Anticoagulant Therapy

Panic Value: INR or PT?

Hi, We run coagulation tests at my work place on an ACL 9000 from Instrumentation Laboratory and I would like to know what should be considered as a panic value, a high prothrombin time (PT) value or the international normalized ratio (INR) value? If it is the PT value, what value should be considered as […]

Anticoagulant Therapy

UFH Infusion: a Max Dose

This question was forwarded to me by my friend and colleague, Marisa Marques, MD, Director of the University of Alabama at Birmingham Hospital special coagulation laboratory and transfusion service: “One of our pharmacists asked if there was a maximum dose for the heparin bolus or infusion rate for obese patients since our current recommendations are based on body […]

Anticoagulant Therapy

New Anticoagulants in AF

Guidelines for Coumadin, aspirin, dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis) are changing rapidly, favoring the new oral anticoagulants in most cases of atrial fibrillation. See the current TheHeart.org discussion based on “CardioStim 2012 in Nice, France. Geo

Anticoagulant Therapy

QQ: Anti-Xa Heparin Assay

Here’s a summary of our June, 2012 Quick Question: To perform the chromogenic anti-Xa heparin assay, how many separate reference curves do you maintain for unfractionated (UFH), low molecular weight (LMWH) heparin and fondaparinux? a. One hybrid curve for UFH and LMWH, same curve (computed) for fonda: 7 (16%) b. One hybrid curve for UFH […]

Anticoagulant Therapy

Do You Use Anti-Xa for Heparin?

I received this question from my good friend and colleague, Marisa B. Marques, MD, who directs the transfusion service and special coagulation laboratory at the University of Alabama at Birmingham Hospital: George: Could you find out which medical centers are using anti-Xa instead of PTT to monitor unfractionated heparin? I would like to hear their input and […]

Anticoagulant Therapy

Finally Some Good News About Pradaxa

Dabigatran (Pradaxa) seems to get a lot of negative press in the US; the lawyers are circling! Here is a recent article from the European Medicine Agency reporting that Dabigatran post-market data show less bleeding fatalities than in the clinical trials.

Anticoagulant Therapy

Correlating ACT from the i-STAT and Hemochron

A message from Sue Allen at Baptist Hospital: George, a while back you posted aquestion to the masses about the correlation between the Abbott i-STAT ACT versus the ITC Hemochron 401 and the Hemochron Jr. and I was wondering if you ever received any responses and have any further information on the subject. We are currently doing the same conversion and […]

Anticoagulant Therapy

How Long Does HIT Ab Remain?

In the comments section of our

Anticoagulant Therapy

PTT Reagent Selection

For those who participated in our summer, 2011 questionnaire (designed by Precision BioLogic’s marketing analyst Mr. Ankush Randhawa) about the choice of PTT reagent relative to its application and sensitivity to lupus anticoagulant, the results now appear in Fritsma GA, Dembitzer FR, Randhawa A, Marques MB, Van Cott EM, Adcock-Funk D, Peerschke EI. Recommendations for appropriate […]

Anticoagulant Therapy

How to Remove IgG

This question was posted on Wednesday, May 23 on Pat Letendre’s Medlab list and is reposted here with Linda Stang’s permission: We have a patient with lymphoma and an IgG peak (we think). The antibodies are interfering (and I mean really interfering) in the coags: INR >5.0 but has had clinical challenges with no bleeding. Is there any way to remove […]

Anticoagulant Therapy

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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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