No special patient preparations are necessary.

Tube type:

One 5.0 mL 3.2% sodium citrate (Light Blue) tube or

One 3.0 mL 3.2% sodium citrate (Light Blue) tube or

Special 2.0 mL 3.2% sodium citrate (Light Blue) tubes are available for nursery patients or difficult draws.

Also acceptable: Two 0.5 mL aliquots, frozen, platelet poor citrated plasma minimum.

     
Collection Details:

Labeling:

• Specimen must be labeled with patient name, hospital number, date &  time collected and name of person who collected specimen.

Centrifuge at 2500 RPM for 20 minutes.

If specimen can not be tested within 4 hours, remove plasma from cells after centrifuging. Aliquot two 0.5 mL aliquots of platelet poor citrated plasma into two clean tubes. Freeze plasma.

Clotted or grossly hemolyzed samples.

Short draws or overfilled draws.

Regional Pathology Services Transport Information:
If sample not transported to the lab within 4 hours, see procedure below. Transport plasma frozen.Procedure: To produce platelet poor citrated plasma. Specimens should not become warm during centrifugation. Centrifuge: 1500-2000 Gs. For 20 minutes. The centrifugation time and speed must be determined for each centrifuge. Platelet count on the platelet poor citrated plasma must be <10,000/uL. Double centrifugation is needed for slower centrifuges. Inspect each tube for hemolysis or lipemia. Do not use sticks to check for clots until the plasma has been removed. With plastic transfer pipette, remove 3/4 of the plasma. Do not disturb the plasma near the red cells. Pipet from the top of the plasma portion. Place plasma into plastic tubes. Examine remaining cells for for clots. Cap and freeze the plasma immediately. Label the tube with patient name and indicate 'platelet poor citrated plasma'. Mimimum of 0.5 mL per aliquot. Two aliquots per coagulation assay should be sufficient. Refer to individual test listing. Double centrifugation for slower centrifuges: Recentrifuge the plasma from the first centrifugation for 20 minutes. Remove the top 3/4 of plasma and place into plastic tube with cap. Perform platelet count, if possible. Repeat step until platelet count is <10,000 /uL. Cap and freeze the plasma immediately. Label the tube with patient name and indicate 'platelet poor citrated plasma'. Mimimum of 0.5 mL per aliquot. Two aliquots per coagulation assay should be sufficient.

Notes: Description: The specific degratation of fibrin (i.e. fibrinolysis) is the reactive mechanism responding to the formation of fibrin. Plasmin is the fibrinolytic enzyme derived from inactive plasminogen. Plasminogen is converted into plasmin by plasminogen activators. The main plasmingen activators are tissue plasminogen activator (tPA) and pro-urokinase which is activated into urokinase (UK) by, among others, the contact system of coagulation. In the blood stream, plasmin is rapidly and specifically neutralized by alpha 2-antiplasmin, thereby restricting its fibrinogenolyic activity and localizes the fibrinolysis on the fibrin clot. On the fibrin clot plasmin degrades fibrin into various products, (i.e. D-Dimers). Antibodies specific for these products, which do not recognize fibrinogen, have been developed. The presence of these various fibrin degradation products (FDPs), among which D-Dimer is the terminal product, is the proof that the fibrinolytic system is in action in response to coagulation activation.
Clinical applications for this test are as follows: Disseminated Intravascular Coagulation (DIC), negative predictor for the thrombotic episode and screen for possible reoccurence (MI) and screen for other activation states of coagulation (i.e. post-operative, cancer and cirrhosis).

Storage:

Room temperature for 4 hours

Refrigerator temperature for 0-4 hours

Freezer temperature for 2 weeks.

If specimen can not be tested within 4 hours, prepare platelet poor citrated plasma and freeze plasma in two 0.5 mL aliquots.

Hematology.
Daily, routine and STAT.

Clinical applications for this test are as follows: Disseminated Intravascular Coagulation (DIC), negative predictor for the diagnosis of a thrombotic episode (i.e. DVT,PE), efficacy of treatment for a thrombotic episode and screen for possible reoccurrence (MI), and screen for other activation states of coagulation (i.e. postoperative, cancer , cirrhosis).

Description: The specific degratation of fibrin (i.e. fibrinolysis) is the reactive mechanism responding to the formation of fibrin. Plasmin is the fibrinolytic enzyme derived from inactive plasminogen. Plasminogen is converted into plasmin by plasminogen activators. The main plasmingen activators are tissue plasminogen activator (tPA) and pro-urokinase which is activated into urokinase (UK) by, among others, the contact system of coagulation. In the blood stream, plasmin is rapidly and specifically neutralized by alpha 2-antiplasmin, thereby restricting its fibrinogenolyic activity and localizes the fibrinolysis on the fibrin clot. On the fibrin clot plasmin degrades fibrin into various products, (i.e. D-Dimers). Antibodies specific for these products, which do not recognize fibrinogen, have been developed. The presence of these various fibrin degradation products (FDPs), among which D-Dimer is the terminal product, is the proof that the fibrinolytic system is in action in response to coagulation activation.

Hematology.
Daily, routine and STAT.

Main Lab:  Instrumentation Laboratory ACL Top 500

Oakview:  Instrumentation Laboratory ACL Top 300

Bellevue:  Instrumentation Laboratory ACL Top 500/300

Results same day.

STAT results within 1 hour.

Routine results within 2 hours

Main Lab, Oakview Lab, and Bellevue lab: Normal = <500 ng/ml FEU

Grand Island lab only: Normal = <230 ng/ml D-DU

(FEU = Fibrinogen Equivalent Units)