HAEMOSTASIS

• Introduction

• Mechanisms

• Coagulation factors

• Anti – coagulant mechanisms

• Introduction =
- Haemostasis is the process of forming clots in the wall of
Injured / damaged blood vessels and preventing blood loss
While maintaining blood in the fluid state within the
vascular System.

• Mechanisms = three stages

1) Vasoconstriction of blood vessels
2) Temporary plug formation
3) Permanent plug [clot] formation

• 1) Vasoconstriction of blood vessels =

- Immediate vasoconstriction of blood vessel after injury is
 - Local myogenic spasm of blood vessel
-Release of vasoconstrictor substances like – serotonin,
Thromboxane- A2

• 2) Temporary plug formation=

- By platelets
- Platelets adhesion, activation, aggregation-
- Helps in formation of temporary plug

• 3) Permanent plug [clot] formation =

- Formation of definitive plug by conversion of temporary
plug

- There two [2] important mechanisms which are having

four [4] sub mechanisms- with the help of clotting factor
• Intrinsic Extrinsic
Uses the clotting factors
Form 1)
Prothrombin activator
Prothrombin Thrombin 2)
Fibrinogen Fibrin 3)

Retract + Stabilize 4)
• Intrinsic Extrinsic
Triggered by – Triggered by-injury to
1) Exposure of blood to collagen
Of damaged endothelium 1) injurybody tissues
• Two Imp Mechanisms = 1) Intrinsic 2) Extrinsic

• Four Imp sub- mechanisms =

1) Formation of prothrombin Activator
2) Conversion of prothrombin to thrombin
3) Conversion of fibrinogen to fibrin
4) Clot retraction and stabilization

• Clotting factors=
- Factor I = Fibrinogen
- Factor II = Prothrombin
- Factor III = Thromboplastin
- Factor IV = Calcium
 - Factor V = Labile factor / proaccelerin
- Factor VI = ---------------Absent / non –existent
- Factor VII = Stable factor / procenvertin
- Factor VIII = Antihaemophilic factor – A
- Factor IX = Christmas factor / AHF – B
- Factor X= Stuart – Prower factor
- Factor XI = plasma Thromboplastin antecedent / AHF – C
- Factor XII = Hageman factor
- Factor XIII = fibrin stabilizing factor
- HMW-K = High molecular weight – kininogen
- Pre – ka = Prekallikrein
- Ka = Kallikrein
- PL = Platelet phospholipids
 Anticoagulant
•
These are the substances which prevent the coagulation of blood.

• Anticoagulants are of three types:

• 1. Anticoagulants used to prevent the blood clotting inside the body, ie; in vivo

• 2. Anticoagulants used to prevent clotting of blood outside the body,ie; in vitro

• 3. Anticoagulants used to prevent blood clotting both in vivo and in vitro.

• a) Heparin-It is a naturally produced anticoagulant in the body by mast cells and
basophils. It prevents clotting by antithrombin activity and it inactivates the
active form of other clotting factors. Heparin is used in vivo and invitro.
• Coumarin derivatives
• Warfarin and dicoumarol are the derivatives of coumarin. It prevent blood
clotting by inhibiting the action of vitamin K. vitamin K is essential for the
formation of various clotting factors. These are oral anticoagulants to prevent
myocardial infarction, stroke and thrombosis.

• c) EDTA
• Ethylenediaminetetraacetic acid (EDTA) prevent blood clotting by removing
calcium from the blood. it is used in vivo and in vitro(intravenously for lead
poisoning and for laboratory purposes).

• d) Oxalate compounds
• Oxalate compounds prevent blood clotting by forming complexes with calcium,
calcium oxalates. it is precipitated later. Thus it removes calcium from blood and
prevents clotting. It is used in vitro. Earlier sodium and potassium oxalates were
used. Nowadays, mixture of ammonium oxalate and potassium oxalate is used.
E, Citrates
• Sodium, ammonium and potassium citrates are used as anticoagulants. Citrate
removes calcium from the blood by forming complexes with calcium, calcium citrates.
Thus it prevents blood clotting. It is used in vitro for laboratory purposes.

• f) Other substances which prevent blood clotting

• -Peptone

• -C- type lectin (protein from venom of viper snake)

• -Hirudin (from leech).

• g) Physical methods to prevent blood clotting

• - cold(reducing temperature below 50 C postpones blood clotting)

• - collecting blood in a container with smooth surface like silicon - coated container
prevent blood clotting by inhibiting the activation of factor XII, so the formation of
prothrombin activator is prevented.