Hemostasis Division
The hemostasis laboratory has a vital role in the diagnosis and management of patients with hereditary and acquired bleeding and thrombotic disorders. It has also a vital role in the monitoring of patients under anticoagulant therapies.
Sample requirement:
Hemostasis tests are extremely sensitive to methods of collection and preservation.
Therefore it is important to follow the instructions of blood collection and processing so we insure accurate test results.
Coagulation tests
| Test |
3.2% Sodium citrated sample
(blue top)
|
Sample Age |
Comments |
All Routine coagulation screening test
(APTT,PT,FIB ,TT & D-Dimer) |
1 tube of 4.5ml or 2.7 ml as whole blood or
1ml plasma into 5ml plastic tube |
Not less than 4 hours from blood collection |
*Samples should be transported in a closed ice box. |
*Coagulation Factors screen.
*Anti-Xa heparin assay
*Factor VIII inhibitor screen |
1-2 tubes of 4.5ml or 2.7ml or 4ml plasma into 5ml plastic tube |
Not less than 4 hours from blood collection |
*Samples should be transported in a closed ice box. |
| Lupus anticoagulant |
2 tubes of 4.5ml or 2.7ml as whole blood or
4ml plasma into 5ml plastic tube |
Not less than 4 hours from blood collection |
*Samples should be transported in a closed ice box. |
Thrombophilia assay &
Fibrinolysis assay. |
4 tubes of 4.5ml or 2.7ml as whole blood or
10ml plasma into 4 plastic tubes. |
Not less than 4 hours from blood collection |
*Samples should be transported in a closed ice box. |
| Von willebrand factor assay |
2 tubes of 4.5ml or 2.7ml as whole blood or
4ml plasma into 5ml plastic tube |
Not less than 4 hours from blood collection |
*Samples should be transported in a closed ice box. |
| Platelet aggregation & bleeding Time |
NA |
See comments |
Appointment to be schedule by the haemostasis laboratory. |
Heparin induced
thrombocytopenia |
1 tube of 4.5ml whole blood |
Not less than 4 hours from blood collection |
Appointment to be schedule by the haemostasis laboratory. |
| |
|
|
Unacceptable samples:
Samples that are incorrectly collected, labeled, processed or transported will be rejected because this will lead to inaccurate results. The haemostasis laboratory will notify the area, by telephone or by fax [in case of outside samples].
Request for testing
Testing is requested via the trackcare system used in the SQUH or hemostasis laboratory form (if samples sent from outside the SQUH).
The electronic request or the ordinary form must have the following information to avoid delay or rejected in testing:
- Patient identification (including patient`s name, hospital number & date of birth & all these must match information on sample).
-Name of the Physician who is ordering the test.
-Date & time of request and sample collection.
-Status of the sample, for example if frozen, filtered or double Centrifuged plasma is submitted.
-Name of the area (like wards or physician) or the hospital where the report should be sent.
-The form must include a contact and phone number for someone who can answer questions concerning the order.
Labeling Samples.
All samples must be properly labeled and information must agree with the patient identification on the request form.
Transporting samples.
All samples must be sent in a sealed bag marked with a biohazard sticker to comply with ISO9000 safety standard to haematology laboratory receiving area or to:
Sultan Qaboos University Hospital
Hematology Department
Hemostasis Laboratory.
Tel. No: +968-24141736 ; Fax. No: +968-24144887
Referral tests:
Some tests like Platelet antibody test, Soluble Transferrin Receptor Assay, and Quantitative G6PD Assay are not available at SQUH and are sent abroad to a referral laboratory Laboratoire Marcel Merieux, France on Sunday. Referral request forms must be signed by the requesting ward doctorsand the hospital director. All information must be filled in a referral form. These referral forms are not available from the Hematology department, but they are printed out from the HIS system when the relevent test are ordered in the trackcare system.
Test results:
For the SQUH PATIENT:
The normal test results are usually authorized via the trackcare system used in the SQUH by the senior or chief in the hemostasis laboratory, the abnormal test results usually sent to the Consultant Hematologist for the final result confirmation.
For external SQUH Patients:
The test results report will be faxed by the hematology staff or secretary after receiving the final confirmation of the patient reports from the Consultant Hematologist or it can be mailed to the laboratory or hospital as required.
