How to report results of prothrombin and activated partial thromboplastin times

Tripodi, Armando; Lippi, Giuseppe; Plebani, Mario

doi:10.1515/cclm-2015-0657

Cited by 25 publications

(18 citation statements)

References 27 publications

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“…Overall, the PT and aPTT thresholds most commonly identified as indicating concern (13 to 20 seconds and 30 to 45 seconds, respectively), were consistent with reference ranges (typically 10 to 12 seconds for PT and 24 to 37 seconds for aPTT),20,21 although reference ranges are known to be variable and depend on the laboratory performing the test, due in part to variability in the reagents, analyzer instruments, and calibration. Outliers regarding PT thresholds included the German cohort, half of whom selected a higher range of 21 to 40 seconds as cause for concern, and the French cohort, the greatest percentage (40%) of whom identified a very high threshold of ≥50 seconds.…”

Section: Discussionsupporting

confidence: 60%

A global quantitative survey of hemostatic assessment in postpartum hemorrhage and experience with associated bleeding disorders

James

Cooper

Paidas

2017

IJWH

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PurposeCoagulopathy 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.MethodsA quantitative survey was completed by 302 obstetrician-gynecologists from 6 countries (the UK, France, Germany, Italy, Spain, and Japan). The survey included questions on the use of hematologic laboratory studies, interpretation of results, laboratory’s role in coagulation assessments, and experience with bleeding disorders.ResultsOverall, the most common definitions of “massive” PPH were >2,000 mL (39%) and >1,500 mL (34%) blood loss. The most common criteria for rechecking a “stat” complete blood count and for performing coagulation studies were a drop in blood pressure (73%) and ongoing visible bleeding (78%), respectively. Laboratory coagulation (prothrombin time/activated partial thromboplastin time [PT/aPTT]) and factor VIII/IX assays were performed on-site more often than were mixing studies (laboratory coagulation studies, 93%; factor VIII/IX assays, 63%; mixing studies, 22%). Most commonly consulted sources of additional information were colleagues within one’s own specialty (68%) and other specialists (67%). Most respondents had consulted with a hematologist (78%; least, Germany [56%]; greatest, UK [98%]). The most common reason for not consulting was hematologist unavailability (44%). The most commonly reported thresholds for concern with PT and aPTT were 13 to 20 seconds (36%) and 30 to 45 seconds (50%), respectively. Most respondents reported having discovered an underlying bleeding disorder (58%; least, Japan [35%]; greatest, Spain [74%]).ConclusionGlobal survey results highlight similarities and differences between countries in how PPH is assessed and varying levels of obstetrician-gynecologist experience with identification of underlying bleeding disorders and engagement of hematology consultants. Opportunities to improve patient management of PPH associated with bleeding disorders include greater familiarity with interpreting PT/aPTT test results and identification of and consistent consultation with hematologists with relevant expertise.

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Section: Discussionsupporting

confidence: 60%

A global quantitative survey of hemostatic assessment in postpartum hemorrhage and experience with associated bleeding disorders

James

Cooper

Paidas

2017

IJWH

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“…This percentage is intuitive property and is based on the observation that normal pooled plasma possess 100 % PT activity and is taken as 100 and further on dilution, the clotting time as well as % activity goes on decreasing and a calibration curve was plotted between percentage activity vs. clotting times. The % PT activity of the samples was evaluated from the same calibration curve 33 . All the experiments were performed at 37˚C and in triplicate batches.…”

Section: Plasma Clottingmentioning

confidence: 99%

“…The different concentrations were chosen according to the minimum and maximum amount of sample required for i.v bolus administration 32,44 . The pathway of blood coagulation includes intrinsic and extrinsic pathways which quote for APTT (activated partial thromboplastin time) and PT (Prothrombin time) respectively 33 . Although APTT and PT were reported as clotting time (sec.)…”

Section: Evaluation Of Haemocompatibilitymentioning

confidence: 99%

Genistein-Loaded Nanostructured Lipid Carriers for Intravenous Administration: A Quality by Design Based Approach

Mittal¹,

Vardhan²,

Ajmal³

et al. 2019

Int. Res. J. Pharm.

