Abstract

A 14 year-old girl having truncus arteriosus and ventricular septal defect diagnosis admitted at Pediatric Cardiology Clinic had complaints of cyanosis and early fatigue during exercise. Her hematocrit value was over 77% that is why she got hospitalized in order to appling phlebotomy. Since the patient hadn’t gone through anticoagulant therapy and didn’t have history of bleeding and had prothrombin time of 49.0 sec, international normalized ratio of 5.3 and activated partial thromboplastin time of 52.6 sec, the hematology oncology consultation was requested. Because of the test results were incompatible with the patient's clinical outcome, the case was consulted with laboratory. Because of the patient hematocrit value was >55%, prothrombin time, international normalized ratio and activated partial thromboplastin time values decreased until 14 sec, 1.2 and 28 sec, respectively, by adjusting the citrate concentration within blood collection tube by laboratory. There was no more complaint so the patient was discharged.

There are many preanalytical changes that affect routine coagulation tests. One of them is also high hematocrit value of the patient. In blood samples with high hematocrit values, adjusting the amount of citrate used for coagulation tests is recommended. Our goal in our study is to achieve the changes of coagulation tests in this patient (children) with high hematocrit.

In this case, the coagulation test results are adjusted by the help of consalt laboratory and the clinically unintended consequences are prevented. In order to provide accurate and reliable results consulting with laboratory specialist and evaluating patient as multidisipliner in the discordant test results with clinical state of patient both at the same time are applied.