Lab Test

Fibrinogen

Factor I

Test Codes

Antrim: 26170, EPIC: LAB7027, LAB314

Department

Coagulation

Instructions

Specimens with hematocrit values greater than 55% must have anticoagulant adjusted. Specimens must be re-collected using a specified whole blood to sodium citrate ratio. Contact the performing Laboratory for specific instructions.

Specimen Collection Criteria

Collect: One Light Blue-top 3.2% Sodium Citrate tube.

TUBE MUST BE FULL.

Physician Office/Draw Specimen Preparation

Maintain whole blood specimen at room temperature (20-26°C or 68-78.8°F) prior to transport. Transport whole blood to the Laboratory within 4 hours of collection. If transport within 4 hours is not possible, the following procedure must be followed for accurate results:

  1. Centrifuge the capped tube at 1500 x g for 15 minutes.
  2. Transfer plasma with a plastic pipette into a plastic polypropylene centrifuge tube, cap and centrifuge an additional 15 minutes at 1500 x g to obtain platelet poor plasma (PPP) which has a platelet count less than 10 bil/L. Plasma with a platelet count of less than 10 bil/L is critical for accurate results.
  3. Immediately remove only the top two-thirds of the PPP and transfer it into a screw cap, 5 ml, 75 x 13 mm, round base, polypropylene tube.
  4. Freeze (-20°C/-4°F or below) the PPP immediately.
  5. Transport frozen on DRY ICE. Specimen must remain frozen during transport.  

Preparation for Courier Transport

Transport: Whole blood at room temperature (20-25°C or 68-77°F), or plasma obtained through the process listed above, frozen (-20°C/-4°F or below).

Rejection Criteria

  • Glass tubes and 3.8% Sodium Citrate tubes.
  • Specimens that are clotted or grossly hemolyzed.
  • Inappropriate specimen volume.
  • Thawed or partially thawed specimens. 

In-Lab Processing

Whole blood specimens must be processed as follows upon receipt in the Laboratory:

  1. Centrifuge the capped tube at 1500 x g for 15 minutes.
  2. Transfer plasma with a plastic pipette into a plastic polypropylene centrifuge tube, cap and centrifuge an additional 15 minutes at 1500 x g to obtain platelet poor plasma (PPP) which has a platelet count less than 10 bil/L. Plasma with a platelet count of less than 10 bil/L is critical for accurate results.
  3. Immediately remove only the top two-thirds of the PPP and transfer it into a plastic tube.
  4. Test or freeze specimen according to lab protocol.


Storage

Specimen Stability for Testing:

Whole Blood
Room Temperature (20-26°C or 68-78.8°F): 4 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Platelet Poor Plasma (PPP)
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): 30 days. Plasma aliquot must be frozen for transport.

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26 C or 68-78.8 F): 7 days
Refrigerated (2-8°C or 36-46°F): 7 days*

*NOTE: A new sample is required in order for add-on testing.

Laboratory

Dearborn Hematology/Coagulation Laboratory
Farmington Hills Hematology/Coagulation Laboratory
Grosse Pointe Hematology/Coagulation Laboratory
Lenox Main Laboratory
Livonia Main Laboratory
Royal Oak Coagulation Laboratory
Troy Hematology/Coagulation Laboratory
Taylor Hematology/Coagulation Laboratory
Trenton Hematology/Coagulation Laboratory
Wayne Hematology/Coagulation Laboratory

Performed

Sunday – Saturday, 24 hours a day.
STAT results available within 30 minutes of receipt in the Laboratory unless further verification is necessary.
Routine results available within 4 hours of receipt in the Laboratory.

Reference Range

200-450 mg/dL.

Test Methodology

Clauss Method (IL ACL-TOP Series).

Interpretation

In patients on direct thrombin inhibitors (e.g., Argatroban), fibrinogen antigen testing may be more accurate.

Low levels are seen in hypofibrinogemia, DIC, dysfibrinogenemia.
Elevated levels associated with inflammation, infection.

Clinical Utility

The fibrinogen assay is used to detect (acquired or congenital) increased or decreased fibrinogen (factor I) concentration. This assay also aids in monitoring the severity and treatment of disseminated intravascular coagulation and fibrinolysis.

CPT Codes

85384
LOINC:  3256-5

Contacts

Last Updated

10/3/2023

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