| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
FIBRIN MONOMER, QUAL
Message"Do not draw from an arm with a heparin lock or heparinized catheter
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Test Code
500150
CPT Codes
85362
Preferred Specimen
plasma
Minimum Volume
1 ml
Instructions
"Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge and carefully remove the plasma using a plastic transfer pipette, being careful not to disturb the cells. Transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp N° 49482). Freeze immediately and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.
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Transport Container
"Blue-top (sodium citrate) tube
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Transport Temperature
freeze
Specimen Stability
room temp-4 hours;
Methodology
"Fibrin monomer is detected by mixing test plasma with human erythrocytes specifically coated with purified fibrin monomer.6 When monomer complexes are present in the plasma, agglutination takes place. The assay is considered negative if there is no discernible macroscopic agglutination of the red cells. The assay is considered positive when macroscopic agglutination is observed. Evenly distributed small agglutinates, sparsely distributed large agglutinates, as well as massive clumping may be observed. The higher the concentration of fibrin monomers present in the test plasma, the larger the red cell agglutinate becomes. "
Limitations
"Fibrin monomers, the intermediate products between fibrinogen and fibrin, are produced during proteolysis of fibrinogen by thrombin.6 In normal hemostasis, linkage to other fibrin monomers occurs with the end result being the fibrin clot. Circulating pathological fibrin monomer complexes suggest abnormal activation of coagulation, as can occur in disseminated intravascular coagulation (DIC). DIC evolves when there is vascular endothelial damage, or when there is a release of tissue thromboplastin into the circulation as is found in septicemia, carcinoma, leukemia, transfusion incompatibility, and in obstetrical complications such as placenta abruption, fetal demise, or amniotic fluid embolism. Elevated fibrin monomer levels in the plasma may be accompanied by increases in other markers of coagulation activation including D-dimer, fibrin(ogen) degradation products (FDP), prothrombin fragment 1+2, and thrombin-antithrombin complex. The hemagglutination test for fibrin monomers is considered to have greater sensitivity and specificity than either the ethanol gelation test or protamine sulfate test. The assay does not appear to be affected by fibrinogen levels >500 mg/dL.
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