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Genistein (Gen) is a naturally occurring soy isoflavonoid, ing anticancer, antiproliferation & antioxidant-like properties which make it suitable as an anticancer medicine. The disadvantage of poor solubility and less oral bioavailability restrict its use as potential anticancer agent. In the present study, Gen was entrapped into solid-liquid lipid mixture with the aid of surfactant by using modified solvent evaporation technique. The present work was carried out with the aim to screen the component as well as process variables to ease the formulation process which ends up with the finished product having characteristics of best nanoformulation in all respects. Optimized levels by employing numerical optimization technique for each factor viz. surfactant concentration (X1), Lipid concentration (X2) & amount of organic solvent (X3) were 0.3 %, 0.78 % & 8.51 ml respectively. The resultant formulation exhibited a particle size of 122.22 nm, and entrapment efficiency of 92.8 %, & zeta potential of-21.25 mV with unimodal size distribution. Findings of the haemocompatibility studies suggested that optimized formulation was pretty safe for intravenous administration. In a nutshell, GenNLC seems to be a superior alternative carrier system for the formulation industry to obtain the higher entrapment with excellent stability of the formulation.

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“…1 The PT, originally developed by Quick in 1935, 17 is a firstline clotting test based on simultaneous recalcification of citrated plasma and activation of the extrinsic/TF pathway of blood coagulation (i.e., FVII) by using recombinant thromboplastin preparations which mimic the effect of TF. 18 This test is therefore mostly sensitive to defects of FVII and other factors of the common pathway of blood coagulation (i.e., FX, prothrombin, and Fbg) (►Fig. 1).…”

Section: First-line Coagulations Testsmentioning

confidence: 99%

Diagnostics of Inherited Bleeding Disorders of Secondary Hemostasis: An Easy Guide for Routine Clinical Laboratories

Lippi

Franchini

Favaloro

2016

Semin Thromb Hemost

Self Cite

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The investigation of inherited bleeding disorders of secondary hemostasis remains a challenge for most clinical laboratories, especially those that lack experience or specialized personnel. Bleeding can be essentially caused by a variety of acquired or congenital conditions, which impair either primary or secondary hemostasis. Since a universally agreed approach for the diagnostics of hemorrhagic disorders is still unavailable, this article aims to provide an easy guidance for routine clinical laboratories. This pragmatic approach to identifying and diagnosing inherited bleeding disorders of secondary hemostasis entails a multifaceted strategy, based on a collection of personal and family history, the results of first-line tests, which can then be followed by second- or third-line analyses to definitely establish the specific nature and the severity of the bleeding phenotype. Briefly, the presence of profound hemorrhages rather than mucocutaneous bleeding is suggestive of a disorder of secondary hemostasis. Although a positive family history is frequently reported in patients with congenital conditions, the lack of clinically meaningful symptoms in patient's relatives is not absolutely indicative of an acquired disorder. The next step encompasses the assessment of first-line coagulation tests (i.e., prothrombin time, activated partial thromboplastin time, and fibrinogen) if family history is not suggestive of a specific factor deficiency. The emergence of abnormal data of these assays and the variable combination of their results is then helpful to guide the performance of second-line tests, in particular specific factor assays, which will then provide a reasonable basis for a preliminary diagnosis. Third-line tests (namely, immunological assays of clotting factors and molecular biology) are then supportive for a final diagnosis and for identifying the nature of the factor deficiency (i.e., quantitative or functional).

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How to report results of prothrombin and activated partial thromboplastin times

Cited by 25 publications

References 27 publications

A global quantitative survey of hemostatic assessment in postpartum hemorrhage and experience with associated bleeding disorders

A global quantitative survey of hemostatic assessment in postpartum hemorrhage and experience with associated bleeding disorders

Genistein-Loaded Nanostructured Lipid Carriers for Intravenous Administration: A Quality by Design Based Approach

Diagnostics of Inherited Bleeding Disorders of Secondary Hemostasis: An Easy Guide for Routine Clinical Laboratories

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