Biologie des anomalies de l’hémostase. - Brief INAHTA - Biology of haemostasis disorders: Thrombin time

Has

Description

Mis en ligne le 20 juil. 2011 Ce travail a eu pour but d’évaluer dix actes de biologie mesurant les anomalies de l’hémostase, qui avaient été signalés par le demandeur de cette évaluation soit comme obsolètes mais figurant encore à la Nomenclature des actes de biologie médicale (NABM), soit comme pertinents mais ne figurant pourtant pas dans cette nomenclature.Cette évaluation pourra donc permettre l’actualisation du sous chapitre 5-02 « Hémostase et coagulation » de la NABM. Cette évaluation a donné lieu à la rédaction de sept documents :Tome I : Evaluation du Temps de saignement (Epreuve de DUKE et tests d’IVY) ;Tome II : Temps de Thrombine et correction du Temps de Thrombine ;Tome III : Test photométrique d’agrégation plaquettaire ;Tome IV : Recherche d’anticorps antifacteur 4 plaquettaire dans le cadre d’une thrombopénie induite par l’héparine ;Tome V : Recherche et titrage d’inhibiteur contre les facteurs antihémophiliques ;Tome VI : Détection d’un anticoagulant de type lupique ;Tome VII : Recherche de la mutation G1691A du gène du facteur V (FV de Leiden) et de la mutation G20210A du gène du facteur II. Le texte court de cette évaluation reprend la totalité des 7 tomes (10 actes évalués). Mis en ligne le 20 juil. 2011

Sujets

• Biologie

Informations

• Publié par: haute-autorite-sante-techniques-et-procedures-de-diagnostic
• Publié le: 01 juillet 2011
• Nombre de lectures: 5
• Licence : En savoir +
  Paternité, pas d'utilisation commerciale, partage des conditions initiales à l'identique
• Langue: Français

Extrait

 

INAHTA brief   Title of haemostasis disorders: Thrombin time Biology    Agency French National Authority for Health (Haute Autorité de Santé) HAS,  2 avenue du Stade de France – F 93218 La Plaine Cedex, France  Tel: + 33 (0) 1 55 93 71 13 – Fax: + 33 (0) 1 55 93 74 35  fré[e-mail],s-haw.ww.erfastn    Referencebir//f82-dieogolamona-se-ed-seilanteas-sport.fr/cjsmia/l0099c/1_ww.h://whttp lhemostase      Aim The National Salaried Workers’ Health Insurance Fund (CNAMTS) asked HAS to assess the value of the different laboratory tests for haemostasis abnormalities with a view to updating the section in the Nomenclature of Procedures in Laboratory Medicine (NABM) containing the procedures in laboratory medicine for measuring abnormalities of haemostasis (subsection 5-02). One of those tests is the thrombin time (TT), an NABM procedure, which is a global test for the investigation of fibrin formation. The TT is the clotting time of citrated platelet-poor plasma (PPP) at 37°C in the presence of thrombin. Clot formation could be detected by chronometric, electromechanical or optical methods. A test of correction by adding control plasma can be carried out: the absence of any correction in TT indicates that unfractionated heparin is present in the sample. Historically, TT was used to make a preoperative assessment of haemostasis, investigate haemorrhagic syndrome or to detect the presence of unfractionated heparin in the sample.   Conclusions and results According to the different documents analysed, TT is not recommended for use in the preoperative assessment of the risk of haemorrhage, the investigation of disseminated intravascular coagulation (DIC), the follow-up of heparin treatments, or for the diagnosis of other disorders such as von Willebrand’s disease. It is still proposed for the diagnosis of rare congenital fibrinogen abnormalities. It should be noted that it is the determination of fibrinogen which is recommended in practice, and that this determination is already an NABM procedure. In conclusion, TT is not advocated either for preoperative assessment of the risk of haemorrhage or for the investigation of haemorrhagic syndrome.   Recommendations   On the basis of the literature identified and analysed, TT has been shown to be a procedure which should no longer be used in current practice.   Methods This assessment is based on a critical analysis of the literature carried out by the Haute Autorité de Santé, and reviewed by experts in haemostasis. It takes into account the arguments of a group of experts assembled by CNAMTS on which CNAMTS based its request. The assessment of this procedure is based on a critical analysis of the literature consisting of nine guidelines relating to disorders associated with the prescribing conditions (but no document recommending TT), and the review by three experts in haemostasis.   Written by   Aurélie Pacull, Haute Autorité de Santé, HAS, France.

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