Global Hemostasis Assays

Shortened PTT

Hendrik Orman asks, “We are seeing more low aPPT results (less then 20) from ER, same with the redraw. Today, we gad 18.9 with repeat 15.3. Is there anything like medication etc. that might cause this?” Thanks. Hello, Hendrik, and thank you for your question. I’ll refer you to a recent series of posts and […]

Global Hemostasis Assays

Unexplained Elevated D-dimer

From Tony Tang: Dear George, recently we met a 1 year old child with serious hepatitis, the results of coagulation tests were as follows: PT: 26s, APTT: 56s, FIB: 1.07 g/L, TT: 23s, D-dimer: greater than 80 ug/mL FEU, FDP: greater than 360 ug/mL, AT-III: 54%, factor VIII: 212%, PLT count: 102 X 109/L (and […]

TEG or ROTEM

From Meg Hardin. George, The surgical services in our hospital are requesting that we look into purchasing the Thromboelastograph (TEG) or Rotational Thromboelastometry System (ROTEM) in order to decrease blood utilization. TEG representatives tell surgical services that they can receive results with in 2 minutes of the blood being placed on the analyzer. I know nothing (except what I read) […]

Anticoagulant Therapy

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

Bleeding After CABG: Heparin?

Here is a puzzling case sent by Crystal Azevedo: Hi George! I have a question for you from one of my pathologists. 24 hours after an uneventful coronary bypass procedure a 51 kg patient developed acute hemorrhage. A post-protamine thromboelastogram (TEG) on the day of surgery was completely normal. At the time bleeding occurred, the patient […]

Anticoagulant Therapy

How Are You Using the TEG?

From Kim Kinney at IU Health (formerly Clarian): Hi George. I am trying to collect as much information from Thromboelastograph® (TEG) users as possible. We are in the process of validation to support the Berlin Heart transplant for our pediatric population. I am wondering what other sites use TEG for, who runs the samples, who interprets and what results are entered into […]

Global Hemostasis Assays

Participant Poll: Who Uses TEG?

From Kim Kinney at Indiana University Medical Center (IU Health): Hi George. We are being asked to make the thromboelastograph (TEG) available in our special coag lab for clinical use. I am curious to poll others regarding the use of TEG, who is running the test, who is interpreting the results, etc. We have had the TEG available […]

Global Hemostasis Assays

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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.

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