Skip to main content
SpringerLink
Log in

Pathophysiology of Coagulation

  • Chapter
  • First Online:
Point-of-Care Tests for Severe Hemorrhage

  • 1477 Accesses

Abstract

Hemostasis preserves vascular integrity by balancing the physiologic processes that maintain blood in a fluid state under normal circumstances and prevent excessive bleeding after vascular injury. Preservation of blood fluidity depends on an intact vascular endothelium and a complex series of regulatory pathways that maintains platelets in a quiescent state and keeps the coagulation system in equilibrium. In contrast, arrest of bleeding requires rapid formation of hemostatic plugs at sites of vascular injury to prevent exsanguination. Perturbation of hemostasis can lead to bleeding or thrombosis. Bleeding will occur if there is failure to seal vascular leaks either because of defective hemostatic plug formation or because of premature breakdown of the plugs [1–3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. White GC II, Marder VJ, Shulman S, Aird WC, Bennett JS (2013) Overview of basic coagulation and fibrinolysis. In: Marder VJ, Aird WC, Bennett JS, Schulman S, White GC II (eds) Hemostasis and thrombosis: basic principles and clinical practice. Lippincott, Williams & Wilkins, Philadelphia, pp 103–109

    Google Scholar 

  2. Davidson CJ, Tuddenham EG, McVey JH (2003) 450 million years of hemostasis. J Thromb Haemost 1:1487–1494

    Article  CAS  PubMed  Google Scholar 

  3. Weitz JI (2012) Overview of hemostasis and thrombosis. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Witz JI, Anastasi J (eds) Hematology: basic principles and practice. Elsevier Saunders, Philadelphia, pp 1774–1783

    Google Scholar 

  4. Chee YL (2014) Coagulation. J R Coll Physicians Edinb 44:42–45

    Article  CAS  PubMed  Google Scholar 

  5. Versteeg HH, Heemskerk JWM, Levi M, Reitsma PH (2013) New fundamentals in hemostasis. Physiol Rev 93:327–358

    Article  CAS  PubMed  Google Scholar 

  6. Stassen JM, Arnout J, Deckmyn H (2004) The hemostatic system. Curr Med Chem 11:2245–2260

    Article  CAS  PubMed  Google Scholar 

  7. Arnout J, Hoylaerts MF, Lijnen HR (2006) Haemostasis. Handb Exp Pharmacol 176:1–41

    Article  CAS  Google Scholar 

  8. Sucker C, Zotz RB (2015) The cell-based coagulation model. In: Marcucci CE, Schoettker P (eds) Perioperative hemostasis, 1st edn. Springer, Berlin, pp 3–11

    Google Scholar 

  9. Berndt MC, Metharom P, Andrews RK (2014) Primary haemostasis: newer insights. Haemophilia 20(Suppl 4):15–22

    Article  CAS  PubMed  Google Scholar 

  10. van Hinsbergh VW (2012) Endothelium: role in regulation and coagulation and inflammation. Semin Immunopathol 34:93–106

    Article  PubMed  Google Scholar 

  11. McFadyen JD, Kaplan ZS (2015) Platelets are not just for clots. Transfus Med Rev 29:110–119

    Article  PubMed  Google Scholar 

  12. Andrews RK, Berndt MC (2004) Platelet physiology and thrombosis. Thromb Res 114:447–453

    Article  CAS  PubMed  Google Scholar 

  13. Shattil SJ, Bennett JS (1981) Platelets and their membranes in hemostasis: physiology and pathophysiology. Ann Intern Med 94:108–118

    Article  CAS  PubMed  Google Scholar 

  14. Heemskerk JW, Bevers EM, Lindhout T (2002) Platelet activation and blood coagulation. Thromb Haemost 88:186–193

    CAS  PubMed  Google Scholar 

  15. Lenting PJ, Pegon JN, Groot E, de Groot PG (2010) Regulation of von Willebrand factor-platelet interactions. Thromb Haemost 104:449–455

    Article  CAS  PubMed  Google Scholar 

  16. Broos K, Feys HB, De Meyer SF, Vanhoorelbeke K, Deckmyn H (2011) Platelets at work in primary hemostasis. Blood Rev 25:155–167

