Lesson 3 6 Laboratory Fdp

Med Lab

1. Lesson 3-6
Rapid
Hemostasis Tests

2. Rapid Hemostasis Tests
•Activated Clotting Time Plus (ACT+)
•Heparin management test (HMT)
•FDP and D-Dimer tests

3. Use of
Rapid Hemostasis Tests
•Monitor heparin therapy
•Identify
–Disseminated
Intravascular Coagulation (DIC)
–Deep vein thrombosis (DVT)
–Pulmonary embolism

4. Activated Coagulation Time (ACT)
•The ACT test evaluates coagulation
status.
The ACT responds linearly to heparin level
changes and responds to wider ranges of
heparin concentrations than does the APTT.
•The ACT, however, assays overall
coagulation activity. Therefore, prolonged
values may not be exclusively the result
of heparin.

5. Normal
•ACT: 70–120 seconds
•Therapeutic range: 180–240
seconds
• (two times normal range)

6. Heparin Therapy
•Action of heparin
–Inhibits Factors IX, X, XI, and XII
–Inhibits platelet release factor
•Used to prevent thrombosis

7. Tests for
Heparin Effectiveness
•ACT+
•APTT

8. Disseminated
Intravascular Coagulation
•Widespread thrombosis and
hemorrhage
•Due to:
–Crush injuries
–Certain infections
•Coagulation factors and platelets
become depleted

9. Deep Vein Thrombosis
and Pulmonary Embolism
•DVT
–Caused by slow blood flow
–Thrombi form in lower extremities
•Pulmonary Embolism
–Complication of DVT
–Thrombus dislodges and travels to lungs
–Life threatening

10. FDP and XDP
•Fibrinogen/fibrin degradation products
•Crosslinked fibrin derivatives
When fibrin is split by plasmin, positive tests for
fibrin degradation (split) products, identified by the
letters X, Y, D, and E, are produced. These products
have an anticoagulant action and inhibit clotting when
they are present in excess in the circulation. Increased
levels of FDPs may occur with a variety of pathologic
processes in which clot formation and lysis occur.
This test is done to establish the diagnosis of DIC and
other thromboembolic disorders.

11. FDP and XDP

12. FDP and XDP
•Formation
–Plasmin cleaves fibrin and fibrinogen
–Cleavage of stable clot forms XDP
–D-dimer, another name for XDP

13. Reference Values
•Negative at 1:4 dilution or <10 µg/mL (<10 mg/L)
Increased FSP and FDP are associated with DIC and are seen in:
Venous thrombosis
Primary fibrinolysis
Thoracic and cradiac surgery or renal transplantation
Acute myocardial infarction
PE
Carcinoma
Liver disease

14. FDP and XDP
•Tests for FDP and XDP (D-dimer)
–Manual latex agglutination tests
–Instrumentation