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Thromb Haemost 2006; 95(02): 362-372
DOI: 10.1160/TH05-01-0047
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH

Developmental haemostasis

Impact for clinical haemostasis laboratories
Paul Monagle
1   Department of Haematology
4   Department of Pathology, University of Melbourne, Australia
,
Chris Barnes
1   Department of Haematology
,
Vera Ignjatovic
1   Department of Haematology
5   Murdoch Children’s Research Institute, Melbourne, Australia
,
Janine Furmedge
1   Department of Haematology
,
Fiona Newall
1   Department of Haematology
,
Anthony Chan
6   Department of Paediatrics, McMaster University, Hamilton, Canada
,
Lidia De Rosa
1   Department of Haematology
,
Simone Hamilton
1   Department of Haematology
,
Philip Ragg
2   Department of Anaesthetics
,
Stephen Robinson
2   Department of Anaesthetics
,
Alex Auldist
3   Department of Surgery, Royal Children’s Hospital, Melbourne, Australia
,
Cathy Crock
1   Department of Haematology
,
Neil Roy
7   Department of Neonatology
,
Shelley Rowlands
8   Department of Obstetrics, Royal Women’s Hospital, Melbourne, Australia
› Author AffiliationsFinancial support: The authors thank Diagnostica Stago, France and Bayer Diagnostics, Australia for supply of relevant reagents.
Further Information

Publication History

Received 20 January 2005

Accepted after resubmission 02 January 2005

Publication Date:
28 November 2017 (online)

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Summary

Developmental haemostasis is a concept, now universally accepted, introduced by Andrew et al. in the late 1980’s. However, coagulation analysers and reagents have changed significantly over the past 15 years. Coagulation testing is known to be sensitive to changes in individual reagents and analysers. We hypothesised that the reference ranges developed by Andrew et al. may not be appropriate for use in a modern coagulation laboratory. Our study was designed to determine whethera current day coagulation testing system (STA Compact analyser and Diagnostica Stago reagent system) was sensitive to agerelated changes in coagulation assays. This is the first large scale study since Andrew et al. to determine the age associated numerical changes in coagulation proteins. Our results confirm the concepts of developmental haemostasis elucidated by Andrew et al. However, our results clearly demonstrate that the absolute values of reference ranges for coagulation assays in neonates and children vary with analyser and reagent systems. The results confirm the need for coagulation laboratories to develop age-related reference ranges specific to their own testing systems. Without this, accurate diagnosis and management of neonates and children with suspected bleeding or clotting disorders is not possible. Finally we present age related reference ranges for D-dimers, TFPI, and endogenous thrombin potential, previously not described.

Keywords

Reference ranges - developmental haemostasis - paediatric
 

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