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Pre-Procedural Guidelines for Assessing Blood Pressure01:10

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Influence of posture on routine hemostasis testing.

Giuseppe Lippi1, Gian Luca Salvagno, Gabriel Lima-Oliveira

  • 1aLaboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma bDepartment of Life and Reproduction Sciences, Laboratory of Clinical Biochemistry, University of Verona, Verona, Italy cDepartment of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Pathology West, Westmead Hospital, Westmead, NSW, Australia.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|June 18, 2015
PubMed
Summary

Patient posture significantly impacts hemostasis tests. Changes from supine to standing altered activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen, with some variations exceeding quality standards.

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Area of Science:

  • Clinical Pathology
  • Hemostasis and Thrombosis

Background:

  • Biological variability is crucial for interpreting hemostasis tests.
  • Limited evidence exists on posture's effect on routine clotting tests like APTT, PT, and fibrinogen.

Purpose of the Study:

  • To investigate the impact of different body postures on APTT, PT, and fibrinogen levels.
  • To assess whether postural changes introduce significant bias in routine hemostasis testing.

Main Methods:

  • 19 healthy volunteers participated in the study.
  • Blood samples were collected after participants maintained supine, sitting, and standing positions for specific durations.
  • Activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen levels were measured.

Main Results:

  • Changing from supine to sitting position significantly decreased PT and increased fibrinogen, with fibrinogen variation exceeding quality specifications.
  • Transitioning from supine to standing caused significant bias in APTT, PT, and fibrinogen, with PT decrease and fibrinogen increase exceeding quality specifications.
  • Shifting from sitting to standing also induced significant bias in all tested parameters, though variations remained within quality specifications.

Conclusions:

  • Patient posture significantly influences routine hemostasis test results.
  • The change from supine to standing position poses the greatest risk for introducing bias in APTT, PT, and fibrinogen measurements.
  • Clinical laboratories should consider patient positioning when interpreting hemostasis test results.