Fibrinolysis

TXA in DIC

A colleague asks what people are doing in regards to the antifibrinolytic TXA use in patients with DIC who are massively hemorrhaging. George has found a number of articles describing the efficacy of tranexamic acid and epsilon-amino-caproic acid in treating post-partum hemorrhage, which is close, but nothing directly recording TXA in DIC. If you have […]

Dr. John Olson on D-dimer Vs FDP

Hello George, Good to hear from you. I hope that all is well with you. Greet the folks at Precision the next time you see them. There are a number of questions that would be good to raise. For example, for what clinical situations are the OB docs using FSP? It cannot, of course, be used […]

D-dimer versus FDP

From Anne Gaffney: Hi George, we would like to discontinue our fibrin degradation products (FDP, fibrin split products, FSP) latex agglutination testing, however the OB docs like to use the less sensitive test as the D-dimer test is “always” positive in their pregnant patients. Do you have any evidence based literature to help us support […]

August Quick Question: Fibrinolysis

Here are the results of our August, 2017 Quick Question with 68 total votes: How do you test for fibrinolysis? a. TEG or TEM: 9 (13%) b. D-dimer: 36 (53%) c. Plasminogen: 0 (0%) d. PAI-1: 1 (1%) e. D-dimer plus plasminogen: 10 (15%) f. D-dimer, plasminogen, and PAI-1: 6 (9%) f. We don’t test […]

Unable to Obtain Dimer Result on Xarelto

From Heather DeVries, Indiana University Health. Hi George! We use the DDHS kit from IL on our TOP series instruments. There is a cancer patient at one of our facilities who has not been able to get a dimer result while on Xarelto. From the error codes, it looks like it would be human anti-mouse […]

Anticoagulant Therapy

D-dimer AMR and CRR

From Heather DeVries, Indiana University: Greetings George! The labs within our system have been discussing our reportable range for D-dimers. Our vendor’s stated limit is beyond what calculates from our AMR and maximum dilution. We are debating changing our reportable range to what we calculate, and stop using the vendor’s limit so that we truly […]

D-dimer Interference

With reference to our September 8, 2016 discussion entitled Still More on Xarelto and D-dimer, attached is information on another individual with whom I have been corresponding for several months whose D-dimer remains moderately to markedly elevated but whose lab results have demonstrated there is no human anti-mouse antibody or rheumatoid factor present. This person, […]

Still More on Xarelto and D-dimer

Here is further follow-up on our April 13 discussion entitled Xarelto and D-dimer (click or tap). In summary, a patient who was on Xarelto had markedly elevated D-dimer results reported by the laboratory where the patient was being treated, but normal D-dimer results when tested at two other laboratories using alternate technologies. George has since […]

More on Xarelto and D-dimer

Dr. Jeanine Walenga, Clinical Coagulation Laboratory Director at Loyola University Medical Center added a helpful comment to our April 13, 2016 discussion about Xarelto and D-dimer. Click here to see the discussion and her comment.

Anticoagulant Therapy

D-dimer Questionnaire

Remember that D-dimer questionnaire link that we asked you to post on Fritsma Factor in early November of 2014?: https://docs.google.com/forms/d/1IVMqgIsZRN_rqbv2PdhPoerRB6UERXdEuCi0Czr-7m0/viewform?usp=send_form. Well, we had a look at the responses and greater than 90% have come from Europe/Australia. Seems that North Americans don’t do D-dimers! We are keeping the link open indefinitely. It would be good to […]

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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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