Physiology of Coagulation: Current Concepts Applied to Perioperative Care
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May 29, 2013
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Abstract
Recent advances in the understanding of coagulation physiology have led to the development of new theories, more consistent and better correlated with clinical disturbances. This paper discusses recent evidence on molecular and cellular level, merging them into a simple and unified conceptual model, applying it to the understanding of the various changes and medications that affect hemostasis in the perioperative period.
Keywords
hemostasia, coagulación, fisiología, cuidado perioperatorio, Hemostasis, blood coagulation, physiology, perioperative care,
References
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3. Tanaka KA, Key NS, Levy JH. Blood coagulation: hemostasis and thrombin regulation. Anesth Analg. 2009 May;108 (5):1433-46.
4. Smith SA. The cell-based model of coagulation. J Vet Emerg Crit Care (San Antonio). 2009 Feb;19(1):3-10.
5. Hoffman M, Monroe DM. Coagulation 2006: a modern view of hemostasis. Hematol Oncol Clin North Am. 2007 Feb;21(1):1-11.
6. O’Connor SD, Taylor AJ, Williams EC, Winter TC. Coagulation concepts update. AJR Am J Roentgenol. 2009 Dec;193(6):1656-64.
7. Eyre L, Gamlin F. Haemostasis, blood platelets and coagulation. Anaesth Intensive Care Med. 2010;11(6):244-246.
8. Kriz N, Rinder CS, Rinder HM. Physiology of hemostasis: with relevance to current and future laboratory testing. Clin Lab Med. 2009 Jun;29(2):159-74.
9. Davie EW, Ratnoff SI. Waterfall sequence for intrinsic blood clotting. Science. 1964;145:1310-2.
10. Davidson CJ, Tuddenham EG, McVey JH. 450 million years of hemostasis. J Thromb Haemost. 2003;1:1487-94.
11. Osterud B, Rappaport SI. Activation of factor IX by the reaction product of tissue factor and factor VII: Additional pathway for initiating blood coagulation. Proc Natl Acad. Sci. U.S.A. 1977;74:5260-4.
12. Gailani D, Renne T. The intrinsic pathway of coagulation: a target for treating thromboembolic disease? J Thromb Haemost. 2007;5(6):1106-12.
13. Key NS, Geng J, Bach RR. Tissue factor: from Morawitz to microparticles. Trans Am Clin Climatol Assoc. 2007;118:165-73.
14. Nemerson Y. The tissue factor pathway of blood coagulation. Semin Hematol. 1992;29:170-6.
15. Goodeve AC, Rosén S, Verbruggen B. Haemophilia A and von Willebrand‘s disease. Haemophilia. 2010 Jul;16 Suppl 5:79-84.
16. Lenting PJ, Pegon JN, Christophe OD, Denis CV. Factor VIII and von Willebrand factor--too sweet for their own good. Haemophilia. 2010 Jul;16 Suppl 5:194-9.
17. Coughlin SR. Protease-activated receptors and platelet function. Thromb Haemost 1999;82:353-6.
18. Vretenbrant K, Ramström S, Bjerke M, Lindahl TL. Platelet activation via PAR4 is involved in the initiation of thrombin generation and in clot elasticity development. Thromb Haemost. 2007 Mar;97(3):417-24.
19. Kempton CL, Hoffman M, Roberts HR et al. Platelet heterogeneity: Variation in coagulation complexes on platelet subpopulations. Arterioscler Thromb Vasc Biol. 2005;25(4):861-6.
20. Yamaji-Hasegawa A, Tsujimoto M. Asymmetric distribution of phospholipids in biomembranes. Biol Pharm Bull. 2006;29(8):1547-53.
21. Zwaal RF, Comfurius P, Bevers EM. Surface exposure of phosphatidylserine in pathological cells. Cell Mol Life Sci. 2005;62(9):971-88.
22. Alberio L, Safa O, Clemetson KJ, et al. Surface expression and functional characterization of alpha-granule factor V in human platelets: effects of ionophore A23187, thrombin, collagen, and convulxin. Blood. 2000;95:1694-702.
23. Monroe DM, Roberts HR, Hoffman M. Platelet procoagulant complex assembly in a tissue factor-initiated system. Br J Haematol. 1994;88:364-71.
24. Lee A, Crowther M. Practical issues with vitamin K antagonists: elevated INRs, low time-in-therapeutic range, and warfarin failure. J Thromb Thrombolysis. 2011 Apr;31(3):249-58.
25. Blomback B, Bark N. Fibrinopeptides and fibrin gel structure. Biophys Chem. 2004;112(2-3):147-51.
26. Lauricella AM. Fibrin network variability. Acta Bioquím Clín Latinoam. 2007;41(1).
27. Hornyak TJ, Shafer JA. Interactions of factor XIII with fibrin as substrate and cofactor. Biochemistry. 1992;31:423-9.
28. Peerschke EI, Zucker MB, Grant RA, Egan JJ, Johnson MM. Correlation between fibrinogen binding to human platelets and platelet aggregability. Blood. 1980 May;55(5):841-7.
29. Nakahata N. Thromboxane A2: physiology/pathophysiology, cellular signal transduction and pharmacology. Pharmacol Ther. 2008 Apr;118(1):18-35. Epub 2008 Jan 26.
30. Kim S, Kunapuli SP. P2Y12 receptor in platelet activation. Platelets. 2011; 22(1):54-8. Review. PubMed PMID: 21231822.
31. Robert T. Dorsam, Satya P, et al. Central role of the P2Y12 receptor in platelet activation. Clin Invest. 2004;113(3):340-45.
32. Bajzar L, Manuel R, Nesheim ME. Purification and characterization of TAFI, a thrombinactivable fibrinolysis inhibitor. J Biol Chem. 1995;270:14477-84.
33. Ott I, Miyagi Y, Miyazaki K, et al. Reversible regulation of tissue factor-induced coagulation by glycosyl phosphatidylinositol-anchored tissue factor pathway inhibitor. Arterioscler Thromb Vasc Biol. 2000;20:874-82.
34. Shimada K, Kobayashi M, Kimura S, Nishinaga M, Takeuchi K, Ozawa T. Anticoagulant heparin-like glycosaminoglycans on endothelial cell surface. Jpn Circ J. 1991 Oct;55(10):1016-21.
35. Owen WG, Esmon CT. Functional properties of an endothelial cell cofactor for thrombin-catalyzed activation of protein C. J Biol Chem. 1981 Jun 10;256(11):5532-5. PubMed PMID: 6894592.
36. Jin RC, Voetsch B, Loscalzo J. Endogenous mechanisms of inhibition of platelet function. Microcirculation. 2005 Apr-May;12(3):247-58.
37. Szymanski LM, Pate RR, Durstine JL. Effects of maximal exercise and venous occlusion on fibrinolytic activity in physically active and inactive men. J Appl Physiol. 1994;77:2305-10.
38. Anglés-Cano E. Overview on fibrinolysis: plasminogen activation pathways on fibrin and cell surfaces. Chem Phys Lipids. 1994 Jan;67-68:353-62.
39. Kitchens CS. To bleed or not to bleed? Is that the question for the PTT? J Thromb Haemost. 2005 Dec;3(12):2607-11. Epub 2005 Sep 9.
40. Shaw PH, Reynolds S, Gunawardena S, et al. The prevalence of bleeding disorders among healthy pediatric patients with abnormal preprocedural coagulation studies. J Pediatr Hematol Oncol. 2008;30:135-41.
41. Kozek-Langenecker SA. Perioperative coagulation monitoring. Review. Best Pract Res Clin Anaesthesiol. 2010 Mar;24(1):27-40.
42. Innerhofer P, Kienast J. Principles of perioperative coagulopathy. Best Pract Res Clin Anaesthesiol. 2010 Mar;24(1):1-14.
43. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008 Jan;108(1):71-7.
44. Peyvandi F, Cattaneo M, Inbal A, De Moerloose P, Spreafico M. Rare bleeding disorders. Haemophilia. 2008 Jul;14 Suppl 3:202-10.
45. Martlew VJ. Peri-operative management of patients with coagulation disorders. Br J Anaesth. 2000 Sep;85(3):446-55.
46. Dunn CJ, Goa KL. Tranexamic acid: a review of its use in surgery and other indications. Drugs. 1999 Jun;57(6):1005-32.
47. Alvarado IM. Tendencias actuales en el manejo preoperatorio de pacientes anticoagulados con warfarina. Rev Colomb Anestesiol. 2012;40(1):52-9.
48. Dumont B, Faille D, Ajzenberg N. [New oral anticoagulant drugs: dabigatran, rivaroxaban and apixaban. Present and future]. Med Sci (Paris). 2011 May;27(5):493-500. Epub 2011 May 25.
49. Sun JC, Whitlock R, Cheng J, , et al. The effect of pre-operative aspirin on bleeding, transfusion, myocardial infarction, and mortality in coronary artery bypass surgery: a systematic review of randomized and observational studies. Eur Heart J. 2008;29:1057-71.
50. Harder S, Klinkhardt U, Alvarez JM. Avoidance of bleeding during surgery in patients receiving anticoagulant and/or antiplatelet therapy: pharmacokinetic and pharmacodynamic considerations. Clin Pharmacokinet. 2004;43(14):963-81.
51. Fleisher LA, Beckman JA, Brown KA, Calkins H, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Anesth Analg. 2008 Mar;106(3):685-712.
52. Savonitto S, D‘Urbano M, Caracciolo M, Barlocco F, et al. Urgent surgery in patients with a recently implanted coronary drug-eluting stent: a phase II study of ‚bridging‘ antiplatelet therapy with tirofiban during temporary withdrawal of clopidogrel. Br J Anaesth. 2010 Mar;104(3):285-91.
2. Adams RL, Bird RJ. Review article: Coagulation cascade and therapeutics update: relevance to nephrology. Part 1: Overview of coagulation, thrombophilias and history of anticoagulants. Nephrology (Carlton). 2009 Aug;14(5):462-70.
3. Tanaka KA, Key NS, Levy JH. Blood coagulation: hemostasis and thrombin regulation. Anesth Analg. 2009 May;108 (5):1433-46.
4. Smith SA. The cell-based model of coagulation. J Vet Emerg Crit Care (San Antonio). 2009 Feb;19(1):3-10.
5. Hoffman M, Monroe DM. Coagulation 2006: a modern view of hemostasis. Hematol Oncol Clin North Am. 2007 Feb;21(1):1-11.
6. O’Connor SD, Taylor AJ, Williams EC, Winter TC. Coagulation concepts update. AJR Am J Roentgenol. 2009 Dec;193(6):1656-64.
7. Eyre L, Gamlin F. Haemostasis, blood platelets and coagulation. Anaesth Intensive Care Med. 2010;11(6):244-246.
8. Kriz N, Rinder CS, Rinder HM. Physiology of hemostasis: with relevance to current and future laboratory testing. Clin Lab Med. 2009 Jun;29(2):159-74.
9. Davie EW, Ratnoff SI. Waterfall sequence for intrinsic blood clotting. Science. 1964;145:1310-2.
10. Davidson CJ, Tuddenham EG, McVey JH. 450 million years of hemostasis. J Thromb Haemost. 2003;1:1487-94.
11. Osterud B, Rappaport SI. Activation of factor IX by the reaction product of tissue factor and factor VII: Additional pathway for initiating blood coagulation. Proc Natl Acad. Sci. U.S.A. 1977;74:5260-4.
12. Gailani D, Renne T. The intrinsic pathway of coagulation: a target for treating thromboembolic disease? J Thromb Haemost. 2007;5(6):1106-12.
