Comparison of Ethanol and Protamine Tests in Demonstration of Soluble Fibrin and Early Products of Fibrin Degradation

Summary

Performance and applicability of ethanol-induced gelation and protamine-induced paracoagulation for the demonstration of soluble fibrin monomer complexes and fragment X^o complexes was studied by using 1. fibrin monomer plasma prepared by adding small amounts of thrombin to plasma, 2. clot lysis products, and 3. thrombin -treated mixture of fibrinogen degradation products and plasma. To increase the specificity of the protamine tests only visible fibrin strand formation was recorded as positive. In addition to qualitative tests the amount of paracoagulable material was measured by a spectrophotometric method.

The ethanol gelation test proved very simple, reproducible and considerably more sensitive than the protamine tests in demonstrating soluble fibrin monomer complexes, irrespective of whether fibrinogen degradation products were present or not. On the other hand, the protamine tests were clearly superior for demonstration of clot lysis products (fragment X^o complexes). Therefore it seems advisable to perform both types of tests when screening for intravascular coagulation.

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