Instrumentation

DIC and Hemolysis

Anne D’ Agostino asks, “Should we reject hemolyzed samples from someone in DIC?” The simple answer is “do not reject,” because the hemolysis is likely intravascular, reflecting DIC‘s microangiopathic hemolytic anemia [MAHA]. But to elaborate, there’s no foolproof way to differentiate intravascular [in vivo] hemolysis from spurious [in vitro] hemolysis, the consequence of specimen collection […]

Bleeding Disorders

Poster: a Handheld Fibrinogen Assay Device

The qLab FIB is a recently introduced handheld point-of-care device that returns a fibrinogen result within ten minutes using a single drop of citrated whole blood.

OR Hemostasis Presentation

I [Geo] will present “Hemostasis in the Operating Room” at the American Society for Clinical Laboratory Sciences Joint Annual Meeting in Grand Rapids, Michigan, Wednesday, tomorrow, June 29, 1:45–2:45 EDT. The “JAM” will be a hybrid meeting, so presentations will be available on-site or online. My talk covers anticoagulation and coagulopathy management and features the […]

Global Hemostasis Assays

Factor IX Assay Unexpected Results

Mike Meyer asks, “we run three dilutions for all of our factor testing. Occasionally, we see results in which upon higher dilutions, the factor value decreases after adjusting for the dilution. For instance, I had a case today in which the FIX values were 0.64, 0.55, and 0.43 U/mL for the 1:10, 1:20, and 1:40 […]

Bleeding Disorders

CoaguCheck Test Strip Recall

Thanks to Ali Sadeghi-Khomami PhD, Precision BioLogic, and Joan Polancic, MS MLS, Denver Health, for the heads-up on this announcemment: Roche Diagnostics, the manufacturer of CoaguChek meters and test strips, is recalling the CoaguChek XS PT Test Strips due to inaccurate INR test results, when compared to laboratory results. Roche re-calibrated the CoaguChek XS PT […]

Anticoagulant Therapy

Effect of HCT on POC INR

George received this question from the ASCLS Consumer Web Forum via Bonnie Jo Taylor, MHS, MT(ASCP)SH. I have hemochromatosis, too much iron in my blood. I’ve also had blood clots in my lungs. I peroidically undergo phlebotomy treatments to lower iron count. Will this alter the results of my INR finger prick test results? Here […]

Anticoagulant Therapy

FDA Registration

I’m posting this message at the request of a colleague. “George, I’m told by one of my suppliers that their products are US FDA registered. Does this mean the FDA endorses the company and its products?” Thank you for your question. FDA terminology may sometimes be complex and has perhaps confused your supplier’s representative. The […]

Instrumentation

Yet More on Promacta

This is from friend and colleague, Dean Willett, Instrumentation Laboratory: Hi, George; A few points to consider… There are two potential sources of interference here: biochemical and optical. Much like hemolysis, if the sample contains biochemical interference, results will be affected regardless of detection method. In the absence of any data it’s not clear if this drug […]

Bleeding Disorders

More on Promacta

From my friend Ali Sadeghi-Khomami, PhD, Precision Biologic Inc: Eltrombopag is a diazo derived compound that acts like pH indicators, i. e., it changes colour at different concentrations of hydronium ions. Thus it is expected that it interferes with chromogenic assays such as the bilirubin assay, especially when assay calibration will not match the colour of the testing sample. […]

Bleeding Disorders

Resource to Compare Analyzers

From Stephanie Morgan: We are comparing analyzers that perform factor assays, platelet studies, thrombosis testing, and other specialty testing while remaining cost efficient. Where would be the best resource to compare analyzers in each category? Thank you. Hello, Stephanie, and thank you for your question. Your best resource is the College of American Pathologists’ CAP Today Product […]

Instrumentation

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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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