Hemostasis in the Lab, Approaching to the Correct Diagnosis in the Coagulopathies

Lopez S N, Cortina DLR E, Gonzalez P M, Nunez T M
2020 American Journal of Pediatrics  
Coagulation is the result of a coordinated interaction of blood proteins, circulating cells, endothelium cells and extracellular matrix proteins in the vessel wall. This process works in conjunction with other mechanisms that have to keep the blood in an effective flow, without hemorrity when damage occurs or without a thrombus when clotting begins. Most of the time, there is not so much information that a clotting test gives us, however, in the face of a real clinical scenario that concurrent
more » ... ith a personal haemorrhage, this is essential to take action. In addition, there is a thrombophilic scenario that has to be investigated. In all of them, it is important to note that doctors have to take into account that the pre-analytical phase plays a fundamental role, so it is very important to look around any situation that may impact the patient's results. There is a wide range of laboratory tests to evaluate different mechanisms of hemostasis, according to the history and characteristic of the clinical patient. With this in mind, there is a right time to ask for the right test, to get a better result for diagnosis and treatment. Analytical quality is the set of actions that are carried out in the laboratory with the aim of obtaining an accurate result, reflecting the real situation of the patient. Grossly, platelets, clotting factors and the fibrinolytic system could be studied, not all patients need all tests, they could be solved with a simple test, but may require a deep focus; that is why the patient with a history of mucocutaneous bleeding has to be studied for thrombocytopaties or VWD; a patient with muscle or joint bleeding has to be a factor deficiency test. We propose an initial approach to detecting the pathological situations essential to make decisions. Each person has different symptoms and different approaches, which is why identification and the right tests give us the greatest opportunity to get the right diagnosis.
doi:10.11648/j.ajp.20200602.16 fatcat:4cedvbuvvzcdtcbbnz2i7zx2ya