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Specimen Hemolysis and D-dimer Elevation

This question arrived January 8 from Twyla Bader MT (ASCP), Heme/Coag Supervisor at St. Joseph Hospital, Bellingham WA: We use Diagnostica Stago’s STA Compact analyzers and their LIA D-dimer reagent. Their package insert states there is no interference by hemolysis up to 5.0 g/L HGB. We did find a discrepancy between a hemolyzed sample and […]

StaClot-LA on ACL-TOP

Larry Smith at Memorial Sloan-Kettering asks, anyone out there running Stago’s Sta-Clot LAs on the ACL-TOPS instrument? Please respond here and to Larry [email protected].

Does the ACT Monitor Low Molecular Weight Heparin?

I received a question last Friday asking whether the activated clotting time assay (ACT) is affected by low molecular weight heparin such as Lovenox. Yes, but first… …For readers under forty, the ACT has been around for many years, and is based on an even older test I learned as the Lee-White clotting time. This […]

A Daunting Task: Validating 13 New Analyzers

Kim Kinney at Indiana University Medical Center (and Clarian) wrote: Hi George, We are about to validate our new Beckman Coulter coag equipment. We will have three TOP analyzers at our central lab and ten Elites at our beltways, north and west hospitals and our ED lab. We will have all 13 pieces of equipment here […]

Global Assays: Calibrated Automated Thrombogram (CAT)

I meant to mention in a previous post Stago-US is marketing a global hemostasis system called the Calibrated Automated Thrombogram (CAT) from Thermo Electron Corp. And another called ROTEM. I saw one of the CATs at the ASH meeting in Atlanta this past December… These instruments seem particularly popular among surgeons. Donna Castellone at Mt. […]

Hemolyzed, Lipemic, and Icteric Specimens

Kim Kinney of the Indiana University Medical Center (Clarian) lab writes: We are getting ready to switch from the BioMerieux MDA to the Beckman Coulter TOPS and I was wondering how labs are now handling specimens that are hemolyzed, lipemic, or icteric. We have had the MDAs for six years and I will miss their […]

Thromboelastography

Jerry Sapp, Blood Bank Supervisor at Birmingham’s respected Children’s Hospital of Alabama asks whether Thromboelastography would be of any use in monitoring the coagulopathy associated with massive transfusion. Thromboelastography (TEG) is a global in vitro hemostasis assay that analyzes whole blood clotting patterns for the management of coagulopathies and anthrombotic therapy. Various forms of the […]

Local ISI (or INR) Calibration

It seems strange North American coagulation laboratories have not adopted local ISI or INR calibration despite articles such as Poller L, Keown M, Ibrahim S, et al. Comparison of local International Sensitivity Index calibration and ‘direct INR’ methods in correction of locally reported International Normalized Ratios: an international study. J Thromb Haemost 2007;5:1002-9 and Adcock […]

More on Arixtra Monitoring

A post from Bryan McGill, PharmD at St. Mary’s Hospital in Madison, WI: We have a patient with a history of HIT, so we are using Arixtra 2.5 mg q24h for prophylaxis. Unfortunately the patient also has a CrCl hovering at 30mL/min, so I am worried that the drug may start to build up. Are […]

Checking for Clots

We check all citrate specimens for clots by probing them with applicator sticks before centrifugation. Is this common practice? Are there alternatives?

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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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