Coagulation | Prothrombin Time/INR

UWHC Lab Test Details
Test NameProthrombin Time/INR
Test Code(s)PT
CPT Code(s)85610
Clinical Information

Methodology

University Hospital, The American Center, West Clinic, Digestive Health Clinic- Optical Clot detection

Days PerformedDaily, 24 hours.
In-Lab Turnaround Time4 hours.
Stat In-Lab Turnaround Time1 hour.
Collection Requirements
SpecimenBlood
Collection Container
Collection ContainerLight blue top (3.2% NaCitrate)
Collection Instructions

The venipuncture MUST be atraumatic to avoid hemolysis and contamination with tissue factors and platelets. Tube MUST be allowed to fill up to "fill" line indicated on tube.

 

If unable to collect 1.8 ml tube (pediatrics only) please call UWHC Coagulation Lab at (608)263-9617 or UWHC Special Coagulation Lab at (608) 263-5005 for alternate tube and instructions.

Collection Volume3.5 mL
Pediatric Collection Volume1.8 mL
Specimen Processing Requirements
Stability
Stability Ambient

24 hours if unspun; 4 hours if spun and opened

Stability Refrigerated

Not acceptable

Stability Frozen

2 weeks at -20°C; 6 months at -70°C

Sample AnalyzedPlasma
Testing Volume0.5 mL
Pediatric Testing Volume0.5 mL
Specimen Processing

Centrifuge specimen to yield platelet poor plasma (platelet count should be less than 10K/uL). Separate plasma and transfer to plastic tube or vial. Freeze plasma at -20°C or below.

Specimen Transport

Transport whole blood specimen in an unopened tube at room temperature to the laboratory within 24 hours of collection. Specimens that have been opened and spun must be less than 4 hours old when received by the laboratory. Otherwise, transport frozen plasma aliquot on dry ice.

Unacceptable Criteria

Grossly hemolyzed specimens, clotted specimens, partially filled tubes and specimens greater than 24 hours old when received by the laboratory are not acceptable.

Interpretation
Reference Interval
     
 7 months and up:  0.9 - 1.2  

 

Critical CallsView here
Additional Information

INR is the International Normalized Ratio which takes into account the instrumentation and reagent system used at UWHC. The INR is intended to standardize reporting of the prothrombin time. For patients NOT on anticoagulants, the reference range for the INR is 0.9-1.2. The recommended therapeutic range for warfarin is an INR of 2.0-3.0. (Exception: The recommended range for many mechanical valves is INR 2.5-3.5.) Reference: CHEST 2012; 141 pgs e5925-e5945.

 

Heparin concentrations exceeding 1.2 IU/mL may prolong the INR and thus interfere with monitoring of vitamin K antagonists such as warfarin. Inhibitors of the Lupus type anticoagulants can influence prothrombin and lead to INR’s that do not accurately reflect the true level of anticoagulation. Direct thrombin inhibitors (bivalrudin, dabigatran, etc.) in therapeutic dose result in prolonged prothrombin times.