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Test Code DDIMV D-Dimer HS, Quantitative LAB2810

Important Note

Human anti-mouse antibodies (hama) may be present in samples from patients who have received immunotherapy or diagnostic procedures utilizing monoclonal antibodies or in individuals who have been regularly exposed to animals. Additionally, other heterophile antibodies, such as human anti-goat antibodies may be present in patient samples. Manufacturers formulate assays to minimize the effects of these antibodies; however careful evaluation of patient results must be done when patients are known to have such antibodies.

Test Method

Turbidimetric Immunoassay; ACL Systems, Beckman Coulter, IL APPT
SP

Specimen Requirement

Sodium citrate blue-top tube filled to the area within the
indicator arrow printed on the side of the tube.

Reference Values

< 500 ng/mL Fibrinogen Equivelant Units (FEU)

The D-Dimer cutoff value to use for exclusion of
DVT (deep vein thrombosis) and/or PE (pulmonary embolism) is 500
ng/dL..

Performance

Testing is performed Monday through Sunday.

Routine: Typically completed within 4 hours

STAT: Typically completed within 25 minutes after the specimen
arrives at the testing site.

CPT Code Information

85380 Coagulopathy Testing: Fibrin degradation products,
D-dimer; ultrasensitive, qualitative or semiquantitative

Useful For

Diagnosis of intravascular coagulation and fibrinolysis, also
known as disseminated intravascular coagulation, especially when
combined with clinical information and other laboratory test data
(eg, platelet count, assays of clottable fibrinogen and soluble
fibrin monomer complex, and clotting time assays-prothrombin time
and activated partial thromboplastin time).

Excluding the diagnosis of acute pulmonary embolism or deep vein
thrombosis, particularly when results of a sensitive D-dimer assay
are combined with clinical information, including pretest disease
probability.

Additional Specimen Collection Information

 

Invert the sodium citrate tube end to end 4 times to
thoroughly mix blood and anticoagulant. The tube should be left
stoppered until time of testing.

  • Specimen is stable up to 4 hours after collection if stored
    refrigerated or at room temperature and unopened.
  • If the testing is not completed within 4 hours:
  1. Remove the plasma from the cells and transfer to a plastic
    tube.
  2. Freeze the sample for up to two weeks.
  3. Frozen samples should be rapidly thawed at 37°C while
    gently mixed.
  4. Thawed samples should be centrifuged and tested
    immediately.
  5. If testing cannot be performed immediately the sample may be
    held for a maximum of 2 hours refrigerated, until tested.
  • Precautions:

    • It is not recommended to use a winged blood
      collection set (Butterfly).
    • If a vacuum tube butterfly must be used, the first tube in the
      series will be under-filled. Collect a “discard citrate
      tube”, and then collect the citrate tube used for testing.
      This will ensure the proper blood to anticoagulant ratio.
    • If using a syringe, use a BD Blood Transfer Device to transfer
      blood from the syringe to the citrate tube within one minute of
      collection. Hold the syringe with the plunger in the up-right
      position and allow the vacuum present to fill the tube. Before
      collection, be sure the syringe plunger is pushed to the top of the
      syringe. The transfer device may pop up and needs to be
      held down to completely fill tube to between fill
      lines.
    • Do not “force fill” blood into a vacuum tube. This
      may result in activation of the platelets possibly leading to
      erroneous results. Allow the vacuum present to fill the tube.
    • Do not remove vacuum tube cap to add blood.
    • Specimens should be obtained from a single venipuncture with
      minimal tissue trauma. Never combine multiple blood collections
      into a single vacuum tube.
    • Never re-use a syringe that was used for a pic line saline
      flush.

Refer to the “Citrated Plasma for Coagulation Studies” protocol
in the Quality Assurance Manual.