Q: Why does blood in pleural and pericardial fluids not clot?
Answer: Hemorrhage within the pleural and pericardial space generally does not clot due to 3 reasons.
- mechanical defibrination (movement of lungs and heart)
- activation of fibrinolytic mechanisms
- Also, platelets disappear within hours following hemorrhage
#hematology
References:
1. Willner DA, Shams P, Grossman SA. Pericardiocentesis. [Updated 2025 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470347/
2. Kumar S, Verma SK, Singh R, Prasad R. Hemorrhagic pleural effusion secondary to sarcoidosis: A brief review. Ann Thorac Med. 2009 Jan;4(1):27-31. doi: 10.4103/1817-1737.44783. PMID: 19561920; PMCID: PMC2700470.
3. Lending G, El Ghani YA, Kaykov E, Svirsky B, Cohen HI, Altman E. Hemorrhagic Malignant Pleural Effusion: Diagnosis, Survival Rate, and Response to Talc Pleurodesis. Indian J Surg Oncol. 2021 Mar;12(1):54-60. doi: 10.1007/s13193-020-01099-2. Epub 2020 Nov 14. PMID: 33814832; PMCID: PMC7960834.
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