Fibrinogen Degradation Product : 1000338

Message
The aliquot must remain frozen. Freeze thaw cycle will adversely affect specimen integrity. CRITICAL FROZEN: Separate specimens must be submitted when multiple tests are ordered.

Test Code
FDP or 1000338

Alias/See Also
FSP; Fibrin Split Products

CPT Codes
85362

Instructions
Blue top tube, 3.2% sodium citrate.
• Obtain venous blood by clean venipuncture. Avoid slow-flowing draws and/or traumatic venipunctures as either of these may result in an activated or clotted specimen. Do not use needles smaller than 23 gauge. Do not leave the tourniquet on for an extended length of time before drawing the sample.
• A pilot tube (non-additive or light blue tube) before drawing coagulation specimens in light blue vacuum tubes is only necessary when using a butterfly blood collection set as this will cause reduced draw volume in the first tube. Discard the pilot tube.
• Fill light blue tubes as far as vacuum will allow and mix by gentle inversion. Exact ratio of nine parts blood to one part anticoagulant must be maintained. Inadequate filling of the sample tube will alter this ratio and may lead to inaccurate results. Patients who have hematocrit values above 55 percent should have the anticoagulant adjusted to maintain the 9:1 ratio. Use the following formula to determine the amount of anticoagulant to use: [(100 – Hct) / (595 – Hct) ]* total volume = amount of anticoagulant required.
• After collecting the blood, examine the tube to ensure that it is filled to within 90% of the fill line.
• Note: Specimens containing heparin should not be used for coagulation studies. If possible, stop heparin therapy before the draw to avoid contamination. Heparin interferes with most clotting assays. If heparinized line must be used to obtain the sample, flush line with 5mL saline and discard the first 5 mL of blood drawn into a syringe, or 6 “dead space” volumes of the line.

Transport Container
Blood collected in 3.2% sodium citrate (light blue top tube). Proper blood to anticoagulant ratio is required. The tubes must be at a 100 ± 10% fill volume to maintain the correct ratio. Centrifuge light blue-top tube at 1500 g for no less than 15 minutes or speed/time to consistently yield platelet-poor plasma (<10,000/µL). Using a plastic pipette, remove plasma, taking care to avoid the WBC/platelet buffy layer, and place into a plastic transport tube (Min. 1 mL). Immediately freeze the aliquot and ship on dry ice.

Transport Temperature
Frozen.

Specimen Stability
After separation from cells: Ambient: 8 hours; Refrigerated: Unacceptable; Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Moderate to marked hemolysis; marked icterus; marked Lipemia; received thawed; received refrigerated

Methodology
Agglutination

Setup Schedule
Sunday - Saturday

Report Available
1 day

Reference Range
<5 ug/mL

Clinical Significance
Fibrin Degradation Products (FDP)

Fibrinogen is a glycoprotein with a molecular weight of 340,000 daltons and is composed of two peripheral areas D and a central domain E. In vivo, thrombin converts plasma fibrinogen into insoluble fibrin with the fibrin clot being stabilized by Factor XIII. Plasmin splits fibrinogen as well as fibrin into various degradation products. The fragments X and Y constitute the early split products from fibrinogen, and from non-crosslinked fibrin. The fragments D and E constitute the late split products. The degradation of the stabilized fibrin by plasmin leads to the formation of complexes named X-oligomers (YXD/DXY, YY/DXD, DY/YD) and finally to the terminal product D-dimer.

In normal conditions, the fibrinolytic process is localized on the fibrin clot, since α2-antiplasmin and the plasminogen activator inhibitors prevent fibrinolysis from spreading. However, during disseminated intravascular coagulation (DIC), fibrinolysis spreads and becomes systemic, in which case the degradation of circulating fibrinogen will occur. The fragments that are produced are very heterogenous: products derived from fibrin, soluble complexes, degradation products from fibrinogen and from non-stabilized fibrin.

An abnormal fibrinolytic and/or fibrinogenolytic activity shown by high levels of FDP in plasma can also be found in clinical states, such as eclampsia, promyelocytic leukemia, post-operative complications, cardiac and hepatic disorders, pulmonary embolism, and deep vein thrombosis. The FDP are rapidly cleared, so a persistently elevated level of FDP indicates that the fibrinogenolytic or fibrinolytic process is continuing and suggests that the causative agent continues to exert its effect.


Performing Laboratory
med fusion



The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.