Coagulation testing in the perioperative period

Abstract

Perioperative coagulation management is a complex task that has a significant impact on the perioperative journey of patients. Anaesthesia providers play a critical role in the decision-making on transfusion and/or haemostatic therapy in the surgical setting. Various tests are available in identifying coagulation abnormalities in the perioperative period. While the rapidly available bedside haemoglobin measurements can guide the transfusion of red blood cells, blood product administration is guided by many in vivo and in vitro tests. The introduction of newer anticoagulant medications and the implementation of the modified in vivo coagulation cascade have given a new dimension to the field of perioperative transfusion medicine. A proper understanding of the application and interpretation of the coagulation tests is vital for a good perioperative outcome.

Routine Preoperative Coagulation Tests in Children Undergoing Elective Surgery or Invasive Procedures: Are They Still Necessary?

“…Abnormal coagulation profiles are not commonly associated with perioperative complications or abnormal laboratory results. 2,12,13…”

“…The very low incidence of postoperative bleeding due to bleeding disorders in our study (1/2078, 0.05%) support the current evidence that routine coagulation testing has limited impact on the perioperative outcome. 2,11,15 Defects of coagulation detected preoperatively have poor correlations with postoperative bleeding risks and volume of blood loss or transfusion requirement. 16…”

“…Both PT and APTT are used to assess the final common pathway of coagulation cascade (factors II, V, X, and fibrinogen). 2…”

Estudio de tres pruebas de función plaquetaria en adultos jóvenes residentes en una ciudad de gran altitud (Cusco, 3399 msnm)

“…El tiempo de sangría (TS) según método de Duke 6,13,14 , mide la duración de la hemorragia producida por la punción hecha en el lóbulo de la oreja con una lanceta 5,13 . Detecta la fase plaquetaria vascular de la hemostasia primaria in vivo 5,6,11,13 , evalúa la función plaquetaria cuando la cifra es normal como sucede en trombastenia de Glanzman, enfermedad de von Willebrand, uremia, uso de aspirina, entre otros 15 .…”

Technology Advancements in Blood Coagulation Measurements for Point-of-Care Diagnostic Testing

“…Second, the remained process includes three consecutive phases: the initiation phase, an amplification phase, and the propagation phase. In the two last phases, both platelets and thrombin are actively contributing (Thiruvenkatarajan et al, 2014). In the intrinsic pathway, negatively charged surfaces stimulate blood clotting with factors XII, XI, IX, and VIII.…”