It is a well established fact that in certain clinical conditions, especially those following surgical procedures and trauma, the equilibrium of the coagulation elements of the blood is shifted to a state favorable to clotting.1 A laboratory procedure is needed for detecting this tendency to intravascular clotting before the appearance of thrombotic phenomena. If such a procedure were available to the clinician, in vivo anticoagulants, such as heparin or dicoumarin (3,3′-methylene-bis [4-hydroxycoumarin] ), could be administered to patients having indications of such a tendency. Serious consequences and long periods of hospitalization could be averted in many instances. The introduction of dicoumarin,2 however, has posed another problem, that of maintaining a precise control of the mechanism for blood coagulation in order to avoid hemorrhagic consequences following the use of this drug. Difficulty in maintaining a given clotting level, as well as undesirable results, including death, has been reported.3
BRAMBEL CE. THROMBOPLASTIC REAGENT: DEVELOPMENT OF A MORE SUITABLE PREPARATION FOR MEASURING ACCELERATED CLOTTING TENDENCY AND FOR USE FOLLOWING ADMINISTRATION OF DICOUMARIN (3,3′-METHYLENE-BIS-[4-HYDROXYCOUMARIN]). Arch Surg. 1945;50(3):137–147. doi:10.1001/archsurg.1945.01230030143003
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