Clinical Hemostasis Practice: The Major Impact of Laboratory Automation

Abstract

This article has reviewed basic disease states of hemostasis and thrombosis with an emphasis on laboratory technologic advances comparing manual and semiautomated techniques with new fully automated technology that is now available for both aiding in a diagnosis and monitoring efficacy of therapy. As these new automated methods become generally available, more and more information will be accumulated to determine exactly how precise many of these modalities will be for diagnosis and monitoring. Many of these newer modalities have already gained general acceptance as highly sophisticated tools that certainly belong in any clinical laboratory having to deal with patients with thrombohemorrhagic disorders.

Newer Synthetic Peptide Substrates in Coagulation Testing: Some Practical Considerations for Automated Methods

“…There is agreement with several published reports in which normal methods have been adapted to auto mated instruments. 6,10,17,21,32,40 This is, however, not true for the clot-based methods, where signifi cant differences may be seen when a method is per formed on different instruments. Since the sample dilution, reagent consistency, and precision in reagent handling are best performed in an auto mated mode, the performance characteristics of these instruments utilizing synthetic substrate-based methods are outstanding.…”

Effect of FUT-175 (Nafamstat Mesilate) on Platelets in Canine Acute Experimental Pancreatitis

“…In this case, subendothelial collagen is exposed to circulating blood platelets. These factors should be taken into consideration as one of the causes of thrombocytopenia in the course of acute pancreatitis which we ob served during our investigation [1,2,33].…”

Syndromes of Thrombosis and Hypercoagulability: Congenital and Acquired Thrombophilias

“…Homozygous and heterozygous patients can be identified by synthetic substrate assays for biological activity of plasminogen, and a comparison of biological activity with immunological levels will identify those patients who have dysfunctional plasminogen (type II) versus those with quantitative hypoplasminogenemia (type I) (heterozygotes) or aplasminogenemia (homozygotes). All usual global tests of coagulation, including the platelet count, prothrombin time, partial thromboplastin time, thrombin time, and bleeding time are normal, and the diagnosis depends upon specific plasminogen assay for biological activity (205,214). Successful therapy has included the use of heparin, warfarin, antiplatelet agents, and urokinase (212,213).…”