Role of the peripheral intravenous catherer in false-positive D-dimer testing

Alan C. Heffner, Jeffrey A. Kline

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

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 saline-locked 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.

Original languageEnglish (US)
Pages (from-to)103-106
Number of pages4
JournalAcademic Emergency Medicine
Volume8
Issue number2
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • D-dimer
  • Decision making
  • Deep venous thrombosis
  • Diagnosis
  • Diagnostic tests
  • Pulmonary embolism
  • Respiratory system
  • Thromboembolism

ASJC Scopus subject areas

  • Emergency Medicine

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