Just wondering if anyone is still using the Protamine Sulphate? Or an FDP for DICs. Or if they report out just a D-Dimer? Thanks

Our DIC panel still includes an FDP. D-dimer is used here primarily for screening for DVT or PEs in ER, but it does seems like it should have replaced the FDP in all situations by now.

Scott

D-dimer here

Why or perhaps How did the protamine sulfate test fall out of favor? I looked through several coagulation sections of hematology textbooks and there is no to minimal references to this test (which should tell me something right there!). What is a good suggestion to replace or substitute for this test?

Our laboratory is looking at revising our coagulation testing. This is one test on our revision list but we have a pathologist who is reluctant to give it up. What can I offer him in exchange for this?

Protamine sulfate is used for other purposes in medicine, but if I am not mistaken, its main use in Lab testing is to differentiate DIC (and other simular thrombotic problems like pulmonary embolism and deep vein thrombosis) from primary fibrinolysis. It seems to me that the D-dimer, which is specific for cross-linked fibrin, has made this test obselete.

Quantitative D-dimer assays can be easily run on most automated coagulation analyzers. There are also point-of-care analyzers that will run d-dimers.

Scott