Laboratory Assessment of Physiologic and Pathologic Hemostasis

Abstract

Clinical laboratory tests are available to detect activated platelets, coagulation enzymes and inhibitors, products of intravascular fibrin formation and dissolution, and drug monitoring. Since the integrity of the blood specimen for coagulation testing is a critical aspect of the validity of the test result, this chapter opens with a discussion on the acceptable practice for blood collection and handling. This chapter then describes all the commonly used and the newly developed hemostasis tests available for the clinical laboratory. Tests described include screening tests used to identify a defect for initial categorizing and special tests to confirm a diagnosis. Sections are devoted to tests that assess platelet function, fibrinolysis, a hypercoagulable state, and assessment of anticoagulant and antiplatelet drug treatment.