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Test Code 044 D-Dimer HS, Quantitative

Important Note

Human anti-mouse antibodies (hama) may be present in samples from patients who have received immunotherapy or diagnostic procedures utilizing monoclonal antibodies or in individuals who have been regularly exposed to animals. Additionally, other heterophile antibodies, such as human anti-goat antibodies may be present in patient samples. Manufacturers formulate assays to minimize the effects of these antibodies; however careful evaluation of patient results must be done when patients are known to have such antibodies.

Additional Codes

MLAB: DDIMER

PowerChart: D-Dimer Highly Sensitive

Epic: LAB2810 D-Dimer Sensitive, Quantitative

MA Cerner: D-Dimer.

Test Method

Turbidimetric Immunoassay; ACL Systems, Beckman Coulter, IL APPT SP

Specimen Requirement

Sodium citrate blue-top tube filled to the area within the indicator arrow printed on the side of the tube.

Additional Specimen Collection Information

 

Invert the sodium citrate tube end to end 4 times to thoroughly mix blood and anticoagulant. The tube should be left stoppered until time of testing.

  • Specimen is stable up to 4 hours after collection if stored refrigerated or at room temperature and unopened.
  • If the testing is not completed within 4 hours:
  1. Remove the plasma from the cells and transfer to a plastic tube.
  2. Freeze the sample for up to two weeks.
  3. Frozen samples should be rapidly thawed at 37°C while gently mixed.
  4. Thawed samples should be centrifuged and tested immediately.
  5. If testing cannot be performed immediately the sample may be held for a maximum of 2 hours refrigerated, until tested.
  • Precautions:

    • It is not recommended to use a winged blood collection set (Butterfly).
    • If a vacuum tube butterfly must be used, the first tube in the series will be under-filled. Collect a “discard citrate tube”, and then collect the citrate tube used for testing. This will ensure the proper blood to anticoagulant ratio.
    • If using a syringe, use a BD Blood Transfer Device to transfer blood from the syringe to the citrate tube within one minute of collection. Hold the syringe with the plunger in the up-right position and allow the vacuum present to fill the tube. Before collection, be sure the syringe plunger is pushed to the top of the syringe. The transfer device may pop up and needs to be held down to completely fill tube to between fill lines.
    • Do not “force fill” blood into a vacuum tube. This may result in activation of the platelets possibly leading to erroneous results. Allow the vacuum present to fill the tube.
    • Do not remove vacuum tube cap to add blood.
    • Specimens should be obtained from a single venipuncture with minimal tissue trauma. Never combine multiple blood collections into a single vacuum tube.
    • Never re-use a syringe that was used for a pic line saline flush.

Refer to the "Citrated Plasma for Coagulation Studies" protocol in the Quality Assurance Manual.

Performance

Testing is performed Monday through Sunday.

Routine: Typically completed within 4 hours; Mercy DV and MA West within 24 hours

STAT: Typically completed within 25 minutes after the specimen arrives at the testing site.

Reference Values

< 230 ng/mL D-Dimer Units (DDU)

The D-Dimer cutoff value to use for exclusion of DVT (deep vein thrombosis) and/or PE (pulmonary embolism) is 230 ng/dL..

CPT Code Information

85380 Coagulopathy Testing: Fibrin degradation products, D-dimer; ultrasensitive, qualitative or semiquantitative

Useful For

Diagnosis of intravascular coagulation and fibrinolysis, also known as disseminated intravascular coagulation, especially when combined with clinical information and other laboratory test data (eg, platelet count, assays of clottable fibrinogen and soluble fibrin monomer complex, and clotting time assays-prothrombin time and activated partial thromboplastin time).

Excluding the diagnosis of acute pulmonary embolism or deep vein thrombosis, particularly when results of a sensitive D-dimer assay are combined with clinical information, including pretest disease probability.

LOINC Code Information

48066-5 Fibrin D-Dimer DDU [Mass/Volume] In Platelet Poor Plasma