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Test Code LAB2848 Bivalirudin Level

Important Note

Capillary blood (e.g. heel stick or finger prick) samples are not acceptable for coagulation testing because of the potential for contamination with tissue factor, dilution with tissue fluid, and difficulty with filling tubes to adequate volume. Coagulation assays have not been validated for capillary blood samples.

Clinical System Name

Bivalirudin Level
 

Description

Bivalirudin is used for prophylaxis or treatment of thrombosis in patients with heparin induced thrombocytopenia (HIT). The quantitative determination of plasma Bivalirudin levels is useful for monitoring treatment efficacy.

Sample Requirements

Specimen: Whole Blood

Container(s): Lt Blue/Citrate

Required Vol: (1) 1.8 mL or (1) 2.7 mL 

Minimum Vol: N

 

Note:  This is enough for a PT, PTT, TT, Fibrinogen, and Bivalirudin to be run on the same sample.

 

Preferred method of collection is venipuncture with vacuum fill. Test results are affected by incorrect blood volume. Use of a Vascular Access Device for the collection of coag testing is not recommended. Please review the Coagulation Lab Collection Job Aid for detailed instructions.

Processing Instructions: Main Campus

Deliver whole blood to Coag bench. Coag Technologist will process.

 

Reject due to: clotted, insufficient quantity (underfill), or improper collection (overfill).

Spin: Y

Aliquot: Y

Storage location: Core 14 Freezer ( -70 C).

 

Specimen should be centrifuged within one hour of collection. Transfer upper 3/4 layer of plasma to plastic tube affixed with large Epic aliquot label. Do not pool. Assay immediately. 

Processing Instructions: Offsite & Regional Clinics

Reject due to: clotted, insufficient quantity (underfill), or improper collection (overfill).

Spin: Y

Aliquot: Y

Storage location:  -70 C (preferred) or -20 C. 

 

Specimen should be centrifuged within one hour of collection. Double spin, transfer upper 3/4 layer of plasma to plastic tube affixed with large sample label. Freeze one aliquot of plasma at -70 C (preferred) or -20 C. Preferred plasma volume: 1.0 mL, minimum plasma volume: 0.6 mL. Do not pool. 

 

Non-Children's Hospital Offsite collection: Ship completely frozen on dry ice.

 

Children's Hospital Regional Clinic collection: Ship completely frozen in frozen Nalgene Labtop cooler with ice pack inside an insulated soft cooler.

Stability

Specimen Type Temperature Time
Citrated platelet-poor plasma Room temp ≤ 4 h
  Refrigerated N
  Frozen   -20 C or -70 C ≤ 3 m

 

Performing Laboratory

Seattle Children's Laboratory    

 

Department

Department:  Coagulation

 

Phone Number: 206 987-2617 (Client Services)

Synonyms

LAB2848

BIVAL

DTI Level

Direct Thrombin Inhibitor Level

 

Availability

STAT Performed TAT
Y

Daily

 1 h

 

Methodology

Method:  Electromagnetic mechanical clot detection assay by STA-R MAX

Analytical Volume: 100 uL plasma

Limitations: Method is affected by insufficient quantity (underfill), improper collection (overfill), improper processing, and improper storage. High hematocrit greater than or equal to 56% requires a citrate adjusted tube.

The PT/INR shows variable prolongations in patients on direct thrombin inhibitors, such as argatroban and bivalirudin, and should not be used to monitor coagulation factor levels. To monitor coagulation factors in patients on direct thrombin inhibitors please order Factor 10 Assay, Chromogenic (LAB3030).

Reference Range

Therapeutic Range: 0.7 - 1.5  µg/mL.

Cardiopulmonary Bypass Patients: 5.0 - 20 µg/mL.

CPT Codes

80299

Critical Values

Not defined for this test.