Coagulation Parameters in Infants

Introduction to Coagulation Parameters

• The American Academy of Pediatrics recommends using age-specific reference ranges for interpreting prothrombin time (PT) results in infants, as adult reference ranges may not be applicable due to developmental hemostasis 1

Age-Dependent Changes and Reference Ranges

• PT results vary significantly depending on the laboratory reagent and analyzer used, with a study showing that using adult reference ranges for pediatric samples can lead to misdiagnosis in up to 30% of children, highlighting the need for age-specific and reagent-specific reference ranges 1

Reagent and Analyzer Specificity

• Different PT reagents show varying age-specific patterns, so published reference ranges should only be used if the identical analyzer and reagent system are employed, as stated by the International Society on Thrombosis and Haemostasis 1

Misdiagnosis and Inappropriate Testing

• Misinterpreting PT values in infants by using adult reference ranges can lead to unnecessary additional testing, inappropriate treatment decisions, potential cancellation of surgical procedures, and psychological impact on families from incorrect labeling of bleeding disorders, emphasizing the importance of using age-specific reference ranges 1

Clinical Recommendations

• Clinicians should always refer to age-specific, reagent-specific reference ranges provided by their laboratory for accurate interpretation of PT results in infants, as recommended by the College of American Pathologists 1