Platelet Function Closure Time with Reflex to ADP

Abbrev Code:PFCT   
Order Code:LAB3672Order Name:Platelet Function Closure with Reflex
Synonyms:Replaces Bleeding Time; Recommended for Aspirin Resistance
Methodology:Activated clotting
CPT Codes: 85576 x1, 85576 x1
Turnaround Time:Performed and reported 24 hours/day.
Special Instructions:
Do not send in PTS.

Collection Instructions

Optimal Volume:5.4 mL (in two 3 mL tubes for correct anticoagulant to blood ratio)
Minimum\Peds Volume:2.7 mL (in a 3 mL tube) Note: This volume does not permit further testing if results are abnormal.
Container:Blue Na Citrate, 3.2% - fill to fill line on tube
Collection Instructions:
Samples should be collected using a 21 gauge needle or larger. Do not use first 2 mL of blood collected. For correct anticoagulant to blood ratio, place 2.7 mL blood in 3 mL tube. If patient's hematocrit is greater than 55%, contact laboratory to obtain a special tube. Do not send in Pneumatic Tube System (PTS).
After Care:If the patient has a coagulation abnormality, apply direct pressure to the puncture site for 10 minutes; apply a pressure dressing. Instruct the patient to leave the bandage on for 12 hours.
Causes for Rejection:Over filled or under filled tubes; clotted specimens; plasma specimens; centrifuged specimens; hemolyzed specimens; refrigerated specimens; specimens greater than 4 hours; specimens sent through the PTS.

Processing and Shipping

Specimen Processing:Do not process. Do not store.
Shipping Instructions:
Ship at room temperature. Specimens must arrive ASAP (within 3 hours if possible) as testing must be completed within 4 hours of collection. Do not send in PTS.  
Test Performed at or Referral Lab Coagulation  (Range, Southdale, UMMC East Bank, UMMC/UMMCH-West Bank)


Reference Range:
The collagen/epinephrine (CEPI) membrane detects platelet dysfunction induced by any intrinsic platelet defects (von Willebrand disease, aspirin, etc.). Abnormal samples (CEPI greater than 170) are tested as a second step on the collagen/ADP (CADP) membrane to enable discrimination of aspirin effects.
  Col/EPI Col/ADP
Normal Less than 170 sec Less than 120 sec
Aspirin abnormal normal
von Willebrand's
abnormal abnormal
abnormal abnormal
Closure times may be prolonged with platelet counts less than 150,000 or hematocrit less than 35%.    
Use: Closure time is indicated when a disorder of platelet function is suspected by a personal or family history of easy bruising, nosebleeds, menorrhagia or post-operative bleeding. It is not recommended as a screen for potential bleeding risk. Abnormal closure times, indicating possible defective platelet function, should be further investigated with standard platelet aggregation tests. The platelet function closure time (CT) replaced bleeding time which was a poor indicator of surgical bleeding risk, labor intensive and operator dependent, demonstrated poor correlation to platelet function, and caused scarring. The CT is sensitive to platelet adhesion and aggregation abnormalities, thereby providing increased sensitivity for von Willebrand screening and aspirin-induced platelet dysfunction in comparison to the bleeding time.

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