Screening for deficiencies or inhibitors of the coagulation system.
Monitoring the dosing effect of unfractionated heparin therapy.
If patient is on unfractionated heparin the specimen will need to be to the testing laboratory within 45 minutes of collection.
* This volume does not allow for repeat testing
Specimens must be filled appropriately see this example
Correct ratio of blood to citrate is critical (9:1). Tube must be filled to the minimum fill indicator mark on the tube. Do not overfill.
If utilizing a butterfly to collect, a blue top discard tube must be drawn first to remove air from the line. If this is not done, the collection blue top tube will not be filled properly due to the vacuum in tube and a redraw will be required
Heparinized patient specimens must be spun within 1 hour of collection - Follow Platelet Poor Collection
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 specimens 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.
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
Whole blood that was refrigerated or placed on ice
DO NOT freeze in a frost-free freezer
Frozen samples that were thawed in transport, or thawed samples that were refrozen
Patients receiving unfractionated heparin (UFH):
Patients not receiving heparin- centrifuged and unspun samples are stable for up to 24 hours room temperature.
23.5 - 33.0 seconds
Therapeutic range for pre-mixed heparin is 50.0 - 70.0 seconds. Heparin therapeutic range is based on the APTT range corresponding to a heparin concentration of 0.3 to 0.7 Units/milliliter, determined by Factor Xa inhibition assay.
>= 110.0 seconds
Screening for deficiencies or inhibitors of the coagulation system.
Monitoring the dosing effect of unfractionated heparin therapy.
Same day/1 to 2 days
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85730