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Related Concept Videos

Coagulation01:09

Coagulation

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The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
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Extrinsic and Intrinsic Pathways of Hemostasis01:20

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Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
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Introduction to Hemostasis01:05

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Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
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Disorders of Hemostasis01:24

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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Formation of the Platelet Plug01:22

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The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
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A Microfluidic Flow Chamber Model for Platelet Transfusion and Hemostasis Measures Platelet Deposition and Fibrin Formation in Real-time
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Does whole blood coagulation analysis reflect developmental haemostasis?

Hanne Berg Ravn1, Jo Bønding Andreasen, Anne-Mette Hvas

  • 1aDepartment of Cardiothoracic Anaesthesia, Rigshospitalet, Copenhagen bDepartment of Anaesthesiology and Intensive Care cDepartment of Clinical Biochemistry, Centre for Haemophilia and Thrombosis, Aarhus University Hospital, Aarhus, Denmark.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
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Conventional coagulation tests show age-dependent changes in children, but whole blood tests like rotational thromboelastometry (ROTEM) and Multiplate analyzer do not reflect these developmental hemostasis differences. Anticoagulant type significantly impacts platelet function results.

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Area of Science:

  • Pediatric Hematology
  • Hemostasis and Thrombosis
  • Point-of-Care Testing

Background:

  • Developmental hemostasis in children is well-documented, with established age-dependent reference ranges for plasma coagulation.
  • The increasing use of point-of-care (POC) whole blood tests necessitates evaluating age-dependent changes for these assays.

Purpose of the Study:

  • To investigate age-dependent changes in conventional hemostasis parameters and whole blood POC tests in children.
  • To compare rotational thromboelastometry (ROTEM) and Multiplate analyzer results with conventional tests across different pediatric age groups.

Main Methods:

  • Blood samples from 149 children (1 day to 5.9 years) were analyzed for activated partial prothrombin time, prothrombin time, and functional fibrinogen.
  • Whole blood analysis included ROTEM for coagulation capacity and Multiplate analyzer for platelet aggregation.
  • Statistical analysis was performed to identify age-dependent changes for all variables.

Main Results:

  • Significant age-dependent differences were observed in conventional coagulation tests (P < 0.05).
  • ROTEM showed no significant developmental changes, except for clotting time in the EXTEM assay (P < 0.03).
  • Platelet aggregation showed marked differences between age groups but lacked statistical significance; anticoagulant type significantly affected results (P < 0.003).

Conclusions:

  • Conventional coagulation tests confirm known age-dependent hemostatic changes in children.
  • Whole blood POC testing with ROTEM and Multiplate analyzer does not consistently reflect these developmental hemostasis changes.
  • Anticoagulant choice critically influences platelet aggregation measurements in pediatric whole blood samples.