I received a message from Eric Hardy, a 1990s graduate of our University of Alabama at Birmingham CLS program and now a physician assistant practicing in the area. A McNeil Labs representative was advocating for one of the new oral anti-Xa anticoagulants . I have seen no announcement nor ads indicating any of the new oral drugs have been released for the US market. What is their current status?
A question from Bruce King at Lancaster General:
I was wondering about the practicality of adding a test for factor VIII inhibitors in our community hospital setting. Although we don’t get many requests for it, it appears that when you get a request for a factor VIII inhibitor in a non-hemophilia patient, there is a significant degree of urgency in getting rapid results. Our current reference laboratory performing this test has a TAT of about a week which is less than ideal for a more urgent clinical need for this information. We currently do some more manual coagulation methods such as inhibitor screens with 50:50 mixes and incubation phases. Are there community hospitals doing this test and how did you go about setting it up and running it? Any assistance is most appreciated. Read more »
Back on February 14, Ann Tidwell posted a question on delta checks. Steve Duff at Precision BioLogic alerted us to a simultaneous critical values initiative.The North American Specialized Coagulation Laboratory Association (NASCOLA) has sent the following message…
Dear Members,
The newly formed Critical Values Committee is conducting a survey of current practices in the definition and use of critical values in hemostasis and thrombosis. Please access this important survey via the following link:
http://www.surveymonkey.com/s.aspx?sm=Gda9nqnv7S8uIQLhZ2NFrg_3d_3d
For your convenience, we have also attached a pdf document of the complete survey to assist in gathering data needed to complete the questions.
NASCOLA Critical Values Survey PDF
Thank you for your input. The results of the survey will be shared with the North American Specialized Coagulation Laboratory Association (NASCOLA) members.
NASCOLA Critical Values Committee
Dr. Menaka Pai, Chair
The most recent large validation cohort study that supports screening for CYP2C9 and VKORC1 polymorphisms to assist in estimating warfarin dosage is available at The International Warfarin Pharmacogenetics Consortion: Estimation of the warfarin dose with clinical and phamacogenetic data. NEJM 2009; 360: 753-764. Geo
Another good one from Kim Kinney at Clarian:
Hi George,
I have a question regarding cold agglutinins and clotting coag samples. I have heard from one of our sites that specimens from someone with a cold agglutinin will clot in citrate tubes. In order to get a good sample the tubes and the blood must be heated to 37 degrees…I have not heard of this. Any opinions out there??
(Kim, I assume this means the blood is collected and maintained at 37 degrees until separation, right?) Geo
From C. Jordan:
Does anyone have a weight-based nomogram for continuous IV unfractionated heparin (UFH) infusion when the anti-Xa assay is used for monitoring instead of the PTT?
Partial answer… Read more »
Please respond to the quick question posted 2-19-09 on prothrombin time delta checks. Our question system does not provide for an open-ended response, but in addition to choosing the reporting format, we would like to compute the average delta check range. Please report your range as a response to this posting, thank you. Geo
Here are the results of our 2-16-2009 D-dimer assay question:
“What method do you use to measure D-dimer for the purpose of ruling out deep venous thrombosis or pulmonary embolism?”
Answers… Read more »
Anticoagulant Therapy | GeorgeFritsma | 
February 26, 2009 1:03 pm | 
Comments (0) 
Subscribe