During ongoing transfusion therapy, what should the INR or aPTT be?

During ongoing transfusion therapy, what should the INR or aPTT be?

• A. Normal or near normal
• B. Significantly prolonged
• C. Not measured
• D. Elevated only with ongoing bleeding

Answer: (A)

The main idea is to support restored coagulation during transfusion by bringing clotting times back to the normal range. When you’re actively transfusing to treating a coagulopathy, the goal is to replenish clotting factors and re-establish hemostasis, so the INR and aPTT should be normal or near normal. If these times stay prolonged, it signals that there is still coagulation factor deficiency or dilutional coagulopathy despite transfusion, and more factor-containing products (like FFP) may be needed, or the situation may require a re-evaluation of ongoing blood loss. You wouldn’t expect INR or aPTT to be elevated solely because transfusion is happening, nor would you refrain from measuring them, since they guide how much correction is needed.

The main idea is to support restored coagulation during transfusion by bringing clotting times back to the normal range. When you’re actively transfusing to treating a coagulopathy, the goal is to replenish clotting factors and re-establish hemostasis, so the INR and aPTT should be normal or near normal. If these times stay prolonged, it signals that there is still coagulation factor deficiency or dilutional coagulopathy despite transfusion, and more factor-containing products (like FFP) may be needed, or the situation may require a re-evaluation of ongoing blood loss. You wouldn’t expect INR or aPTT to be elevated solely because transfusion is happening, nor would you refrain from measuring them, since they guide how much correction is needed.