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Top Ten Problems: Please Download and Respond

I’m planning a presentation, “The Top Ten Problems in Coagulation Testing” for a scientific meeting in Seattle on October 14, 2011. Linked below are 13 problems I’ve thought of, in no particular order. Please rank each problem 1–5, 5 indicating your most critical. I’ll add your scores and produce a 10-1 rank order for my […]

Monitoring IV Unfractionated Heparin with the PTT

From “Berrylane:” If a patient is on IV heparin and a partial thromboplastin time (PTT, APTT) is ordered, what is the correct procedure for the blood draw? Hello, and thank you for your question. In accordance with Hirsh J, Bauer KA, Donati MB, et al. Parenteral anticoagulants. Chest 2008:133:141S–59S, dosing of unfractionated, standard IV heparin for […]

Quick Question Summary: Monitoring Dabigatran

Here is a summary of our July, 2011 Quick Question: Now that dabigatran (Pradaxa), the new oral direct thrombin inhibitor, is available, how do you intend to monitor it? a. Ecarin clotting time: 7 (13%) b. We will not monitor Pradaxa: 18 (32%) c. Partial thromboplastin time: 12 (21%) d. Stago Ecarin chromogenic assay: 7 […]

Venous Sinus Thrombosis in a 2-YO

I fielded a question from the ASCLS Consumer Information Forum last week. A mom asked about thrombosis risk factors in a 2-YO who had suffered a venous sinus thrombosis. Fortunately the child was treated and had no lasting effects, but do you know of any data that document anti-phospholipid antibody syndrome (lupus anticoagulant) in pediatric populations?

Anti-Factor VIIa Inhibitors?

Dr. Michael Steiner posted this question on the MedLab list last week, and with his permission, I am posting it here: Has the development of an inhibitor to factor VII ever been reported after therapy with recombinant coagulation factor VIIa (NovoSeven)? My provisional statement was “No, it has not…” PD Dr. med. Michael Steiner Medizinisches […]

Factor XII Deficiency and Infections?

From “Sunny:” Do people with factor XII (Hageman factor) deficiency suffer constant infection? Can you provide references? Hello and thank you for your question. No, there is no clinical relationship between coagulation factor XII deficiency and infections. Factor XII deficiency is relatively common; one study* reported a prevalence of 2% among normal subjects. Although factor […]

More on Discard Tubes

Hi George, I would like to know what other labs use for the discard tube when collecting coag samples? CLSI recommends non-additive or another coag tube. Thanks for all you do. Vicki Cardone, Hematology Supervisor Children’s Hospital, Birmingham, AL Hi, Vicki, nice to hear from you. Both BD and Greiner market plastic non-additive tubes; BD […]

How to Assay Factor II

Dear George, Thank you for the terrific, practical newsletter. It is a wonderful aid to those of us in clinical lab medicine. Question from the below newsletter: In the case from “nomorefede”, is the factor II level measured in-house? If so, what method is used? Thanks! Margie Peters, MD, Pathologist Methodist Hospital, San Antonio, TX […]

Monitoring Dabigatran (Pradaxa)

Monitor LMWH with PTT?

I thought that I should respond to the August 4

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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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