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Role of the Peripheral Intravenous Catheter in False‐positive D‐dimer Testing
Author(s) -
Heffner Alan C.,
Kline Jeffrey A.
Publication year - 2001
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2001.tb01272.x
Subject(s) - venipuncture , medicine , d dimer , mcnemar's test , phlebotomy , venous blood , vein , anesthesia , nuclear medicine , gastroenterology , surgery , statistics , mathematics
.Objective: To determine whether inserting a peripheral intravenous catheter (IV) can significantly increase the circulating D‐dimer concentration. Methods: Twenty healthy young adult volunteers underwent cannulation of an antecubital vein with a 20‐gauge Teflon IV. Time 0 venous blood was drawn during IV insertion. The IV was salinelocked and left in place for 90 minutes, at which time a second venipuncture was performed in a contralateral antecubital vein (+90 min). A qualitative D‐dimer assay [erythrocyte‐agglutination assay, SimpliRED (SRDD)] and a quantitative spectrophotometric assay [enzyme‐linked immunosorbent assay (EIA), Dimertest Gold] were performed on all samples. Time 0 means (±SD) were compared with +90 min means by paired t‐test, and SRDD pairs were compared with McNemar's test. Results: Time 0 initial venipuncture blood samples yielded a mean D‐dimer concentration of 15 ± 24 ng/mL, with 2/20 SRDD tests read as positive (95% CI = 1% to 32%). At +90 min, the D‐dimer concentration was 33 ± 21 ng/mL (p = 0.04 vs time 0), with 5/20 SRDD tests read as positive (95% CI = 9% to 49%, p = 0.248). Conclusions: Insertion of an IV increased the circulating D‐dimer concentration (determined by EIA), but did not lead to a significant increase in false‐positive conversion of the SRDD. An effort should be made to perform D‐dimer testing on “first‐stick” blood to optimize specificity. However, a strongly positive D‐dimer reaction cannot be ascribed to the presence of an IV.