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New USP Heparin Dosage Standards October 8

The FDA has issued a news release warning that beginning October 8, heparin will be shipped at new, lower dosages. Labs will have to confirm their therapeutic ranges relative to the new dosages. Geo.

Anti-Xa Heparin Assay: Antithrombin in the Reagent?

A new question from Kim Kinney at Clarian Hi George, We are looking at switching our heparin assay from a two stage kit (antithrombin [ATIII] reagent included) to one that has no antithrombin and relies upon patient antithrombin. We are facing re-establishing our PTT therapeutic range and wondered how this will impact the therapeutic range […]

Freezing Coagulation Specimens

From Maureen Caraker: If coagulation testing is not performed immediately and needs to be prepared for send outor stored for special coagulation batch testing, is it necessary to flash freeze plasma? I cannot find any regulation addressing this. Hi, Maureen, thank you for your question. H-21 A5 is the current CLSI standard for coagulation specimen, […]

Factor XII and Sickle Cell Crisis

I had a conversation with a colleague who mentioned they were seeing decreased factor XII activity and antigen levels during sickle cell crisis. I found two references on reduced contact factors in sickle cell: Gordon EM, Klein BL, Berman BW, et al. Reduction of contact factors in sickle cell disease. J Pediatr 1985; 106:427-30, and Miller RL, Verma […]

Do Plastic Tubes Affect INRs?

From Kim Kinney at Clarian: I got a call from an area lab that is having some issues with INRs. These are all being drawn in BD 2.7 mL plastic tubes. They are getting large discrepancies in INRs after an initial spin. They got a call from an ambulatory area questioning a 4.23 INR. When […]

Send-out Specimens

Hi George, I have recently taken over the duties of technical coordinator of our send-out department. This is a very large area with many reference labs. I am trying to standardize our specimen processing area since this seems to be one area where we have issues with sample quality. I was wondering if someone would […]

A “Wispy” Clot In a Manual PTT

A note from Beth Lewis: Hi George, I’ve just signed onto your site and so far am very impressed with its content. I’ll know I’ll refer to it regularly. Thanks so much for setting it up. I have a question for which I’ve been unable to find a good answer: When performing a manual test […]

Perform Staclot LA on TOP?

Kim Kinney of Clarian asks: Is anyone performing the Diagnostic Stago Staclot LA on the Beckman-Coulter TOPS analyzer?

ISTH SSC 2009 Updated Guidelines for Lupus Anticoagulant Detection

At the ISTH meeting in Boston I attended the July 11 Scientific and Standardization Committee on Lupus Anticoagulant, chaired by Vittorio Pengo, MD, of the University Of Padua School Of Medicine. Dr. Pengo and distinguished members of the committee presented an update of the Lupus Anticoagulant (LA) Detection Guidelines, first published in 1995. Their updates […]

PTT Reagent Sensitivity for FVIII & FIX

Here is a question from Fiona McCall at Siemens: Do laboratories investigate their normal PTT reference range routinely? I have concerns that laboratories try to determine the factor VIII & factor IX sensitivity of their PTT reagent without really knowing what is an abnormal PTT for their current PTT reagent lot number. Can anyone share with me the […]

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George Fritsma is a medical laboratory scientist, educator, and author. George is a member of the International Society on Thrombosis and Hemostasis, the International Society for Laboratory Hematology, and the American Society for Clinical Laboratory Science.

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