Coagulation function tests: principles and clinical application

Abstract

Coagulation function tests that comprehensively evaluate blood coagulation performance are difficult to standardize and are often used in research. Rotational thromboelastometry (ROTEM) is one of the most common tests used in clinical practice. It involves dynamic stimulation of blood, with recording and evaluation of changes in viscosity over time as coagulation progresses. ROTEM is used for point-of-care monitoring in the operating room. In contrast, coagulation waveform analysis (CWA) provides more usable data. Fully automated blood coagulation analyzers measure the change in turbidity over time as fibrinogen changes to fibrin, and CWA is used to analyze the coagulation reaction curve obtained in this process. One advantage of CWA is that it facilitates collection of large amounts of sample data. Our group developed a diagnostic tool for dysfibrinogenemia using CWA and implemented it as an application in Sysmex’s automated blood coagulation analyzer.