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Home :: Fibrin split products

Fibrin Split Products

After a fibrin clot forms in response to vascular injury, the clot is eventually degraded by plasmin, a fibrin-dissolving enzyme. The resulting fragments arc known as fibrin split products (FSP), or fibrinogen degradation products. In this test, FSP are detected in the diluted serum that is left in a blood sample after clotting.

Purpose

  • To detect FSP in the circulation
  • To help determine the presence and the approximate severity of a hyperfibrinolytic state (such as disseminated intravascular coagulation [DIC]) that may result in primary fibrinogenolysis or hypercoagulability.

Patient preparation

  • Explain to the patient that this test is used to determine if blood clots normally.
  • Tell him that a blood sample will be taken Explain who will perform the venipuncture and when.
  • Reassure him that drawing a blood sample will take less than 3 minutes.
  • Explain that he may feel slight discomfort from the tourniquet pressure and the needle puncture.
  • Check patient history for use of any medications (especially heparin) that may interfere with accurate determination of test results.
  • Inform the patient that food or fluids n.cd not be restricted before the test.

Procedure and posttest care

  • Perform a venipuncture, and then draw 2 ml of blood into a plastic syringe.
  • Transfer the sample to the tube provided by the laboratory, which contains soybean trypsin inhibitor and bovine thrombin.
  • If a hematoma develops at the veniclnre site, apply warm soaks
Precautions
  • Draw the sample before administering heparin to avoid false-positive test results.
  • Gently invert the collection tube several times to mix the contents thoroughly.
  • The blood clots within 2 seconds and then must be sent immediately to the laboratory, to be incubated at 98.60 F (370 C) for 30 minutes before testing proceeds.

Reference values

Serum contains less than 10 ug/ml of FSP. A quantitative assay shows levels of less than 3 ug/ml.

Abnormal findings

FSP levels increase in primary fibrinolytic states, due to increased levels of circulating profibrinolysin; in secondary states, due to DIC and subsequent fibrinolysis; and in alcoholic cirrhosis, preeclampsia, abruptio placentae, congenital heart disease, sunstroke, bums, intrauterine death, pulmonary embolus, deep-vein thrombosis (transient increase), and myocardial infarction (after 1 or 2 days). FSP levels usually exceed 100ug/ml in active renal disease or renal transplant rejection.

Interfering factors

  • Pretest administration of heparin (false-high).
  • Failure to fill the collection tube completely, to adequately mix the sample and additive, or to send the sample to the laboratory immediately.
  • Hemolysis due to rough handling of the sample.
  • Fibrinolytic drugs, such as urokinase and streptokinase, and large doses of barbiturates (increase).

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