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D-Dimer
Test CodeDDIMER
Alias/See Also
Dimer
Preferred Specimen
4.5 mL blood (9:1 blood to anticoagulant) in 5 ml tube
Instructions
Tube must be filled to the line to ensure the proper ratio of blood to anticoagulant.
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 5 mL 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.
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 5 mL 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.
Transport Container
3.2% Sodium Citrate (light blue-top)
Specimen Stability
Room temperature: 8 hours, Refrigerated: not recommended, Frozen plasma: 1 month
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Moderate or grossly hemolyzed specimens are unacceptable.
Reference Range
≤ 0.50 ug/mL FEU
Clinical Significance
D-Dimer quantitative assay detects the presence of Disseminated Intravascular Coagulation (DIC). In DIC the fibrinolytic system is activated and therefore the D-Dimer level increases. D-Dimer assays can help in the diagnosis of DIC in these cases. It is established that a normal D-Dimer level is an important factor to rule out the diagnosis of deep venous thromboses (DVT) or pulmonary embolisms (PE). The decrease of D-Dimer levels during heparin therapy for a DVT allows the monitoring of evolution and prognosis of the thrombosis. This decrease reflects the quality of the endogenic thrombolysis. The D-Dimer level increases during the activation states of coagulation because they induce the production of thrombin which is followed by the formation of fibrin and leads to fibrinolysis, the latter being most frequently reactive. The D-Dimer level thus increases following coagulation activation. Increased levels of D-Dimer have been reported in post-operative period, cancers, cirrhosis, and hemorrhages.
