Assessment of Hemostasis

Abstract

Hemostasis is the collection of biological mechanisms responsible for bleeding cessation following surgical procedures or trauma. Congenital and acquired disorders affecting any element of the hemostatic system can result in a spectrum of bleeding pathologies ranging from inability to form stable blood clot to the pathologic propagation of blood clot outside the area of injury. Assessing the hemostatic system in an accurate and timely fashion is critical for detection of these disorders. This review briefly covers the mechanisms of primary and secondary hemostasis before comprehensively exploring the approach to preoperative evaluation of hemostasis, the strengths and weaknesses of commonly used laboratory tests of coagulation, the interpretation of test results, and the management of patients found to have abnormal hemostatic systems. Figures detail the mechanisms of hemostasis and the important features of viscoelastic testing. Tables explain the parameters frequently measured in viscoelastic testing and propose potential treatment plans based on test findings.   This review contains 5 figures, 9 tables and 72 references Keywords: coagulation, conventional coagulation tests, hemostasis, thromboelastography, thromboelastometry