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[Emergency management of abnormalities of preoperative blood coagulation tests]
J L Lorenzini1, F Dutrillaux, V Monnier
1Laboratoire d'Hématologie-Hémostase, Centre Hospitalier et Universitaire, Dijon.
Usual coagulation tests--Platelet count, Prothrombin Time (PT), Activated Partial Thromboplastine Time (APTT)--detect most of coagulation abnormalities in preoperative situation. Emergency surgery remains possible without bleeding in most cases. Patient history of haemostatic responses is absolutely necessary to know in addition to coagulation tests. Platelets transfusion may often be avoid in thrombocytopenic patients with platelet count higher than 50,000 mm3. The PT and/or APTT perturbations need further laboratory investigations to estimate the bleeding risk which is not constant. The correction of an antithrombotic treatment is usually easy except for drugs which inhibit platelet aggregation.
Usual coagulation tests--Platelet count, Prothrombin Time (PT), Activated Partial Thromboplastine Time (APTT)--detect most of coagulation abnormalities in preoperative situation. Emergency surgery remains possible without bleeding in most cases. Patient history of haemostatic responses is absolutely necessary to know in addition to coagulation tests. Platelets transfusion may often be avoid in thrombocytopenic patients with platelet count higher than 50,000 mm3. The PT and/or APTT perturbations need further laboratory investigations to estimate the bleeding risk which is not constant. The correction of an antithrombotic treatment is usually easy except for drugs which inhibit platelet aggregation.