The Role of Plasma D-Dimer As A Prognostic Marker In Critically Ill Patients
Mohamed Rabie Mohamed Ghanem;
Abstract
D-dimer testing was originally developed in the diagnosis of disseminated intravascular coagulation (DIC), it turned out to be useful in diagnosis of thromboembolic process. D-dimer is a fibrin degradation product, a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. During coagulation of blood, fibrinogen is metabolized to fibrin by thrombin activation. Fibrin consists of D and E units. The cleavage of fibrin leads to so called D-dimers.
D-dimer concentration may be determined by a blood test to help diagnose thrombosis. It has become an important test performed patients suspected of thrombotic disorders.
Several assays are used to measure d-dimer: Enzyme-Linked Immunosorbent Assay (ELISA), which is the most accurate but lengthy and expensive; the latex agglutination test, which has high false-negative rates; and the red blood cell agglutination test, which has wide ranges of specificity and sensitivity. These tests have different characteristics; and because each test uses different reagents, the reported sensitivity and specificity for each assay cannot be applied interchangeably.
A negative result practically rules out thrombosis, a positive result can indicate thrombosis but does not rule out other potential etiologies. Its main use, therefore, is to exclude thromboembolic disease where the probability is low.
D-dimer testing is of clinical use when there is a suspicion of deep venous thrombosis (DVT) or pulmonary embolism (PE). In patients suspected of disseminated intravascular coagulation (DIC), D-dimer testing may aid in the diagnosis Increased concentrations of D-dimer are a sign of an active fibrinolysis and have been verified at patients with injury, sickle cell anemia, liver disease, heavy infections, inflammation and malignant disease or in older people. The concentration of D-dimer rises also during a normal pregnancy.
The actual quantity of D-dimer is approximately half of fibrinogen equivalent units (FEU). One FEU is the quantity of fibrinogen that was initially present before it was broken down (When 1.0 of fibrinogen microgram per milliliter (µg/mL) is broken down, 0.5 µg/mL of D-Dimer remain).The cut-off measurement of D-Dimer is 80 ng/ml. This is the value indicating appositive result.
D-dimer may be the first diagnostic screening test in a protocol for symptomatic outpatients with suspected thromboembolism while the major clinical utility of D-dimer is
D-dimer concentration may be determined by a blood test to help diagnose thrombosis. It has become an important test performed patients suspected of thrombotic disorders.
Several assays are used to measure d-dimer: Enzyme-Linked Immunosorbent Assay (ELISA), which is the most accurate but lengthy and expensive; the latex agglutination test, which has high false-negative rates; and the red blood cell agglutination test, which has wide ranges of specificity and sensitivity. These tests have different characteristics; and because each test uses different reagents, the reported sensitivity and specificity for each assay cannot be applied interchangeably.
A negative result practically rules out thrombosis, a positive result can indicate thrombosis but does not rule out other potential etiologies. Its main use, therefore, is to exclude thromboembolic disease where the probability is low.
D-dimer testing is of clinical use when there is a suspicion of deep venous thrombosis (DVT) or pulmonary embolism (PE). In patients suspected of disseminated intravascular coagulation (DIC), D-dimer testing may aid in the diagnosis Increased concentrations of D-dimer are a sign of an active fibrinolysis and have been verified at patients with injury, sickle cell anemia, liver disease, heavy infections, inflammation and malignant disease or in older people. The concentration of D-dimer rises also during a normal pregnancy.
The actual quantity of D-dimer is approximately half of fibrinogen equivalent units (FEU). One FEU is the quantity of fibrinogen that was initially present before it was broken down (When 1.0 of fibrinogen microgram per milliliter (µg/mL) is broken down, 0.5 µg/mL of D-Dimer remain).The cut-off measurement of D-Dimer is 80 ng/ml. This is the value indicating appositive result.
D-dimer may be the first diagnostic screening test in a protocol for symptomatic outpatients with suspected thromboembolism while the major clinical utility of D-dimer is
Other data
| Title | The Role of Plasma D-Dimer As A Prognostic Marker In Critically Ill Patients | Other Titles | دور الدى دايمر فى تشخيص ومتابعة بعض الأمراض الخاصة بمرضى الرعايةالمركزة | Authors | Mohamed Rabie Mohamed Ghanem | Issue Date | 2014 |
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