Bleeding Disorders

In Vivo Hemolysis

Irene Regan writes that despite doing major literature searches there seems to be no consensus regarding what coagulation results should be released when there is a suspicion of in vivo hemolysis such as in disseminated intravascular coagulation (DIC), when the samples are grossly haemolysed. Currently, Irene issues a fibrinogen (Clauss) and in this case she generally […]

Bleeding Disorders

Factor XIII Concentrate

In February 2011, the plasma-derived CLS Behring factor XIII concentrate Corifact™received US Food and Drug Administration (FDA) clearance to provide bleeding prophylaxis for patients with rare congenital factor XIII (fibrin stabilizing factor) deficiency. In January, 2013, the FDA extended Corifact’s indication to include management of perioperative bleeding in factor XIII-deficient patients. The Corifact package insert is attached here: Corifact Prescribing […]

Bleeding Disorders

Factor VIII Inhibitor?

From Deborah Whetzel, Children’s Hospital of the King’s Daughters, Norfolk, VA: We’ve had a couple patients lately that demonstrated inhibition but their factor VIII results are within normal limits or even elevated. The result values differ 30–40% typically between dilutions but as they’re diluted more, the values go up to 300 or 400%. FVIII values that high […]

Bleeding Disorders

Prolonged PT and PTT

A message from Vilas Hiremath: Dear George, hello. Female 30 yrs underwent laparoscopy, started bleeding. Prothrombin time (PT) and partial thromboplastin time (APTT, PT) prolonged, both mixing study 1:1 corrected. Normal fibrinogen and thrombin time (TT). Factor X, VIII. II normal, factor V is 6.0%. Dilute Russell viper venom time (DRVVT) screen and confirm both prolonged, […]

Bleeding Disorders

Prolonged PT, TT, and PTT

From Ning Tang: Hi, George, I come from a clinical laboratory in China. We met a confusing case today and want to get your suggestion: A patient had a prolonged prothrombin time (PT, 20s), partial thromboplastin time (APTT, PTT, 52s) and thrombin time (TT, 127s). Fibrinogen activity is within reference interval (by both Clauss method and […]

Bleeding Disorders

WFH Research RFP

The Word Federation of Hemophilia has just issued a research request for proposals. This is short notice, however, if you have a proposal, WFH will accept a letter of intent by August 31, 2013. Click WFH RFP for submission details.

Bleeding Disorders

FVIII Inhibitor Assays

From Saravanan Vinayagam: We are trying to set up the factor VIII inhibitor assay on our ACL TOP analysers. Has anyone got an SOP or previous experience in validating inhibitor assay in an automated analysers? Thank you. Hello, Saravanan Vinayagam, and thank you for your post. I’m hoping that an IL technical representative will see this […]

Bleeding Disorders

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

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 […]

Bleeding Disorders

Post-partum Hemorrhage and Component Therapy

Originally posted on October 11, 2011. Hi George! As always, I enjoy this educational resource very much! My question is: Why do healthy women who experience post-partum hemorrhage (PPH) seem to “autocorrect” their coagulopathy with very little help from component therapy? I have noted that once the bleeding site has been tended to, the patient […]

Bleeding Disorders

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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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