Global Hemostasis Assays

September 2021 Quick Question: TEG

Our September 2021 Quick Question attracted only 14 responses, perhaps reflecting the minimal communication between the central laboratory and the anesthesiology service in most operating rooms. Our question was “What is the favorite near-patient viscoelastic test of US anesthesiologists?” Here are your answers: Rotational thromboelastometry [ROTEM]: 14% [2] Resonance sonorheometry [Quantra]: 7% [1] Activated clotting […]

Global Hemostasis Assays

Dilute Thrombin Time

From Deanna Miller, Children’s Hospital of Alabama. Do you have any good references for diluted thrombin and utilization of this test? What dilution is best? 1:1 or 1:3? Hello, Deanna, and thank you for your question. We use the plasma-diluted thrombin time to measure the direct thrombin inhibitors [DTIs] dabigatran, argatroban, or bivalirudin. The assay […]

Anticoagulant Therapy

Covid-Coag Conversation 9-15-20

You are invited to our Tuesday, September 15, 2020 webinar, Covid-Associated Coagulopathy: A Conversation about the Controversies and Confusion featuring pathology expert Andrew J. Goodwin, MD, University of Vermont Medical Center Laboratory Director. Click https://conta.cc/3aMDoNp for the eblast or bit.ly/COVID-Coag to go directly to the registration page. Covid-Coag is a PACE-accredited one-hour presentation, 5–6 PM […]

Arterial Thrombosis

Effect of Fibrinogen on PT and PTT

From Alan Neal, Pathlab, NZ. Just wanted a private conversation about the January 11, 2018 Fritsma Factor entry, “POC and Plasma-Based PT/INRs.” I do not agree with the comments made within this article and challenge the logic used. Essentially, if monitoring an enzymatic pathway such as coagulation, with the ‘detector’ being used is fibrinogen to […]

Global Hemostasis Assays

Medical Decision Points

Odetta Hanna from Sekisui Diagnostics asked, “Do you have a good resource to obtain the medical decision points for coagulation assays?” From George, yes, the text I find most helpful for clinical decision-making is Kitchens CS, Kessler CM, Konkie BA. Consultative Hemostasis and Thrombosis, Third Edition, 2013, Elsevier, Philadelphia. Also, if you pardon the self-promotion, […]

Global Hemostasis Assays

What is SEER Sonorheometry?

A colleague saw our January 10, 2017 entry describing T2MR, an emerging global hemostasis methodology, and responded with information about sonic estimation of elasticity via resonance (SEER) sonorheometry, a non-contact technology that employs ultrasound to measure whole blood parameters similar to the viscoelasticity data generated in thromboelastography (TEG) and thromboelastometry (TEM). The technology measures acoustic […]

Global Hemostasis Assays

What is T2MR?

You may be hearing about the emerging diagnostic nanotechnology, T2 Magnetic Resonance (T2MR). Here is a summary of this intriguing new methodology that promises to revolutionize hemostasis testing. T2MR instruments are point of care devices that employ a permanent magnet assembly, radiofrequency probe, and a recording mechanism that measures the spin-spin (T2) relaxation times of […]

Global Hemostasis Assays

IL Acquires ROTEM

Mr. Dean Willett, Precision BioLogic Inc. Director of Marketing and Business Development passed along the news that Instrumentation Laboratory, Inc, (IL) a Werfen company, today acquired CA Casyso AG (Basel, Switzerland) and its Tem subsidiaries (Tem), manufacturer of the ROTEM Delta and ROTEM Sigma rotational thromboelastometry instruments. Click or tap here for IL‘s press release.

Endothelial Barrier Dysfunction

From Suzanne Gorenfeld: Dear Mr. Fritsma, Are there currently in use any tests to monitor endothelial barrier function during and immediately after surgery? Thank you for your very informative site. Kind regards, Suzanne. Hello, Suzanne, and thank you for your question. This is new territory for me, so I will be looking for help from some of our participants. Meanwhile endothelial barrier […]

Global Hemostasis Assays

Correcting for Hypothermia

From Carla Purvis, MT (ASCP) SH, Parkview Regional Medical Center in Fort Wayne: Hi, George. We have acute care clinicians requesting temperature correction for prothrombin time results for patients who have clinically induced hypothermia. CAP standards state prothrombin times must be performed at 37C. Do you have any references for performing temperature corrections? Thanks. Hi, […]

Bleeding Disorders

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

Cheat Sheets from George

Quick Question