Normal Values
| Test |
Sex, Age, Method, Comments |
Range |
Units |
| PT |
(To be established with every new PT reagent) |
9.7 - 11.4 |
Seconds |
| APTT |
(To be established with every new APPT reagent) |
27 - 39 |
Seconds |
| Fibrinogen(Clauss) |
|
1.8 - 4.9 |
g/L |
| Thrombin Time(TT) |
(To be established with every new TT reagent) |
11.9 - 19.6 |
Seconds |
| Lupus Screen |
|
|
|
| LA screen(APTT) |
|
28 - 39 |
Seconds |
| LA confirm(APTT) |
|
Negative |
|
| LA screen(DRVVT) |
|
27 - 42 |
Seconds |
| LA confirm(DRVVT) |
|
27 - 32 |
Seconds |
| LA screen(KCT)20:80 Mix Ratio |
|
<1.2 |
|
vWD Workup
|
|
|
|
| vWFactor Antigen(vWF:Ag) |
|
0.500 - 1.580 |
IU/ml |
| vWFactor Collagen binding assay(CBA) |
|
0.500 - 4.000 |
IU/ml |
| VW Factor Ristocetin assay(vWF:RiCoF) |
|
0.400 - 1.500 |
IU/ml |
| Ristocetin Induced Platelet Aggregation(RIPA) |
|
0.7 - 1.2 |
mg/ml |
| Bleeding Time |
|
2.3 - 9.5 |
Minutes |
Thrombophilia Screen
|
|
|
|
| Protein C Function-Chromogenic assay |
|
0.720 - 1.540 |
IU/ml |
| Protein C Function-Clotting assay |
|
0.800 - 1.810 |
IU/ml |
| Protein C Antigenic assay |
|
0.700 - 1.400 |
IU/ml |
| Protein S Functional assay |
|
Males=0.770 - 1.430 Females=0.550 - 1.230 |
IU/ml |
| Total Protein S Antigenic assay |
|
0.620 - 1.300 |
IU/ml |
| Free Protein S Antigenic assay |
|
0.620 - 1.300 |
IU/ml |
| Antithrombin function(180 sec.Incubation) |
|
0.830 - 1.180 |
IU/ml |
| Antithrombin function(20 sec.Incubation) |
|
0.880 - 1.220 |
IU/ml |
Antithrombin Antigenic assay
|
|
0.800 - 1.400 |
IU/ml |
| Protein C Global |
|
0.75 - 1.43 |
|
| Protein C Global/FV |
|
0.98 - 1.17 |
|
| Activated Protein C resistance(APPT) |
|
>2.1 |
|
| Activated Protein C resistance(DRVVT) |
|
>1.8 |
|
| Activated Protein C resistance(APCR) |
|
4.2 - 6.2 |
|
| Homocystine |
|
5.0 - 15.0 |
mol/L |
| Tissue Plasminogen activator(t-PA) |
|
1.0 - 12.0 |
ng/ml |
| Plasminogen activator inhibitor -1(PAI-1) |
|
4 0 - 43 0 |
ng/ml |
| Plasminogen |
|
0.730 - 1.270 |
IU/ml |
| Alpha-2-Antiplasmin |
|
0.890 - 1.120 |
IU/ml |
Factor Assays
|
|
|
|
| Factor II:C assay |
|
0.600 - 1.160 |
IU/ml |
| Factor V:C assay |
|
0.550 - 1.270 |
IU/ml |
| Factor VII:C assay |
|
0.470 - 1.270 |
IU/ml |
| Factor VIII:C assay |
|
0.495 - 1.382 |
IU/ml |
| Factor IX:C assay |
|
0.360 - 1.360 |
IU/ml |
| Factor X:C assay |
|
0.380 - 1.180 |
IU/ml |
| Factor XI:C assay |
|
0.490 - 1.340 |
IU/ml |
| Factor XII:C assay |
|
0.390 - 1.150 |
IU/ml |
Factor XIII(Clot stability test)
|
|
Negative |
|
| Pre-Kallikrein assay (PK) |
|
0.520 - 1.620 |
IU/ml |
| High Molecular Weight Kininogen (HMWK) |
|
0.500 - 1.360 |
IU/ml |
| Inhibitor Assay(Bethesda) |
|
0.00 - 0.75 |
BU/ml |
| Anti-Xa assay[LMWH monitoring) |
|
Prophylaxis= 0.3 - 0.6 IU Therapeutic= 0.6 - 1.2 IU |
IU/ml |
| D-Dimer assay |
Cut-off for DVT/PE = 0.5 mh/L FEU |
0.19 - 0.67 |
mg/L FEU |
HIT Screen
|
|
|
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