Abnormal Bleeding Profile

CPT: 85049; 85610; 85670; 85730
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Test Details

Synonyms

  • Bleeding Profile, Abnormal

Test Includes

Platelet count; PT and aPTT; TT

Methodology

See individual tests.

Specimen Requirements

Specimen

Whole blood and plasma, frozen

Volume

5 mL EDTA whole blood, one tube citrated whole blood (unopened), and 3 mL citrated plasma, frozen

Minimum Volume

2 mL citrated plasma, frozen

Container

Lavender-top (EDTA) tube, blue-top (sodium citrate) tube (do not open), and frozen plasma aliquoted from blue-top (sodium citrate) tube

Patient Preparation

Ideally, the patient should not be on anticoagulant therapy. Avoid warfarin (Coumadin®) therapy for two weeks prior to the test and heparin, direct Xa, and thrombin inhibitor therapies for about three days prior to testing.

Collection

Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples, except when using a winged blood collection device (ie, "butterfly"), in which case a discard tube should be used.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp N° 49482). Freeze immediately and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.

Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

Storage Instructions

Maintain whole blood at room temperature. Freeze plasma.

Causes for Rejection

Severe hemolysis; improper labeling; clotted specimen; specimen diluted with IV fluids; samples thawed in transit; improper sample type; sample out of stability

Clinical Information

Special Instructions

If the patient's hematocrit exceeds 55%, the volume of citrate in the collection tube must be adjusted. Refer to Coagulation Collection Procedures for directions.

Footnotes

1. Adcock DM, Kressin DC, Marlar RA. Effect of 3.2% vs 3.8% sodium citrate concentration on routine coagulation testing. Am J Clin Pathol. 1997 Jan; 107(1):105-110. 8980376
2. Reneke J, Etzell J, Leslie S, Ng VL, Gottfried EL. Prolonged prothrombin time and activated partial thromboplastin time due to underfilled specimen tubes with 109 mmol/L (3.2%) citrate anticoagulant. Am J Clin Pathol. 1998 Jun; 109(6):754-757. 9620035
3. National Committee for Clinical Laboratory Standardization. Collection, Transport, and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays; Approved Guideline. 5th ed. Villanova, Pa: NCCLS:2008. Document H21-A5:28(5)
4. Gottfried EL, Adachi MM. Prothrombin time and activated partial thromboplastin time can be performed on the first tube. Am J Clin Pathol. 1997 Jun; 107(6):681-683. 9169665
5. McGlasson DL, More L, Best HA, Norris WL, Doe RH, Ray H. Drawing specimens for coagulation testing: Is a second tube necessary? Clin Lab Sci. 1999 May-Jun; 12(3):137-139. 10539100

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
116004 Bleeding Profile 115107 INR 6301-6
116004 Bleeding Profile 015289 Prothrombin Time sec 5902-2
116004 Bleeding Profile 015116 aPTT sec 14979-9
116004 Bleeding Profile 109009 Thrombin Time sec 3243-3
116004 Bleeding Profile 015172 Platelets x10E3/uL 777-3
Reflex Table for INR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115109 INR (Thromborel-S) 115109 INR (Thromborel-S) 6301-6
Reflex Table for Prothrombin Time
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 015290 PT (Thromborel-S) 015290 PT (Thromborel-S) sec 5902-2

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