Pemeriksaan Retraksi

Bekuan dan Pengukuran

Masa Lisis Bekuan
 Masa lisis bekuan
Normalnya, bekuan darah akan mencair seluruhnya
setelah 48 jam. Namun, lisis bekuan bisa lebih cepat
terjadi pada
kondisi-kondisi tertentu. Sebagai contoh, pada pasien
dengan penyakit fibrinolitik akut, bekuan dapat mencair
seluruhnya
dalam waktu 1-4 jam.
Laporkan masa lisis bekuan dalam jam.
Clot retraction (Obsolete test)
This test measures the amount of time it takes for a blood
clot to pull away from the walls of a test tube (Shrinking).
The edges of the blood vessel wall at the point of injury
are slowly brought together again to repair the damage.
It is used to evaluate and manage blood platelet
disorders, including Glanzmann's thrombasthenia
So Clot retraction depends primarily on the number and
activity of the blood platelets.
This test is reliable only when the concentration of
fibrinogen within normal limits.
Normally a blood clot will begin to retract from the walls
of the tube and express serum within one hour.
Glanzmann's thrombasthenia
Is an abnormality of the platelets
It is an extremely rare coagulopathy in which the
platelets lack glycoprotein IIb/IIIa .
Reduced glycoprotein IIb/IIIa causes reduced
platelet aggregation and clot retraction - no
fibrinogen bridging can occur, and bleeding time is
significantly prolonged);
Clot retraction test
This is a measure of platelet function. The test is
done in blood to which no anticoagulant has
been added and is allowed to clot. Clot
retraction is then looked for.
Clot retraction becomes abnormal in conditions
like
Fibrinogen deficiency (congenital or acquired)
Thrombocytopenia < 1ooooo
Thrombosthenia
Polycythaemia
Reduced clot formation: Glanzmann
thrombasthenia , DIC, hypofibrinogenemia,
dysfibrinogenemia (small clot with increased
red blood cell fall-out)
 Procedure
1. Obtain 2 ml of blood by venipucture. Place
one ml in a glass test tube in a 37oC water
bath.
2. Inspect clot at 1, 2, 4 and 24 hours after
clotting. Observe for retraction, quality,
and lysis of the clot.
3. Remaining 40-60% consists of serum and
red blood cell fall-out from clot
4. A visual examination of the clot is made.
Usually the clot retracts and expresses
serum within two hours.
Interpretation of results
The clot will retract from the walls of the tube until the red
cell mass occupies 50% of the total volume of blood in
the tube
There is a variable degree of retraction or there is no
retraction at all. Grades as follows:
0 : no serum extruded
1+ : 5-10% serum extruded
2+ : 10-20% serum extruded
3+ : 20-35% serum extruded
4+ : 35-50% serum extruded
Results are reported as the length of time it took for the
clot to retract
2-4 hrs is reported as normal
After 4 hrs is reported as poor
After 24 hrs is reported as no retraction
 Clot lysis test
The whole blood clot lysis time is used to detect
increase fibrinolysis
This test is only able to detect high increase in
fibrinolytic activity
Clot lysis testing is a measure of the presence of the
clot after 24 hours (blood fibrinolysis).
 Procedure
1. At the completion of the clotting time one tube
should remain in the 37 water bath
2. A second tube is placed in the refrigerator as soon as
clotted as a control
3. The tube is test for the disappearance of clot after 4,
8 and 24 hrs
4. If the sample becomes fluid in less than 48 hrs , the
blood is poured out onto a piece of filter paper to be
sure for clot disappearance
Interpretation
The disappearance of clot before 48 hrs means
increase fibrinolysis
After 48 hrs clot may be

37 C tube Refrigerated tube Comment

Disappear Disappear Low fibrinogen

Still intact Still intact Abnormal fibrinolysis

(No clot lysis after 48
hrs)
Disappear Still intact Nomal fibrinolysis
 Activity
What is the test mentioned below and how w we can do it?.

Euglobulin Clot Lysis Time

Next Lecture: Prothrombin Time (PT)
Glanzmann thrombasthenia adalah kelainan platelet yang bersifat
herediter atau genetik. Kelainan ini diturunkan secara autosomal resesif.
Pada kelainan ini terdapat defisiensi atau disfungsi pada kompleks
glikoprotein IIb/IIIa (GP IIb/IIIa) dari platelet. Gen-gen yang terkait dengan
kelainan ini terletak pada kromosom 17. Defek pada kompleks GP IIb/IIIa
berakibat pada gangguan aggregasi platelet dan memicu perdarahan
berikutnya. Walaupun terdapat kelainan, secara kuantitatif dan morfologi
kondisi plalet biasanya normal