PNP Test for LA

Here is a challenging technical question about the platelet neutralization procedure (PNP) for identification of lupus anticoagulant (LA) from Charlene Bierl MD, PhD Director of the Clinical Laboratory. Cooper University Hospital, Camden, NJ. Dr. Bieri’s question was originally addressed to Drs. Marisa B. Marques and Jill Adamski and to specialty technologists Laura Taylor and Patti Tichenor at the University of Alabama at Birmingham Hospital Department of Laboratory Medicine. Following is […]

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Thrombophilia

Jun 5 2013

george

QQ: Pre-op Screens

A summary of our May, 2013 Quick Question with 57 respondents: Surgeons typically order pre-operative hemostasis screens. What assays are included in your pre-operative screen? a. PLT count, PT, PTT: 40 (69%) b. None, we don’t perform pre-op screen: 8 (14%) c. PLT count, PT, PTT, TT, fibrinogen: 5 (9%) d. PLT count, PT, PTT, […]

Screening Assays

Measuring Dabi and Riva

From Kim Kinney at IU Health (formerly Clarian): Our coag lab is being asked by our heme/onc docs to have an assay for both Rivaroxaban and Dabigatran. I thought maybe you could poll your readers to see who is doing what type of assay if any! As always, thanks for your help. Hi, Kim, it is good to hear […]

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Anticoagulant Therapy

May 28 2013

george

Prolonged PTT in FXII Deficiency

From Maria Grana, Baptist Health Center: Hello, we recently had a patient with very high partial thromboplastin time (aPTT, PTT) resu;ts, anywhere from 115 to >200 seconds. The mixing study indicated a factor deficiency. Factor assays performed (IX, XI) were within normal limits, FVIII was elevated (>200) and Factor XII was 48%. It did not appear […]

Coagulation Factors

Hemostasis Specimen Management

I am trying to find a chart or article that tells how long plasma is good for hemostasis testing. The question has arisen about fresh samples and frozen samples. We often get requests for add-on tests and need to know how long is too long. Do you know of a resource that will provide this […]

Specimen Management

Recommended DIC Profile

From Julia Witt: In an effort to standardize our healthcare organizations, we are looking at our current disseminated intravascular coagulation (DIC) panel. All sites have different ideas. George, what are your suggestions? Hi, Julia. Please forgive some self-promotion. Our handbook, Marques MB, Fritsma GA: Quick Guide to Coagulation Testing, 2nd Edition, AACC Press, 2009 provides the following recommendations […]

Bleeding Disorders

Anti Phospholipid Antibody Result Interpretation

From Charles Nakar, Indiana Hemophilia and Thrombosis Center: I would like your opinion on the laboratory results below regarding a patient who recently switched providers with a history of deep venous thrombosis due to May-Thurner syndrome and possible antiphospholipid antibody syndrome. He had positive anticardiolipin antibody (ACL) screens and a positive STA-clot (x1) during the acute event […]

Thrombophilia

ARISTOTLE Analysis: Apixaban Superior to Warfarin

A May 7, 2013 report from the ARISTOTLE trial was highlighted on The Heart.Organd showed superior efficacy for apixaban versus warfarin in stroke, systemic embolism, and all-cause death. The Heart.org also provided this nicely illustrated and definitive European Heart Rhythm Association guide to the use of the new oral anticoagulants, including edoxaban, the most recent direct anti-Xa inhibitor […]

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Anticoagulant Therapy

May 9 2013

george

POCT ACT and Anti-Xa for ECMO

From Deanna Miller, Point of Care Testing (POCT) Coordinator at Children’s of Alabama: We have recently merged our extracorporeal membrane oxidation (ECMO) team with the cardiovascular team from the University of Alabama at Birmingham (UAB) and we are doing all pediatric cardiovascular cases at Children’s now. We would like some insight into monitoring coagulation using the activated coagulation time […]

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Anticoagulant Therapy

May 8 2013

george

TEG in a Community Hospital

From Annette Gaskill, Estes Park Medical Center: I’m a MT at a small critical care hospital and also am part of our facility’s trauma committee. In our discussions of trauma cases involving patients already anticoagulated, our surgeon has asked me about thromboelastograms. Our coagulation menu is PT, PTT, and D-dimer; anything else is sent out. We only […]

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Bleeding Disorders

All Posts

PNP Test for LA

QQ: Pre-op Screens

Measuring Dabi and Riva

Prolonged PTT in FXII Deficiency

Hemostasis Specimen Management

Recommended DIC Profile

Anti Phospholipid Antibody Result Interpretation

ARISTOTLE Analysis: Apixaban Superior to Warfarin

POCT ACT and Anti-Xa for ECMO

TEG in a Community Hospital

George Fritsma MS MLS

Cheat Sheets from George

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