Activated Partial Thromboplastin Time

Overview

  • EPIC Code:
  • LAB325
  • Soft Test Code:
  • PTT
Alternate Names
  • Activated Partial Thromboplastin Time
  • APTT
  • PTT
Clinical Significance

Screening for deficiencies or inhibitors of the coagulation system. 
Monitoring the dosing effect of unfractionated heparin therapy.


Specimen Collection & Preparation

Client Notes

If patient is on unfractionated heparin the specimen will need to be to the testing laboratory within 45 minutes of collection.  


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*
Neonatal 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). 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.


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

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


Transport and Storage:
  • :

Patients receiving unfractionated heparin (UFH):

  • Must be centrifuged to produce PPP within 1 hour of collection.
  • Centrifuged samples are stable 4 hours room temperature.
    • If testing will be performed at another testing location, the PPP should be transfered to a plastic vial. Send both tubes together to testing site.
    • If testing will not be completed within 4 hours, then PPP should be frozen. Do not freeze in frost-free freezer.
      • Stable 2 weeks frozen at -20°C
      • Stable 12 months frozen at -70°C

Patients not receiving heparin- centrifuged and unspun samples are stable for up to 24 hours room temperature.

Clinical Interpretation

Reference Range:

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.


Critical Ranges:

>= 110.0 seconds


Methodology:
  • Photo Optical
Clinical Significance

Screening for deficiencies or inhibitors of the coagulation system. 
Monitoring the dosing effect of unfractionated heparin therapy.


Production Schedule

Sites Performed
  • Parkview Bryan Hospital
  • Parkview DeKalb Hospital
  • Parkview Huntington Hospital
  • Parkview Kosciusko Hospital
  • Parkview LaGrange Hospital
  • Parkview Montpelier Hospital
  • Parkview Noble Hospital
  • Parkview Randallia Hospital
  • Parkview Regional Medical Center
  • Parkview Southwest
  • Parkview Wabash Hospital
  • Parkview Whitley Hospital
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

01450046


CPT Coding

85730


Medical Necessity May Apply