    Article  CAS  PubMed  Google Scholar 

  17. Hawiger J (1987) Formation and regulation of platelet and fibrin hemostatic plug. Hum Pathol 18:111–122

    Article  CAS  PubMed  Google Scholar 

  18. Smith SA, Travers RJ, Morrissey JH (2015) How it all starts: initiation of the clotting cascade. Crit Rev Biochem Mol Biol 28:1–11

    Google Scholar 

  19. Hoffman M, Pawlinski R (2014) Hemostasis: old system, new players, new directions. Thromb Res 133(Suppl 1):S1–S2

    Article  PubMed  Google Scholar 

  20. Brass LF, Wannemacher KM, Ma P, Stalker TJ (2011) Regulating thrombus growth and stability to achieve an optimal response to injury. J Thromb Haemost 9(Suppl 1):66–75

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Mackman N, Tilley RE, Key NS (2007) Role of the extrinsic pathway of blood coagulation in hemostasis and thrombosis. Arterioscler Thromb Vasc Biol 27:1687–1693

    Article  CAS  PubMed  Google Scholar 

  22. Nemerson Y (1987) Tissue factor and the initiation of blood coagulation. Adv Exp Med Biol 214:83–94

    CAS  PubMed  Google Scholar 

  23. Davie EW, Kulman JD (2006) An overview of the structure and function of thrombin. Semin Thromb Hemost 32(Suppl 1):3–15

    Article  CAS  PubMed  Google Scholar 

  24. Laurens N, Koolwijk P, de Maat MP (2006) Fibrin structure and wound healing. J Thromb Haemost 4:932–939

    Article  CAS  PubMed  Google Scholar 

  25. Hoppe B (2014) Fibrinogen and factor XIII at the intersection of coagulation, fibrinolysis and inflammation. Thromb Haemost 112:649–658

    Article  PubMed  Google Scholar 

  26. Weisel JW, Litvinov RI (2013) Mechanisms of fibrin polymerization and clinical implications. Blood 121:1712–1719

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Saldanha C (2013) Fibrinogen interaction with the red blood cell membrane. Clin Hemorheol Microcirc 53:39–44

    PubMed  Google Scholar 

  28. Levy JH, Szlam F, Tanaka KA, Sniecienski RM (2012) Fibrinogen and hemostasis: a primary hemostatic target for the management of acquired bleeding. Anesth Analg 114:261–274

    Article  CAS  PubMed  Google Scholar 

  29. Lowe GD, Rumley A, Mackie IJ (2004) Plasma fibrinogen. Ann Clin Biochem 41:430–440

    Article  CAS  PubMed  Google Scholar 

  30. Asmis LM (2015) Coagulation factor concentrates. In: Marcucci CE, Schoettker P (eds) Perioperative hemostasis. Springer, Berlin, pp 177–204

    Google Scholar 

  31. Hiippala ST, Myllyla GJ, Vahtera EM (1995) Hemostatic factors and replacement of major blood loss with plasma-poor red cell concentrates. Anesth Analg 81:360–365

    CAS  PubMed  Google Scholar 

  32. Izaguirre Avila R (2005) The centennial of blood coagulation doctrine. Arch Cardiol Mex 75(Suppl 3):118–129

    Google Scholar 

  33. MacFarlane RG (1964) An enzyme cascade in the blood clotting mechanism, and its function as a biochemical amplifier. Nature 202:498–499

    Article  CAS  PubMed  Google Scholar 

  34. Douglas AS (1999) Historical review: coagulation history. Oxford 1951–1953. Br J Haematol 107:22–32

    Article  CAS  PubMed  Google Scholar 

  35. Davie EW, Ratnoff OD (1964) Waterfall sequence for intrinsic blood clotting. Science 145:1310–1312

    Article  CAS  PubMed  Google Scholar 

  36. Hoffman M, Monroe DM 3rd (2001) A cell-based model of hemostasis. Thromb Haemost 85:958–965

    CAS  PubMed  Google Scholar 

  37. McMichael M (2012) New models of hemostasis. Top Companion Anim Med 27:40–45

    Article  PubMed  Google Scholar 

  38. Walsh PN (2004) Platelet coagulation-protein interactions. Semin Thromb Hemost 30:461–471

    Article  CAS  PubMed  Google Scholar 

  39. Barkhan P, Silver MJ, Da Costa PB, Tocantins LM (1958) Phosphatidyl serine and blood coagulation. Nature 182:1031–1032

