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Bleeding and Elevated Factor VIII

Our coagulation lab specialists at UAB have noted anecdotally that long term bleeding is accompanied by elevated factor VIII activity levels. Have others seen this, and is there a reference documenting it? Geo.

Heparin Therapeutic Range

Here is a question on how to develop the PTT therapeutic range using the Brill-Edwards method in a low-volume facility. This is from Michael D. Blechner, MD, Assistant Professor of Pathology and Laboratory Medicine, University of Kentucky Medical Center: George, Here at UK (University of Kentucky) we use plenty of unfractionated heparin (UFH) and it […]

D-dimer and FDPs

Here are the results for our 12/11/08 quick question, “What assay do you use to detect abnormalities in fibrinolysis such as DIC? This question was a little ambiguous in that it didn’t provide a way to answer multiple assays. Many of us use the D-dimer and fibrinogen assay in parallel to detect and monitor DIC. […]

Overuse of Platelet Concentrate

Here is an interesting finding presented yesterday at the ASH meeting detailing apparent overuse of platelet concentrate: Click Here for link to article

When to Use the Chromogenic X Assay

A question about the chromogenic factor X assay from Eryn Cramer: I am working as a student in an anticoagulation clinic and we are looking for information on the frequency of chromogenic factor X (CFX) monitoring before returning to INR monitoring for patients with antiphospholipid syndrome (APS). Are there any recomendations for CFX test frequencies? […]

Quick Question: Anticoagulant Adjustment

Here is the result of this week’s Quick Question. We asked, According to CLSI, we reduce the anticoagulant to blood ratio for coagulation testing draws when the hematocrit is over 55%. Assuming you know the hematocrit in advance, how do you manage this? Your answers… a. Always draw into an adjusted blue-stopper tube: 51 (46%) […]

Bethesda Titer Method

Kim Kinney from Clarian headed this “one last question.” Kim, I hope this is not your last question, we love to hear from you. We at Clarian are moving our Bethesda assay from our MDA to our TOP. We use a residual VIII method where we calculate the residual VIII in a mixture of patient […]

A New Question: Overfilled Collection Tubes

A question from Renee Briggs: George, My laboratory recently switched to the Greiner Bio-One plastic collection tubes for coagulation. Greiner has various fill size tubes (2 mL, 3 mL, and 3.5 mL) for their Vacuette sandwich tubes for coagulation. These tubes have specific fill lines in the tube label and even give a recommendation that […]

Delayed Clot in Ped Tube

Another great question from Kim Kinney at Clarian: Hi again George. I have an observation that I am wondering if anyone else has noticed. We use full-draw, BD glass tubes for all of coagulation, but we have had the 1.8 mL pediatric tube come in from Riley Children’s Hospital for PT/PTT. We always check for […]

Pathologist and Technical Staff Communication

Here is a general statement from Col. Lucia More that was posted on Pat Letendre’s Medlab-L. Surprisingly, it generated little discussion there. I asked her if we could put it up on Fritsma Factor to see if we could elicit a response. I’d particulary like to learn people’s response to the ASCLS Doctorate in Clinical […]

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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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