Comparison between a Modified Ethanol Gelation Test and Protamine Sulfate Test. Experimental Studies

Summary

A comparative experimental study has been made to correlate the protamine sulfate test and a modified ethanol gelation test, based on clinical observations of the solubility of a gel formed at 20° C (Godal and Abildgaard procedure) when it was transferred to a bath at 37° C. Two different results were obtained: the gel remained insoluble at 37° C or it became completely soluble, with intermediate degrees of partial solubility.

Our studies indicate that this is due to the amount of fibrin monomers formed and the level of fibrinogen: the first are responsible for the insolubility of the gel and the second for its solubility. This furnishes us with useful information for diagnostic purposes.

We found the protamine sulfate test more sensitive than the ethanol gelation test, and its sensitivity increased when fibrinogen level decreased.

An insoluble gelation test is a sure indication of the presence of fibrin monomers, but a soluble gel calls for the protamine sulfate test to confirm this or the existence of high fibrinogen level.

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