Choosing the Right Coagulation Analyzer

A coagulation analyzer is a laboratory device used to measure the levels of blood coagulation factors. It is also known as a coagulometer, blood coagulation meter, or hemostasis analyzer. Hemostasis encompasses all the natural phenomena that stop bleeding resulting from an injury, trauma, or surgery.
Coagulation tests are recommended for patients with blood disorders that can cause bleeding or thrombosis.

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What are the different types of coagulation analyzers?
Coagulation analyzers are classified either by their operating mode, number of channels, or measurement method.
- By operating mode
1. Automatic coagulation analyzers: These are fully automated devices that operate autonomously.
  
  Semi-automatic coagulation analyzers: These models require the intervention of a laboratory technician to prepare and position the samples.
- By the number of channels:
  Coagulation analyzers are also distinguished by the number of channels they have, i.e. the number of samples they can process simultaneously. Most of these devices have between one and ten channels. For example, a four-channel coagulation analyzer can perform four different analyses at the same time.
- By measurement method:
1. Coagulometric: This process causes colloidal particles suspended in a liquid to agglomerate and form colloids. It results in thickening or, in other words, coagulation.
  
  Immunological: Measures the concentration of a molecule in a blood sample using an antibody or immunoglobulin.
  
  Chromogenic: The process of detecting coagulation factors consists of using specific chromogenic substrates that are broken down into colored products by the metabolism of microorganisms.
  
  Turbidimetric (or immunoturbidimetric): Quantifies the degree of turbidity of blood or a blood suspension. To do this, it uses an optical system (spectrophotometer) that measures the decrease in intensity of a light beam of a known wavelength that passes through the sample.
Note that some analyzers combine different measurement methods.

Horiba automatic coagulation analyzer

Erba semi-automatic coagulation analyzer
Classification of analyzers :
- By operating mode: automatic or semi-automatic
- By number of channels (number of samples processed simultaneously)
- By measurement method: coagulometric, immunological, chromogenic, or turbidimetric
What parameters are measured by coagulation analyzers?
Coagulation analyzers make it possible to test various parameters in order to determine the patient’s hemostatic status, such as fibrinogen levels, bleeding time, platelet count, etc.
- Fibrinogen (or factor 1) levels: Fibrinogen is a protein produced by the liver. It is essential for the formation of blood clots. This test measures the amount of fibrinogen in the blood.
- Platelet count: Platelets are blood cells that help the blood to clot. This test indicates the number of platelets per microliter of blood.
- Clot retraction: Measuring the decrease in volume of a blood clot. When a blood vessel is injured, platelets aggregate and form a clot at the site of the injury. This clot will act as a plug to stop the bleeding. The clot then retracts, joining the edges of the wound and helping to re-establish the continuity of the vessel.
- Clotting time: The normal clotting time varies between 12 and 18 minutes, depending on the ambient temperature. For this reason, the temperature at which the test is carried out must be systematically indicated.
- Prothrombin time (PT): Measures the quality of the clotting factors and the time it takes for the blood to clot. For patients treated with oral anticoagulants, the INR (International Normalized Ratio) test is also usually carried out, which standardizes PT results worldwide, regardless of the device used.
- Activated partial thromboplastin time (aPTT): The partial thromboplastin time (PTT) assesses the body’s ability to form blood clots. The activated partial thromboplastin time is used to test the same functions as the PTT, with the only difference being that an activator is added that accelerates coagulation, resulting in a shorter reference interval.
- Thrombin time (TT): Measures the effectiveness of fibrinogen.
Together, the results of these tests make up the coagulogram.
What are coagulation analyzers used for?
Coagulation analyzers are used to detect diseases, monitor patients, or before surgery.
- Disease detection: The coagulation analyzer is used to detect cases of hemophilia, liver disease, or malabsorption of nutrients.
- Monitoring patients: Monitor patients undergoing treatments that may alter their coagulation capacity.
- Before surgery: A coagulogram is usually performed to assess whether the patient is at greater risk of bleeding during or after a surgical procedure.
A very low TT level (less than 70%) indicates liver failure (hepatitis, cirrhosis, or jaundice) or vitamin K deficiency.
What are the different configurations of coagulation analyzers?
Coagulation analyzers are generally bench-top or portable.
- Benchtop analyzers: These are relatively compact models designed to be placed on the laboratory bench.
- Portable analyzers: These models are very practical, especially for carrying out tests at the bedside, also called Point of Care (PoC).
Dialab portable coagulation analyzer

Sysmex compact coagulation analyzer

Diagon benchtop coagulation analyzer

Wiener Lab benchtop coagulation analyzer
How much does a coagulation analyzer cost?
Depending on the brand, type and number of tests the device can perform, prices can range from a thousand euros to several tens of thousands of euros.

Automatic analyzers are generally more expensive than semi-automatic ones.
Are there any risks associated with using a coagulation analyzer?
Testing with a coagulation analyzer involves taking a blood sample. This can result in a bruise at the puncture site, but this usually disappears within a few days.
Do coagulation analyzers require any special maintenance?
Coagulation analyzers require very little maintenance. Some models have an automatic daily quality control system.