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Test Code TEGHP TEG HEPARIN-ECMO, BYPASS, ETC.

Important Note

For patients receiving heparin therapy (cardiopulmonary bypass, ECMO, and/or other complicated patients on heparin drips)

Specimen and Container/Tube

Specimen Type: Whole Blood

Preferred Specimen: Light Blue Top Tube, 3.2% Sodium Citrate

Other Acceptable specimens: N/A

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

Collect specimen per standard collection procedure and send to laboratory immediately. 

Sample must NOT be refrigerated or exposed to excessive heat.

 

NOTE: Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.

 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Collect specimen per standard collection procedure.
  • Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.
  • Specimen must reach laboratory within 2 hours of blood collection.
  • Sample must NOT be refrigerated or exposed to excessive heat.
  • Samples shipped room temperature.  Samples that are shipped refrigerated or frozen will be rejected.
  • Do NOT centrifuge. Samples centrifuged will be rejected.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that have wrong ratio of blood to anticoagulant (fill volume), clotted or grossly hemolyzed.

Reference Values

 

Test

Age

Sex

Reference Range

Kaolin R Time

ALL

ALL

4.0 - 8.0 minutes

Kaolin K time

ALL

ALL

1.0 - 2.1 minutes

Kaolin Angle

ALL

ALL

60.0 - 73.0 degrees

Kaolin Max Amplitude

ALL

ALL

57.0 - 74.0 mm

Kaolin Lysis

ALL

ALL

0.0 - 5.0 %

Kaolin R Time, Hepatinase

ALL

ALL

4.0 - 8.4 minutes

Kaolin K Time, Heparinase

ALL

ALL

1.0 - 2.4 minutes

Kaolin Angle, Heparinase

ALL

ALL

57.0 - 72.0 degrees

Kaolin Max Amplitude, Heparinase

ALL

ALL

55.0 - 72.0 mm

Kaolin Lysis, Heparinase

ALL

ALL

0.0 - 5.0 %

Critical Values

Analyte

Unit

Low

High

Age

N/A

N/A

N/A

N/A

N/A

CPT Codes

85347, 85525, 85390

LOINC Codes

67790-6, 69552-8

Volume

Preferred Volume: 2 Light Blue Top Tubes, 3.2% Sodium Citrate

 

Minimum Volume: 2 Light Blue Top Tubes, 3.2% Sodium Citrate

Specimen Stability

Storage Temperature

Stability

Room temperature

2 hours

Refrigerated

not acceptable

Frozen

not acceptable

Collection Instructions

  • Using 21G or larger needle, collect two 2.7 mL light blue top tubes after 3 mL discard (5 mL discard if from indwelling catheter).
  • Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.

Test Components

  1. TEG Kaolin: R-time, K-time, Angle, MA and LY30
  2. TEG Kaolin post Heparinase: R-time, K-time, Angle, MA and LY30
  3. Pathologist Interpretation. If selected, it will be resulted into EPIC by the end of the next business day following TEG 5000 testing.

 

In instances where more immediate interpretations may be needed, please contact:

Monday - Friday, 8AM - 5PM: Coagulation Laboratory at 2-1315

All other times: Laboratory Medicine Resident On-Call (LMROC) at Pager 7910

Clinical Indications

Monitoring of heparin therapy.

Methodology

Thromboelastography

Additional Information

Please document any drugs affecting hemostasis as well as any recent transfusions/fluid resuscitations in the relevant parts of this order in EPIC.

 

TEGHP assays will be visible in Citrix (TEG Manager).

 

3.2% sodium citrate light blue top tubes must have 9 to 1 ratio of blood to anticoagulant

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

STAT Turnaround Time: N/A

 

Routine Turnaround Time: 2 hours

 

Testing Schedule: 24/7

Synonyms/Keyword Search

Thromboelastograph; TEG; cardiopulmonary bypass; ECMO, TEG2

Last Review Date

05/29/2024