    Article  CAS  PubMed  Google Scholar 

  40. Dahlback B, Villoutreix BO (2005) Regulation of blood coagulation by the protein C anticoagulant pathway: novel insights into structure-function relationships and molecular recognition. Arterioscler Thromb Vasc Biol 25:1311–1320

    Article  PubMed  Google Scholar 

  41. Bombeli T, Mueller M, Haeberli A (1997) Anticoagulant properties of the vascular endothelium. Thromb Haemost 77:408–423

    CAS  PubMed  Google Scholar 

  42. Owens AP 3rd, Mackman N (2011) Microparticles in hemostasis and thrombosis. Circ Res 108:1284–1297

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Eby C (2009) Pathogenesis and management of bleeding and thrombosis in plasma cell dyscrasias. Br J Haematol 145:151–163

    Article  PubMed  Google Scholar 

  44. de Maat MP, Verschuur M (2005) Fibrinogen heterogeneity: inherited and non-inherited. Curr Opin Hematol 12:377–383

    Article  PubMed  Google Scholar 

  45. Goodnight SH Jr, Hathaway WE (2001) Disorders of hemostasis and thrombosis, a clinical guide. McGraw-Hill, New York

    Google Scholar 

  46. Nurden A, Nurden P (2011) Advances in our understanding of the molecular basis of disorders of platelet function. J Thromb Haemost 9(Suppl 1):76–91

    Article  CAS  PubMed  Google Scholar 

  47. Lippi G, Salvagno GL, Montagnana M, Lima-Oliveira G, Guidi GC, Favaloro EJ (2012) Quality standards for sample collection in coagulation testing. Semin Thromb Hemost 38:565–575

    Article  PubMed  Google Scholar 

  48. Kamal AH, Tefferi A, Pruthi RK (2007) How to interpret and pursue an abnormal prothrombin time, activated partial thromboplastin time, and bleeding time in adults. Mayo Clin Proc 82:864–873

    Article  CAS  PubMed  Google Scholar 

  49. Bonhomme F, Fontana P (2015) Laboratory testing of hemostasis. In: Marcucci CE, Schoettker P (eds) Perioperative hemostasis. Springer, Berlin, pp 13–24

    Google Scholar 

  50. Marlar RA (2013) Hemostasis test validation, performance, and reference intervals: international recommendations and guidelines. In: Kitchen S, Olson D, Preston FE (eds) Quality in laboratory hemostasis and thrombosis. Wiley Blackwell, Oxford, pp 12–21

    Chapter  Google Scholar 

  51. Haas T, Fries D, Tanaka KA, Asmis L, Curry NS, Schöchl H (2015) Usefulness of standard plasma coagulation tests in the management of perioperative coagulopathic bleeding: is there any evidence? Br J Anaesth 114:217–224

    Article  CAS  PubMed  Google Scholar 

  52. Watson HG, Greaves M (2008) Can we predict bleeding? Semin Thromb Hemost 34:97–103

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Hemorrhagic and Thrombotic Diseases Unit, University of Padua Medical School, Padua, Italy

    Paolo Simioni MD, PhD

  2. Department of Medicine, University of Padua Medical School, Padua, Italy

    Elena Campello MD

Authors
  1. Paolo Simioni MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elena Campello MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Simioni MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy

    Marco Ranucci

  2. Department of Medicine Hemorrhagic and Thrombotic Diseases Unit, University of Padua Medical School, Padua, Italy

    Paolo Simioni

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Simioni, P., Campello, E. (2016). Pathophysiology of Coagulation. In: Ranucci, M., Simioni, P. (eds) Point-of-Care Tests for Severe Hemorrhage. Springer, Cham. https://doi.org/10.1007/978-3-319-24795-3_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-24795-3_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24793-9

  • Online ISBN: 978-3-319-24795-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation