Coagulation Made Simple

Thrombosis and Haemostasis, 2009

Thrombosis Research, 2009

Indian Journal of Clinical Anaesthesia, 2015

Cam and Sakura Medical Journal, 2021

Objective: Prolonged coagulation test is a common finding before surgery. This study determined the prolonged prothrombin time (PT) and/or activated partial thromboplastin time (aPTT) during the surgical preparation of pediatric patients. Material and Methods: As a cross-sectional study, 74 children aged 0.25-17 years, who had prolonged preoperative coagulation tests, were included in the Eskişehir State Hospital Pediatric Hematology and Oncology Clinic between September 3, 2013, and September 16, 2014. Results: The mean age of the children was 5.6±3.4 years, wherein 60 (81%) cases were male. Adenoid-tonsillar operations were planned in 46%, circumcision in 43%, abdominal operations in 5%, and other operations in 6%. A history of bleeding was found in 7 (10%) of the families and 3 (4%) of the cases. Previous surgery or injury was found in 24 (32%) of the children and did not develop more bleeding than expected. The coagulation tests revealed 22 (30%) patients with prolonged PT (value range: 14-35.1 s), 47 (63%) with prolonged aPTT (value range: 37.1-129.6 s), and 5 (7%) with both prolonged PT and aPTT. A necessary operation was performed in 47 patients who did not have a history of bleeding diathesis in the patient or family, with a normal mixed test and factor levels, and PT of <20 s and aPTT of <63.3 s. No bleeding complications were observed during or after the operation in any of these cases. Conclusion: Our results revealed that in case of prolonged PT or aPTT values before surgery, no risk of bleeding is encountered during the surgery if a history of bleeding diathesis is not present in the patient or family and factor levels are normal.

Journal of Neuroanaesthesiology and Critical Care

Perioperative coagulopathy impacts patient outcome by influencing intraoperative hemodynamics and blood loss. We present two cases which despite having normal preoperative coagulation profiles and normotension during the surgery had intraoperative coagulopathy and unusual bleeding. These cases required a multidisciplinary approach to manage them successfully. A thorough knowledge of the coagulation cascade along with a high-degree of suspicion and early recognition of coagulation is required. Abnormalities are critical for a timely intervention. Point-of-care tests like thromboelastography (TEG) as well as platelet function studies helped us arrive at an early diagnosis and initiate prompt treatment.

Transplantation Proceedings, 2006

Key/Practical Hemostasis and Thrombosis, 2009

Anesthesiology Clinics of North America, 1999

Journal of Hospital Medicine

Anesthesiology Clinics of North America, 1999