Clinical relevance
Dabigatran etexilate is a direct thrombin inhibitor which is now clinically used for the prophylaxis and treatment of the thrombosis and related cardiovascular disease. It has been cleared for use without any laboratory monitoring based on its safe pharmokinetic and pharmodynamic profile and short half-life. In certain circumstances measurement of the plasma concentration may aid medical decisions(e.g emergency surgery/severe bleeding).
Reference range
A level of 200-400ng/mL at 2-4 hours post-dose reflects therapeutic anticoagulation.
A level 50-150ng/mL is considered a through level. A level of <30ng/mL should reflect negligible anticoagulant effect.
Minimum volume
The volume of blood in coagulation samples must lie within the volume range as indicated by the size of the black fill arrow present on tubes. Volumes above or below the arrow will result in sample rejection to ensure validity of results.
Turnaround time
4 hours
Age of sample
Samples will be rejected if received more than 2 hours post venepuncture.
Specimen requirements
- 1 blue top (sodium citrate) samples
- all coagulation tubes must be adequately filled (see above)
- All coagulation tubes must be mixed several times by gentle inversion immediately after venepuncture. Mixing the sample with the anticoagulant stops the sample clotting within the tube.
Limitations
- It is not possible to provide results on clotted, insufficient, lipaeamic or haemolysed samples. These samples will be rejected with the appropriate comment.
- Samples tubes that have expired cannot be accepted
Analysing laboratory
Coagulation Lab, James Cook University Hospital, Marton Road, TS4 3BW