Browsing Tag

Kate Rubritius

Compliance & Safety, Hematology

CSF Xanthochromia Result Update

Effective February 24, 2021, Cerebrospinal Fluid (CSF) Xanthochromia results of “Present” will be considered a critical laboratory value.

This change was approved by the MEC and driven by a collaboration between neurology and laboratory departments to assist in expediting the diagnosis and management of patients with possible subarachnoid hemorrhage (SAH).

The following disclaimer will also be attached to all Xanthochromia results: “Xanthochromia is assessed by visual inspection. If the appropriate history and symptoms are present, CSF xanthochromia is suggestive of subarachnoid blood, either as part of an inflammatory reaction such as meningitis, or after subarachnoid hemorrhage (SAH). Xanthochromia must be viewed within the appropriate clinical context.”

For any questions, please use the “Contact Us” link above.

TEST INFORMATION:

Cell Count w/ Differential if indicated, Cerebrospinal Fluid – Epic code #LAB2111025, CPT #89050, 89051, 89050, Interface code #10328

General Information, Hemostasis/Coagulation

Update: Platelet Aggregation Studies

The Spectrum Health Regional Laboratory Coagulation Department will be going live with the Helena AggRam analyzer on February 3, 2021.  This analyzer uses platelet rich plasma to analyze human platelet aggregation which is measured by absorbance.  The following aggregating agents are used in these studies: Arachidonic Acid, ADP, Collagen, Epinephrine, and Ristocetin.

Patients for platelet aggregation studies should be resting, fasting, and non-smoking. Patients should avoid taking any prescription or over the counter medications known to affect platelet function for ten (10) days to two (2) weeks prior to the studies. For a list of medications known to have anti-platelet effects, click here. Continue Reading

Hemostasis/Coagulation, Test Spotlight

New Reference Range: APTT and APTT Assay

Beginning September 8, at approximately 2PM, Spectrum Health Laboratories will go live with their new lot of APTT reagent.  This lot change triggered a new therapeutic curve resulting in new heparin nomograms for the system.  The standard heparin therapeutic range will change from the current 45-65 seconds to a new range of 37-52 seconds based off the new curve.  Reference ranges for the APTT assay will also be updated.  Grand Rapids APTT reference range will be 21-27 seconds and the Regional Hospitals will be 21-31 seconds.

APTT specimens that are unable to reach an endpoint (no clot is detected), will reflex to the Unfractionated Heparin (UFH) (Test Code LAB3389) anti-Xa assay.  To accommodate this change, UFH values have been added to heparin nomograms. The UFH anti-Xa assay is currently only performed in the Grand Rapids labs and valid only for unfractionated heparin.  Any questions concerning these changes may be directed to the Spectrum Health Regional Laboratory Coagulation department at 616-267-2740.

Hemostasis/Coagulation

New Test: Thrombin Time

Effective March 4th, 2020, Thrombin Time will change from a sendout reference test performed by Mayo Clinic Laboratories to an in-house test performed by Spectrum Health Regional Laboratory. This test will be performed in the Coagulation Laboratory and will include a new reference range (please see link in Test Information below).

Thrombin Time is suitable for monitoring fibrinolysis therapy, screening for disorders of fibrin formation and in cases of suspected fibrinogen deficiency states. It is also useful for the differentiation between a heparin induced prolongation of the thrombin time and fibrin formation disorders.

For questions around this test, please contact the Coagulation Department at 616-267-2740.

TEST INFORMATION

Thrombin Time – Epic Code: #LAB11230581, Interface Code: #11230581, CPT: #85670

Hematology, Referral/Sendouts

Hemoglobin A1c Testing Update

For Hemoglobin A1c testing, Mayo Clinic Laboratory has switched to an Ion-Exchange High-Performance Liquid Chromatography (HPLC) method (Bio-RAD D100) which is the same method of A1c testing used at Spectrum Health Regional Laboratory.  They no longer offer the alternative method, boronate affinity chromatography, for A1c testing.

When A1c cannot be determined due to  interferences that affect the Bio-RAD 100 method, measurement of serum fructosamine is recommended (Mayo test FRUCT). Continue Reading