the quality of routine biochemical and hematological tests in our laboratory. Blood samples from 6 hospitalized patients and 8 healthy volunteers were analyzed. Blood samples were delivered to the laboratory by a PTS and by a human courier. We performed the following analysis: ionized calcium, sodium, potassium, lactate deshydrogenase (LDH), aspartate aminotransferase (ASAT), arterial blood gas, complete blood count and coagulation test as prothrombin time, activated partial thromboplastin time, factors V and VIII...
December 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29034090/pre-to-postoperative-coagulation-profile-of-307-patients-undergoing-oesophageal-resection-with-epidural-blockade-over-a-10-year-period-in-a-single-hospital-implications-for-the-risk-of-spinal-haematoma
#12
Owain Thomas, Emanuel Lybeck, Per Flisberg, Ulf Schött
BACKGROUND: Epidural anaesthesia and analgesia are indicated for oesophageal surgery. A rare but serious complication is spinal haematoma, which can occur on insertion, manipulation or withdrawal of catheters. Evidence and guidelines are vague regarding which tests are appropriate and how to interpret their results. We aimed to describe how routine coagulation test results change during oesophagectomy's perioperative course. METHODS: Following ethical approval, we retrospectively identified patients who had undergone oesophagectomy between 2002 and 2012...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29027774/rational-approach-to-transfusion-in-liver-transplantation
#13
Fuat H Saner, Lasitha Abeysundara, Matthias Hartmann, Susan V Mallett
For over 50 years patients with liver cirrhosis were considered to be at markedly increased risk of bleeding. This dogma was seemingly supported by abnormalities in standard laboratory tests (SLTs), such as the prothrombin time, that were interpreted as indicating a bleeding diathesis. However, publications from the last decade have revealed SLTs to be poor predictors of bleeding and it is now understood that stable patients with cirrhosis have a rebalanced haemostatic system and preserved thrombin generation...
March 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#14
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28804834/one-stage-factor-viii-assays
#15
Elizabeth Duncan, Susan Rodgers
Coagulation factor assays using one-stage methodology are widely used to measure factor levels for the purpose of detecting a deficiency, or to monitor replacement therapy. In this chapter, we focus on a method to measure Factor VIII coagulant activity (FVIII:C) by the one-stage assay (FVIII:C-1), with extra information provided to also allow this method to apply to Factor IX (FIX), Factor XI (FXI), and Factor XII (FXII). From the perspective of laboratory testing, these factors are components of the "intrinsic" coagulation pathway and are all measured in test systems based on the correction of the Activated Partial Thromboplastin Time (APTT)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804820/performance-and-interpretation-of-mixing-tests-in-coagulation
#16
Geoffrey Kershaw
Mixing tests in coagulation studies allow the laboratory to correctly differentiate factor deficiency from inhibitors as the cause of a prolonged clotting time. This is important in terms of subsequent laboratory follow-up and clinical patient management. In this chapter, a suggested method of performing mixing tests is given, with procedures applying two different formulas for interpretation, the percent correction and the index of circulating anticoagulant.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28795966/the-coagulation-profile-of-end-stage-liver-disease-and-considerations-for-intraoperative-management
#17
REVIEW
Katherine T Forkin, Douglas A Colquhoun, Edward C Nemergut, Julie L Huffmyer
The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging...
January 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28752844/routine-use-of-clinical-exome-based-next-generation-sequencing-for-evaluation-of-patients-with-thrombotic-microangiopathies
#18
Joseph P Gaut, Sanjay Jain, John D Pfeifer, Katinka A Vigh-Conrad, Meagan Corliss, Mukesh K Sharma, Jonathan W Heusel, Catherine E Cottrell
Next-generation sequencing is increasingly used for clinical evaluation of patients presenting with thrombotic microangiopathies because it allows for simultaneous interrogation of multiple complement and coagulation pathway genes known to be associated with disease. However, the diagnostic yield is undefined in routine clinical practice. Historic studies relied on case-control cohorts, did not apply current guidelines for variant pathogenicity assessment, and used targeted gene enrichment combined with next-generation sequencing...
December 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28740434/a-global-quantitative-survey-of-hemostatic-assessment-in-postpartum-hemorrhage-and-experience-with-associated-bleeding-disorders
#19
Andra H James, David L Cooper, Michael J Paidas
PURPOSE: Coagulopathy may be a serious complicating or contributing factor to postpartum hemorrhage (PPH), and should be promptly recognized to ensure proper bleeding management. This study aims to evaluate the approaches of obstetrician-gynecologists worldwide towards assessing massive PPH caused by underlying bleeding disorders. METHODS: A quantitative survey was completed by 302 obstetrician-gynecologists from 6 countries (the UK, France, Germany, Italy, Spain, and Japan)...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28725305/international-normalized-ratio-does-not-predict-gastrointestinal-bleeding-after-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cirrhosis
#20
Abimbola Adike, Mohanad Al-Qaisi, Noemi J Baffy, Heidi Kosiorek, Rahul Pannala, Bashar Aqel, Douglas O Faigel, M Edwyn Harrison
BACKGROUND: Cirrhosis is often accompanied by an elevated international normalized ratio (INR) due to a decrease in pro-coagulant factors. An elevated INR in cirrhosis is often interpreted as an increased risk of bleeding. There are a paucity of data in the literature on the use of INR to predict risk of gastrointestinal bleeding (GIB) following endoscopic retrograde cholangiopancreatography (ERCP) in patients with cirrhosis. The aims of the study were to determine if there is a correlation between INR and GIB following ERCP in patients with cirrhosis, and to determine if there is a difference in frequency of post-ERCP complications in patients with and without cirrhosis...
June 2017: Gastroenterology Research
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