Thromboembolism laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
In low/moderate suspicion of PE, a normal D-dimer level (shown in a blood test) is enough to exclude the possibility of thrombotic PE.[1]
When a PE is being suspected, a number of blood tests are done, in order to exclude important secondary causes of PE. This includes a full blood count, clotting status (PT, APTT, TT), and some screening tests (erythrocyte sedimentation rate, renal function, liver enzymes, electrolytes). If one of these is abnormal, further investigations might be warranted.
Plasma D-dimer level: D-dimer is a fibrin degradation product and an important marker of activated fibrinolysis. Enzyme linked immunoassay and latex turbidimetric assays methods provide its quantity. It can be elevated in pneumonia, cancer, sepsis, and after surgery. D-dimer values increase progressively throughout pregnancy, and the ranges for normal values by gestational week are not yet universally established. With low or moderate clinical suspicion, a negative d-dimer test rules out pulmonary embolism.
Arterial Blood Gas
- Acid-base status may demonstrate a respiratory alkalosis.
- The arterial blood gas in room temperature demonstrates hypoxemia (PaO2 <80 mm Hg) and an elevated alveolar / arterial oxygen gradient.