13. Key NS, Geng J, Bach RR. Tissue factor: from Morawitz to microparticles. Trans Am Clin Climatol Assoc. 2007;118:165-73.
14. Nemerson Y. The tissue factor pathway of blood coagulation. Semin Hematol. 1992;29:170-6.
15. Goodeve AC, Rosén S, Verbruggen B. Haemophilia A and von Willebrand‘s disease. Haemophilia. 2010 Jul;16 Suppl 5:79-84.
16. Lenting PJ, Pegon JN, Christophe OD, Denis CV. Factor VIII and von Willebrand factor--too sweet for their own good. Haemophilia. 2010 Jul;16 Suppl 5:194-9.
17. Coughlin SR. Protease-activated receptors and platelet function. Thromb Haemost 1999;82:353-6.
18. Vretenbrant K, Ramström S, Bjerke M, Lindahl TL. Platelet activation via PAR4 is involved in the initiation of thrombin generation and in clot elasticity development. Thromb Haemost. 2007 Mar;97(3):417-24.
19. Kempton CL, Hoffman M, Roberts HR et al. Platelet heterogeneity: Variation in coagulation complexes on platelet subpopulations. Arterioscler Thromb Vasc Biol. 2005;25(4):861-6.
20. Yamaji-Hasegawa A, Tsujimoto M. Asymmetric distribution of phospholipids in biomembranes. Biol Pharm Bull. 2006;29(8):1547-53.
21. Zwaal RF, Comfurius P, Bevers EM. Surface exposure of phosphatidylserine in pathological cells. Cell Mol Life Sci. 2005;62(9):971-88.
22. Alberio L, Safa O, Clemetson KJ, et al. Surface expression and functional characterization of alpha-granule factor V in human platelets: effects of ionophore A23187, thrombin, collagen, and convulxin. Blood. 2000;95:1694-702.
23. Monroe DM, Roberts HR, Hoffman M. Platelet procoagulant complex assembly in a tissue factor-initiated system. Br J Haematol. 1994;88:364-71.
24. Lee A, Crowther M. Practical issues with vitamin K antagonists: elevated INRs, low time-in-therapeutic range, and warfarin failure. J Thromb Thrombolysis. 2011 Apr;31(3):249-58.
25. Blomback B, Bark N. Fibrinopeptides and fibrin gel structure. Biophys Chem. 2004;112(2-3):147-51.
26. Lauricella AM. Fibrin network variability. Acta Bioquím Clín Latinoam. 2007;41(1).
27. Hornyak TJ, Shafer JA. Interactions of factor XIII with fibrin as substrate and cofactor. Biochemistry. 1992;31:423-9.
28. Peerschke EI, Zucker MB, Grant RA, Egan JJ, Johnson MM. Correlation between fibrinogen binding to human platelets and platelet aggregability. Blood. 1980 May;55(5):841-7.
29. Nakahata N. Thromboxane A2: physiology/pathophysiology, cellular signal transduction and pharmacology. Pharmacol Ther. 2008 Apr;118(1):18-35. Epub 2008 Jan 26.
30. Kim S, Kunapuli SP. P2Y12 receptor in platelet activation. Platelets. 2011; 22(1):54-8. Review. PubMed PMID: 21231822.
31. Robert T. Dorsam, Satya P, et al. Central role of the P2Y12 receptor in platelet activation. Clin Invest. 2004;113(3):340-45.
32. Bajzar L, Manuel R, Nesheim ME. Purification and characterization of TAFI, a thrombinactivable fibrinolysis inhibitor. J Biol Chem. 1995;270:14477-84.
33. Ott I, Miyagi Y, Miyazaki K, et al. Reversible regulation of tissue factor-induced coagulation by glycosyl phosphatidylinositol-anchored tissue factor pathway inhibitor. Arterioscler Thromb Vasc Biol. 2000;20:874-82.
