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I received an upbeat note from Dean Willett at Instrumentation Laboratory (IL) describing their ACL AcuStar specialty testing instrument, which provides an automated D-dimer immunoassay with a 30-minute dwell time, broad linearity, and a 60 specimen/h throughput.
Dean’s comment led me to reflect on the history of D-dimer methodology and to develop a quick review on what is currently available.
Fibrinolysis | George Fritsma | 
February 9, 2013 7:56 am | 
Comments (1)
From friend and colleague, Kirk Guyer: How would you monitor fibrinolysis to determine when to administer tranexamic acid (Cyklokapron)? I know there are the traditional tests like serial fibrinogens, thrombin time, thromboelastograph (TEG) and reptilase time but do you know of any new tests that are becoming popular?
Fibrinolysis | George Fritsma | January 30, 2013 7:38 am | Comments (1)
Question re-published from December 28, 2011 in an attempt to attract responses.
The December, 2011 issue of Clinical Laboratory News has a concise article describing the role of D-dimer in diagnosing pulmonary embolism. A lot has been written about the value of the D-dimer in ruling out venous thromboembolic disease in patients who have a low pre-test probability of a thrombus. Conversely, you see little about the use of the D-dimer for monitoring DIC. Of course, the results in DIC are extreme, often exceeding 10,000 ug/mL, but we have no limit that defines DIC nor is there any apparent value in following D-dimer results to define DIC resolution. I’d like to get some comments on this, do you routinely use D-dimer to follow DIC?
Fibrinolysis | George Fritsma | January 16, 2013 9:21 am | Comments (3)
From Joanna Carroll, MT (ASCP), North Carolina State University College of Veterinary Medicine. We are running automated D-dimers and recently got a result of 0.00 ng/mL. Have you seen a value reported this low? Would it be better to report out the number as less than our lower limit of the reference range? Thanks for your help.
Fibrinolysis | George Fritsma | December 5, 2012 8:53 am | Comments (0)
Thank you to all who attended George’s presentation, Case Studies in Antithrombotic Therapy, made on Friday, October 12 at the Quest Diagnostics Case-oriented Symposium on Bleeding and Thrombosis in Crystal City, VA, near Washington, DC. As promised, here is my presentation in 6-per-page handout format. Please click the link and feel free to download the file.
Anticoagulant Therapy, Events, Fibrinolysis | George Fritsma | October 15, 2012 6:49 am | Comments (0)
From FD Patel, MD: I had a patient here who was tested for both FDP and D-dimer. Her D-dimer was mildly elevated at 0.79 but her fibrin degradation products (FDP) assay result was undetectable. Since the D-dimer is a type of fibrin split product, how can you explain this discrepancy? I’m thinking it has something to do with what each test measures, but would like to be sure. thank you.
Fibrinolysis | George Fritsma | October 3, 2012 3:37 pm | Comments (0)
A colleague contact me on August 24 about a relative who is an inpatient and is experiencing a pleural effusion subsequent to a MRSA infection. The MRSA has been treated and is resolved, but the effusion is mucinous and drains slowly. The surgeon was planning to use recombinant tissue plasminogen activator (TPA, Alteplase) to liquify the fluid. This was new to me, but is apparently a technique that is used from time to time, as indicated by the attached Cochrane Database metaanlysis (see link at end) describing the use of streptokinase and urokinase.
Fibrinolysis | George Fritsma | August 27, 2012 3:35 am | Comments (0)
I had the opportunity to become reacquainted with Jennifer Jacobsen, MLS (ASCP), Allina Health Laboratories, Minneapolis, while attending the Mayo Laboratories Coagulation Testing Quality conference in Rochester, Minnesota August 7–10. Jennifer has this question about specimen management on patients being treated with tissue plasminogen activator (TPA, Activase®, Alteplase®):
Fibrinolysis, Specimen Management | George Fritsma | August 14, 2012 9:07 am | Comments (0)
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