Fibrinogen Level

Overview

  • EPIC Code:
  • LAB314
  • Soft Test Code:
  • FIBR
Clinical Significance

Decreased fibrinogen levels are associated with increased bleeding tendencies. Increased fibrinogen levels are a risk factor for thrombotic complications.


Specimen Collection & Preparation

Test Notes

It is recommended that an additional blue top tube be drawn for FIBR when other Coagulation testing is ordered.


Specimen Overview

Whole blood is the preferred specimen. If testing will not be performed within 24 hours, the whole blood must be spun to aquire a Platelet Poor Plasma (PPP) specimen before submitting to the testing laboratory. If blue tube is spun for other testing, pull off the plasma to send to PRMC for remaining tests.

Specimen Requirements:

-OR-

2.7 mL Whole Blood in a Blue Top Tube - 3.2% Buffered Sodium Citrate
Minimum Volume:
1.8 mL Whole Blood in a Clear Blue Top Tube*

* This volume does not allow for repeat testing

Collection Instructions:

Specimens must be filled appropriately see this example

Correct ratio of Blood to Citrate is critical (9:1). Specimens must be filled within +/- 10% of stated volume.

If a Blue Top Tube is collected utilizing a butterfly, a Blue Discard Tube must be drawn first to remove air from the line. If this is not done, the Blue Top Tube will not be filled properly due to the vacuum in tube and a redraw will be required

Note:

Collection of blood for coagulation testing through intravenous lines that have been previously flushed with heparin should be avoided, if possible. 
If the blood must be drawn through an indwelling catheter, possible heparin contamination and specimen dilution should be considered. 
When obtaining specimen from indwelling lines that may contain heparin, the line should be flushed with 5mL of saline, and the first 5 mL of blood or 6-times the line volume (dead space volume of the catheter) be drawn off and discarded before the coagulation tube is filled. For those samples collected from a normal saline lock (capped off venous port) twice the dead space volume of the catheter and extension set should be discarded.


Rejection Criteria:

Clotted samples

Improperly filled tubes (under or overfilled)

Wrong anticoagulant (3.8% sodium citrate is NOT acceptable)

Patients with hematocrit (HCT) >55% (red cell volume is >1/2 tube volume)

Hemolyzed samples

DO NOT freeze in a frost-free freezer

Stability time exceeded


Transport and Storage:
  • Ambient (18-24°C): 24 Hours

    Centrifuged or unspun specimens

    Must be tested within 24 hours

    Preferred specimen

-OR-

1.0 mL Platelet Poor Plasma from a Blue Top Tube - 3.2% Buffered Sodium Citrate in a Plastic Vial
Minimum Volume:
1.8 mL Whole Blood in a Clear Blue Top Tube*

* This volume does not allow for repeat testing

Collection Instructions:

Specimens must be filled appropriately see this example

Correct ratio of Blood to Citrate is critical (9:1). Specimens must be filled within +/- 10% of stated volume.

If a Blue Top Tube is collected utilizing a butterfly, a Blue Discard Tube must be drawn first to remove air from the line. If this is not done, the Blue Top Tube will not be filled properly due to the vacuum in tube and a redraw will be required

Note:

Collection of blood for coagulation testing through intravenous lines that have been previously flushed with heparin should be avoided, if possible.

If the blood must be drawn through an indwelling catheter, possible heparin contamination and specimen dilution should be considered. 

When obtaining specimen from indwelling lines that may contain heparin, the line should be flushed with 5mL of saline, and the first 5 mL of blood or 6-times the line volume (dead space volume of the catheter) be drawn off and discarded before the coagulation tube is filled. 

For those samples collected from a normal saline lock (capped off venous port) twice the dead space volume of the catheter and extension set should be discarded.


Processing Instructions:

Follow Platelet Poor Processing


Rejection Criteria:

Clotted samples

Improperly filled tubes (under or overfilled)

Wrong anticoagulant (3.8% sodium citrate is NOT acceptable)

Patients with hematocrit (HCT) >55% (red cell volume is >1/2 tube volume)

Hemolyzed samples

DO NOT freeze in a frost-free freezer

Stability time exceeded


Transport and Storage:
  • Ambient (18-24°C): 24 Hours
  • Refrigerated (2-8°C): 24 Hours
  • Frozen (-20° C or colder): 4 Weeks

    Plasma should be frozen within 24 hours of collection

    NOTE: Freezer cannot be self-defrosting

Clinical Interpretation

Reference Range:

Normal: 150 - 440 mg/dl


Critical Ranges:

Critical Low: <= 80 mg/dl


Methodology:
  • Clauss Fibrinogen
Clinical Significance

Decreased fibrinogen levels are associated with increased bleeding tendencies. Increased fibrinogen levels are a risk factor for thrombotic complications.


Production Schedule

Sites Performed
  • Parkview Randallia Hospital
  • Parkview Regional Medical Center
Days Performed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Departments
  • Coagulation
Turn Around Time

Same day/1 to 2 days


Stat Eligible

Coding & Compliance

CDM

01450040


CPT Coding

85384