PROTHROMBIN TIME
USES:
Measures the factors of extrinsic and common coagulation
pathways.
Screening test for coagulation disorders.(Abnormal with
deficiencies of I, II, V, VII, X,)
To evaluate liver function.
For monitoring anticoagulant therapy.
SPECIMEN COLLECTION FOR COAGULATION
STUDIES:
Care should be taken not to hemolyse the sample
Ratio between blood and anticoagulant should be exactly
1:9 , 3.2% disodium citrate are preferred
Glassware should be clean and dry
Test should be carried at 37⁰ C
PRINCIPLE:
Activated Partial Thromboplastin Time (APTT) is the time
taken by citrated plasma to clot after adding tissue
thromboplastin, and calcium chloride, and correlates with
an overall function of extrinsic and Common pathway of
coagulation system. The appearance of the clot is noted,
and termed PT.
REAGENTS REQUIRED:
Citrated Plasma from a patient
Commercially available tissue thromboplastin
Calcium chloride
Normal control plasma
Waterbath
Test tubes
Stop watch
PROCEDURE:
Pipette 0.1 ml of plasma into a glass tube
Add 0.1ml of thromboplastin to plasma
Add 0.1 ml of calcium chloride to the tube after 1 minute and mix.
Immediately start the stopwatch and leave the tube in waterbath
for 8-9 seconds.
Gently tilt the tube and look for clot. As soon as the clot appears
note the time.
Record as PT time for the sample
Repeat the test with control plasma
REPORTING:
Patient’svalue is always to be reported with the control
values in seconds
NORMAL RANGE:
11-16 Seconds
INTERPRETATION:
Prolonged PT is seen in:
Inherited Coagulation disorders- deficiency of factors I, II,
V, VII, X
Liver disease
Disseminated Intravascular Coagulation
Vitamin K Deficiency
Oral anticoagulant therapy
International normalized ratio: INR
Due to inherent variation in the sensitivity of thromboplastin reagent
it is advisable to report the PT in INR.
It provides a uniform scale in spite of using different sources of
thromboplastin
WHO recommended each thromboplastin should have ISI
value( International Sensitivity Index)
INR is calculated by: INR= PT of patient in seconds / PT of normal
plasma in seconds) ISI