34. Shimada K, Kobayashi M, Kimura S, Nishinaga M, Takeuchi K, Ozawa T. Anticoagulant heparin-like glycosaminoglycans on endothelial cell surface. Jpn Circ J. 1991 Oct;55(10):1016-21.
35. Owen WG, Esmon CT. Functional properties of an endothelial cell cofactor for thrombin-catalyzed activation of protein C. J Biol Chem. 1981 Jun 10;256(11):5532-5. PubMed PMID: 6894592.
36. Jin RC, Voetsch B, Loscalzo J. Endogenous mechanisms of inhibition of platelet function. Microcirculation. 2005 Apr-May;12(3):247-58.
37. Szymanski LM, Pate RR, Durstine JL. Effects of maximal exercise and venous occlusion on fibrinolytic activity in physically active and inactive men. J Appl Physiol. 1994;77:2305-10.
38. Anglés-Cano E. Overview on fibrinolysis: plasminogen activation pathways on fibrin and cell surfaces. Chem Phys Lipids. 1994 Jan;67-68:353-62.
39. Kitchens CS. To bleed or not to bleed? Is that the question for the PTT? J Thromb Haemost. 2005 Dec;3(12):2607-11. Epub 2005 Sep 9.
40. Shaw PH, Reynolds S, Gunawardena S, et al. The prevalence of bleeding disorders among healthy pediatric patients with abnormal preprocedural coagulation studies. J Pediatr Hematol Oncol. 2008;30:135-41.
41. Kozek-Langenecker SA. Perioperative coagulation monitoring. Review. Best Pract Res Clin Anaesthesiol. 2010 Mar;24(1):27-40.
42. Innerhofer P, Kienast J. Principles of perioperative coagulopathy. Best Pract Res Clin Anaesthesiol. 2010 Mar;24(1):1-14.
43. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008 Jan;108(1):71-7.
44. Peyvandi F, Cattaneo M, Inbal A, De Moerloose P, Spreafico M. Rare bleeding disorders. Haemophilia. 2008 Jul;14 Suppl 3:202-10.
45. Martlew VJ. Peri-operative management of patients with coagulation disorders. Br J Anaesth. 2000 Sep;85(3):446-55.
46. Dunn CJ, Goa KL. Tranexamic acid: a review of its use in surgery and other indications. Drugs. 1999 Jun;57(6):1005-32.
47. Alvarado IM. Tendencias actuales en el manejo preoperatorio de pacientes anticoagulados con warfarina. Rev Colomb Anestesiol. 2012;40(1):52-9.
48. Dumont B, Faille D, Ajzenberg N. [New oral anticoagulant drugs: dabigatran, rivaroxaban and apixaban. Present and future]. Med Sci (Paris). 2011 May;27(5):493-500. Epub 2011 May 25.
49. Sun JC, Whitlock R, Cheng J, , et al. The effect of pre-operative aspirin on bleeding, transfusion, myocardial infarction, and mortality in coronary artery bypass surgery: a systematic review of randomized and observational studies. Eur Heart J. 2008;29:1057-71.
50. Harder S, Klinkhardt U, Alvarez JM. Avoidance of bleeding during surgery in patients receiving anticoagulant and/or antiplatelet therapy: pharmacokinetic and pharmacodynamic considerations. Clin Pharmacokinet. 2004;43(14):963-81.
51. Fleisher LA, Beckman JA, Brown KA, Calkins H, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Anesth Analg. 2008 Mar;106(3):685-712.
52. Savonitto S, D‘Urbano M, Caracciolo M, Barlocco F, et al. Urgent surgery in patients with a recently implanted coronary drug-eluting stent: a phase II study of ‚bridging‘ antiplatelet therapy with tirofiban during temporary withdrawal of clopidogrel. Br J Anaesth. 2010 Mar;104(3):285-91.
How to Cite
Alvarado Arteaga, I. M. (2013). Physiology of Coagulation: Current Concepts Applied to Perioperative Care. Universitas Medica, 54(3), 338–352. https://doi.org/10.11144/Javeriana.umed54-3.fcnc
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