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HelpTest Code LAB2934 COAG MIX PANEL
Clinical System Name
Coagulation Panel with Reflex to 1:1 Mix
Synonyms
LAB2934
COAG MIX
1:1 Mix
50:50 Mix
Mixing Study
Coag Mix Panel
Sample Requirements
Specimen: Whole Blood
Container(s): Lt Blue/Citrate
Required Vol: one 1.8 mL tube or one 2.7 mL tube (do NOT over or under fill)
Minimum Vol: N
Note: Preferred method of collection is venipuncture with vacuum fill. Test results are affected by incorrect blood volume, note fill line on tube. Use of a Vascular Access Device for the collection of coag testing is not recommended. If this method is used it requires a 5 mL waste volume; 3 mL for size 2 French catheter or smaller. Blood must be transferred to the Lt Blue/Citrate tube by use of a blood transfer device to ensure proper fill.
Specimen should be centrifuged within 1 hour of collection.
Processing Instructions
Main Campus CPA: Core Technologist will process specimen. Deliver blood directly to Core Coag bench.
Reject due to: Clotted, Insufficient quantity (underfill), or Improper collection (overfill).
Spin: Y
Aliquot: Y
Storage location: Core 14 Freezer ( -70 C).
Core Technologist: Specimen should be centrifuged within 1 hour of collection. Spin whole blood, remove plasma. Transfer upper 3/4 layer of plasma to plastic tube affixed with large computer label.
Off-site collection: Preferred method of collection is venipuncture with vacuum fill. Test results are affected by incorrect blood volume, note the fill line on the tube. Use of a Vascular Access Device for the collection of coag testing is not recommended. If this method is used it requires a 5 mL waste volume; 3 mL for size 2 French catheter or smaller. Blood must be transferred to the Lt Blue/Citrate tube by use of the blood transfer device.
Specimen should be centrifuged within 1 hour of collection. Double spin, transfer upper 3/4 layer of plasma to plastic tube affixed with large computer label. Freeze until solid one aliquot of 1.0 mL plasma in plastic tube at -70C (preferred) or -20C.
Non-Children's Hospital Off-site collection: Ship completely frozen on dry ice.
Children's Regional Clinics: 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 |
Availability
| STAT | Performed | TAT |
|---|---|---|
| Y |
Daily |
3 h |
Performing Laboratory
Seattle Children's Laboratory
Department
Department: Coagulation
Phone Number: 206 987-2617 (Client Services)
CPT Codes
85610
85611
85730
85732
85670
85384
Methodology
Method: Electromagnetic mechanical clot detection system by STA-R MAX
Analytical Volume: 1 mL plasma
Limitations:
Mixing studies will only be run if the PT or APTT results exceed the normal reference range for the assay. The Coag Mix Panel may be added on to a previous coagulation specimen provided there is adequate sample remaining. If there is not enough sample remaining for the entire mix panel, a mixing study alone on the affected analyte will be attempted. Samples that do not contain enough remaining plasma to complete at least a mixing study must be recollected and the Coag Mix Panel performed on the new specimen.
Method is affected by improper collection, processing, and storage.
High hematocrit greater than or equal to 56% requires a citrate adjusted tube.
Reference Range
|
APTT
|
Newborn – 3 months
|
25 – 40 seconds
|
|
3 months and older
|
25 - 35 seconds
|
|
|
PT
|
Newborn – 3 months
|
12.5 – 17.0 seconds
|
|
3 months and older
|
12.5 – 15.2 seconds
|
|
|
Fibrinogen
|
All ages
|
230 – 450 mg/dL
|
|
Thrombin Time
|
Newborn – 3 months
|
14 – 30 seconds
|
|
3 months and older
|
14 – 17 seconds
|
Description
Tests included in this panel: PT, PTT, FIB, TT, and mixing studies when indicated.
Mixing studies may be indicated when a PT or APTT test result is prolonged, whether the prolonged result was due to factor deficiency or the presence of an inhibitor. If the abnormality was the result of factor deficiency, the 1:1 mix with Pooled Normal Plasma will shorten the clotting time of the assay ("correct it") to within the normal reference range for the assay. If the abnormality was due to the presence of an inhibitor, the clotting time obtained on the 1:1 mix may shorten or ‘correct' only partially or not at all. APTT mixes are incubated for 1 hour with Pooled Normal Plasma to help detect factor VIII inhibitors.
Fibrinogen and Thrombin Time are run as part of this panel to rule out other causes for prolonged PT or PTT, such as hypofibrinogenemia, or the presence of heparin.
Critical Values
|
APTT
|
≥ 150 seconds (all ages)
|
|
PT
|
> 30 seconds (all ages)
|
|
Fibrinogen
|
< 60 mg/dL
|
|
Thrombin Time
|
None defined
|