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D-dimer (or D dimer) is a dimer that is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two D fragments of the fibrin protein joined by a cross-link , hence forming a protein dimer .
The purpose of the rule is to select the best method of investigation (e.g. D-dimer testing, CT angiography) for ruling in or ruling out the diagnosis of PE, and to improve the interpretation and accuracy of subsequent testing, based on a Bayesian framework for the probability of the diagnosis.
60–79 years 1 80+ years 2 Previous venous thromboembolism Previous DVT or PE 2 Previous surgery Recent surgery within 4 weeks 3 Heart rate Heart rate >100 beats per minute 1 PaCO 2 (partial pressure of CO 2 in arterial blood) <35mmHg 2 35-39mmHg 1 PaO 2 (partial pressure of O 2 in arterial blood) <49mmHg 4 49-59mmHg 3 60-71mmHg 2 72-82mmHg 1
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Low clinical probability. If negative D-dimer, PE is excluded. If positive D-dimer, obtain MDCT and base treatment on results. Moderate clinical probability. If negative D-dimer, PE is excluded. However, the authors were not concerned that a negative MDCT with negative D-dimer in this setting has a 5% probability of being false. Presumably, the ...
Principles of D-dimer testing. Fibrin degradation products (FDPs), also known as fibrin split products, are components of the blood produced by clot degeneration. [1] Clotting, also called coagulation, at the wound site produces a mass of fibrin threads called a net that remains in place until the cut is healed. As a cut heals, the clotting ...
Findings may include low platelets, low fibrinogen, high INR, or high D-dimer. [2] Treatment is mainly directed towards the underlying condition. [2] [3] Other measures may include giving platelets, cryoprecipitate, or fresh frozen plasma. [2] Evidence to support these treatments, however, is poor. [2] Heparin may be useful in the slowly ...
A measurement of blood D-dimer level may be useful in diagnostic evaluation. A level less than 500 ng/ml may be considered evidence against a diagnosis of aortic dissection, [1] [31] although this guideline is only applicable in cases deemed "low risk" [32] and within 24 hours of symptom onset. [33]