Quick Question Archive

June, 2022 Quick Question Summary: VET Instruments

Our June 2022 Quick Question asked, “What viscoelastometry [VET] equipment is employed in your ER or OR?” Out total response was 22 participants. Answers: Thromboelastograph 5000 [TEG]: 18% [4] Thromboelastograph 6S [TEG]: 18% [4] Thromboelastometry [ROTEM]: 23% [5] Quantra Qplus: 0 Sienco Sonoclot: 0 Our lab doesn’t manage VET testing: 41% [9] At the June […]

Global Hemostasis Assays

May 2022 QQ: Thrombosis Risk Profile Summary

We had near-100% agreement on our May 2022 Quick Question, which attracted 45 voters: “What assay should be deleted from the thrombosis risk factor profile?” Here are our selections: Protein C 0% Protein S 2% [1] Antithrombin 2% [1] Activated protein C resistance 7% [3] Prothrombin G20210A mutation 4% [2] Methylenetetrahydrofolate reductase resistance [MTHFR] polymorphism […]

Quick Question Archive

May 2022 QQ: Thrombosis Risk Profile

Our May 2022 Quick Question asks, “What assay should be deleted from the thrombosis risk factor profile?” Thrombosis risk testing has been available to us since von Kaulla first described “antithrombin 3” deficiency in 1972 using the “serum antithrombin” test. It gained momentum when Dahlbach described activated protein C resistance in 1994, and thrombosis risk […]

Quick Question Archive

April 2022 QQ: Measuring Heparin Summary

Hello, our April 2022 Quick Question asks, “How do you measure unfractionated heparin [UFH]?” Our 37 respondents answered… Chromogenic anti-Xa using a hybrid curve: 38% [14] Chromogenic anti-Xa using the UFH curve: 14% [5] Anti-Xa and PTT: 22% [8] PTT: 26% [9] The majority of respondents are using the chromogenic anti-Xa heparin assay, and most […]

Anticoagulant Therapy

April 2022 QQ: Measuring Heparin

Our April 2022 Quick Question reprises our May 16, 2012 post, “Who Uses the Hybrid Curve?” but adds a twist based on May JE, Siniard RD, Taylor LJ, Marques MB, Gangaraju R. From activated partial thromboplastin time to anti-factor Xa and back again; the evolution of monitoring unfractionated heparin. Am J Clin Pathol 2022;157:321–7 HTTPS://DOI.ORG/10.1093/AJCP/AQAB135. […]

Anticoagulant Therapy

March 2022 Quick Question Summary

The stem of our March 2022 Quick Question was, “How do you measure the anti-Xa DOACs rivaroxaban or apixaban?” The question drew 33 responses and here are the answer selections: We don’t measure the anti-Xa DOACs: 24% [8] Chromogenic anti-Xa using DOAC-specific calibrators and controls: 64% [21] Chromogenic anti-Xa using the unfractionated heparin curve: 3% […]

Anticoagulant Therapy

March 2022 Quick Question: Measuring Anti-Xa DOACs

Please review and answer our March 2022 Quick Question, submitted by colleague and coagulation expert Dave McGlasson. Although the US FDA has never approved the chromogenic anti-Xa assay for the direct oral anticoagulants rivaroxaban and apixaban, calibrators and controls are available from several distributors. Many facilities are called upon to assay for plasma concentration in […]

Anticoagulant Therapy

February, 2022 QQ Response: Platelet Aggs

Thanks to our 57 FF participants for your responses to our February 2022 Quick Question. The question stem was: “What single agonist is your first choice to measure platelet response to aspirin?” ADP: 14% [8] TRAP: 2% [1] Collagen: 2% [1] Epinephrine: 28% [16] Arachidonic acid: 54% [31] Although this question is a poll, my […]

Arterial Thrombosis

February, 2022 Quick Question: Platelet Aggs

Our February 2022 Quick Question asks, What single agonist is your first choice to measure platelet response to aspirin? The typical aggregation profile includes several agonists, however it may be that one is more sensitive to aspirin’s antiplatelet effect than the others. As always, please add your comments below.

Antiplatelet Therapy

January 2022 Quick Question: Case Study

We had 58 responses to our January 2022 Quick Question. The stem asked, “A patient experiences soft tissue bleeding and poor wound healing. The PT, PTT, and TT are normal. What follow-up profile do you recommend? Factors VIII, IX, & XI assays: 10% [6] PAI-1 & D-dimer assays: 0 Thrombosis risk profile: 2% [1] Platelet […]

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

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