Understand the physical effects that red blood cells have on supporting coagulation
Red blood cells can influence coagulation by altering blood viscosity and flow through the microcirculation. The formation of rouleaux may also contribute to coagulation.
Understand the chemical and receptor medicated effects that red blood cells use to influence coagulation
The release of substances such as ADP from red blood cells and the exposure of phosphatidyl serine on red blood cell membranes can activate platelets and coagulation and support thrombin generation, in addition to providing fibrinogen binding areas.
Understand the role of factor XIII in clot stabilization
Factor XIII promotes red blood cell retention in clots through fibrin cross-linkiing. The presence of red blood cells can slow fibrinolysis.
Understand the role of hemolysis in the activation of coagulation
Free heme can trigger oxidant injury which can promote or incite inflammation. In addition, heme can upregulate tissue factor expression and result in a procoagulant phenotype. Free heme is also associated with the phenomenon of netosis, which can also promote coagulation.