Hot topics in coagulation testing: Important considerations for testing children for bleeding/thrombotic disorders.
Coagulation testing
developmental haemostasis
reference ranges
therapeutic anticoagulation
thrombin generation
Journal
International journal of laboratory hematology
ISSN: 1751-553X
Titre abrégé: Int J Lab Hematol
Pays: England
ID NLM: 101300213
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
23
12
2019
revised:
01
03
2020
accepted:
17
03
2020
entrez:
17
6
2020
pubmed:
17
6
2020
medline:
6
1
2021
Statut:
ppublish
Résumé
The accurate use and interpretation of diagnostic investigations are essential for safe and effective patient care. Appropriate application and interpretation of coagulation testing can be challenging, and many controversies exist relating to the standardization of testing procedures, the application of relevant tests to different patient populations and the interpretation of test results. We present a list of the most prominent controversies in coagulation testing and have selected three specific examples (age-appropriate reference ranges, therapeutic anticoagulation monitoring and tests of thrombin generation) for closer discussion, highlighting examples with a paediatric framework. We discuss the limitations of discrete age-partitioned reference intervals, given the established principle of developmental haemostasis; the difficulties in establishing normative data across different laboratories; important pre-analytical variables affecting coagulation testing; the challenges in interpreting APTT and anti-Xa assays for monitoring unfractionated heparin therapy in different clinical situations; and the limitations in interpreting tests of thrombin generation due to current available thrombin-specific substrates and the complicating factor of variable alpha2-macroglobulin levels. These controversies are demonstrated using paediatric examples, but raise important implications for coagulation testing in patients of all ages and highlight the pressing need for further research in these areas.
Substances chimiques
Factor Xa Inhibitors
0
Pregnancy-Associated alpha 2-Macroglobulins
0
Heparin
9005-49-6
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
68-74Informations de copyright
© 2020 John Wiley & Sons Ltd.
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