Hyperglycemia and Prolonged PTT

From “BJ:” I recently cared for a 60 yr old type 2 diabetic in hyperglycemic hyperosmolar state. Initial serum glucose 960. The partial thromboplastin time (PTT) was initially 78 seconds without clear reason. The international normalized ratio (INR) was 1.4. The prothrombin time (PT) was not initially checked. I felt that the value was likely […]

Comments (1)

Screening Assays

Nov 8 2013

george

More on Shortened PTT

From Anita Elledge, MT (ASCP), blood bank/coagulation supervisor, Sierra Vista Regional Health Center, AZ: Our coagulation testing is done on a Stago Compact instrument. The linear range is 20–200 s for the activated partial thromboplastin time (APTT, PTT). We have a policy that any PTT result <22 s must be redrawn, not just rerun the same sample, […]

Screening Assays

Pre-Surgical Screening

Prof. Jeanne Isabel, Medical Laboratory Science Program Director, Northern Illinois University, forwarded the following question, posted to the American Society for Clinical Laboratory Science Consumer Forum: “We run prothrombin time assays with international normalized ratios (PT/INRs) on most all patients pre-procedure regardless of whether they take Coumadin or heparin. I have done some research and this is the […]

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Anticoagulant Therapy

Sep 12 2013

george

Ferritin and Prolonged PT/PTT?

From Natalie Shorey, Stago, Inc. Regional Manager, Sydney, Australia: This clinical case & related question came from the scientists at St George Hospital, one of our teaching hospitals here in Sydney. It prompted some discussion when I put it to other scientists, withour coming to any conclusion so I thought I’d pose the question to you. A patient […]

Coagulation Factors

Sodium Citrate: 3.8%?

A contributor asks, “has sb reported shorter clotting times when using 3.8% (0.129M) sodium citrate tubes than 3.2% (0.109M) tubes? literature and the logic says the opposite.” Hello, and thank you for your question. I’m unsure of your reference to “sb,” however I agree that it is logical to presume that the 3.8% sodium citrate […]

Screening Assays

QQ: Pre-op Screens

A summary of our May, 2013 Quick Question with 57 respondents: Surgeons typically order pre-operative hemostasis screens. What assays are included in your pre-operative screen? a. PLT count, PT, PTT: 40 (69%) b. None, we don’t perform pre-op screen: 8 (14%) c. PLT count, PT, PTT, TT, fibrinogen: 5 (9%) d. PLT count, PT, PTT, […]

Screening Assays

New Quick Question: Preoperative Screens

George has joined a Laboratory Medicine Best Practices panel whose purpose is to review patterns of preoperative coagulation screening panel usage, in particular, preoperative prothrombin times (PT) and partial thromboplastin times (PTT). We are working on the premise that screening PTs and PTTs fail to consistently predict intraoperative hemorrhage in patients who possess no known coagulopathy, and […]

Screening Assays

ACT Testing Time Interval

Here is a question from my friend and colleague Kathleen Finnegan, MS MT (ASCP )SH, Chair of the CLS program at Stony Brook University, New York. This question was posted to the ASCLS Consumer Web Forum through Lab Tests Online: “In the procedure room setting (cardiac catheterization or EP lab) what is the standard length of time to wait to […]

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Anticoagulant Therapy

Mar 14 2013

george

No More PT in Seconds?

From Dr. Larry Brace, Edward Hospital, Naperville, IL: I need an opinion. Here is my view on prothrombin time (PT) in seconds. We should no longer have to do a normal range for the PT in seconds. We know that the general consensus is that the international normalized ratio (INR) is considered normal to at least 1.2 […]

Comments (6)

Anticoagulant Therapy

Mar 13 2013

george

Shortened PTT

Let’s highlight Marianne Thawley’s question that appears in a comment on the March 8 post, Rapid INR Rise in Pneumonia, “What are some causes for decreased PTT results.” In my experience, only technical artifacts shorten the partial thromboplastin time (PTT) to less than the lower limit of the reference interval. Artifacts could include partial activation of the coagulation […]

Comments (6)

Screening Assays

Screening Assays

Hyperglycemia and Prolonged PTT

More on Shortened PTT

Pre-Surgical Screening

Ferritin and Prolonged PT/PTT?

Sodium Citrate: 3.8%?

QQ: Pre-op Screens

New Quick Question: Preoperative Screens

ACT Testing Time Interval

No More PT in Seconds?

Shortened PTT

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question