From our frequent contributor, Kim Kinney at Indiana University Health Pathology Laboratory: Merry Christmas all! George, this may be an old topic, but I am getting some push back from our off-site coordinators. Coagulation samples sent on ice: I have always thought that the current literature stated that iced coag tubes could activate factor VII and potentially shorten the prothrombin time (PT). Is there current literature out there surrounding this topic? Any information would be helpful!
A quick note from Madan Verma: “Is there any thing such as a “vitamin agonist” and does it some how mimic factor VII deficiency? All these years I’ve read about vitamin K antagonists (VKA) but not agonists. I came across this word while reviewing a factor VII assay done by a reference lab.”
- At what INR would they repeat the point of care (POC) prothrombin time and international normalized ratio (PT/INR)?
- At what INR would they do a central laboratory (plasma-based) INR to confirm the POC INR?
- Regarding the correlation between CoaguChek INR and central lab (plasma-based) INR how much does the reagent source of lab INR affect the results. Roche use a recombinant thromboplastin.
The Heart.org is now part of Medscape. Here’s a December 5, 2013 announcement: ‘New’ Oral Anticoagulant Stroke-Protection Benefits in AF Cut Across Subgroups in Meta-Analysis. This is a summary of Ruff CT, Giugliano RP, Braunwald E. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2013; DOI: 10.1016/S0140-6736(13)62343-0 that documents the relative safety and efficacy of all the new direct oral anticoagulants (DOACs). Geo
With thanks for notification from Elaine Benoit, your North American Specialized Coagulation Laboratory Association (NASCOLA) November Newsletter is attached, Among many noteworthy articles, the NASCOLA newsletter features a description of Fritsma Factor. Thanks to NASCOLA for featuring us and to Precision BioLogic Inc for hosting The Fritsma Factor since 2007!
From Meg Hardin. George, The surgical services in our hospital are requesting that we look into purchasing the Thromboelastograph (TEG) or Rotational Thromboelastometry System (ROTEM) in order to decrease blood utilization. TEG representatives tell surgical services that they can receive results with in 2 minutes of the blood being placed on the analyzer. I know nothing (except what I read) about these analyzers and was wondering if any of your readers who use TEG or ROTEM could give me some information? I thank everyone in advance for their time with this question.
With a thanks for the heads-up to Elaine Benoit, Precision BioLogic Inc, here is a fascinating retrospective on Hemophilia testing, Barrowcliffe TW, Laboratory testing and standardisation. Haemophilia 2013;19:799–804, in the November, 2013 edition of the Journal, Haemophilia, publication of the World Federation of Haemophilia. Click here for the article: