The euglobulin lysis time test is used to document excessive fibrinolytic activity. Euglobulins are proteins that precipitate from acidified dilute plasma; these include fibrinogen, plasminogen, and plasminogen activator but very little antiplasmin activity. In euglobulins prepared from normal blood, the initial clot dissolves in 2 to 6 hours. With excessive fibrinolytic activity, a clot forms if thrombin is added to the sample.

Shortened euglobulin lysis times are seen in fibrinolytic therapy with streptokinase or urokinase, prostatic cancer, severe liver disease, extensive vascular trauma or surgery, and shock.

• Lysis in 2 to 6 hours

• Decreased fibrinogen levels may lead to falsely shortened lysis time because of the reduced amount of fibrin to be lysed.³⁶
• Traumatic venipunctures and excessive agitation of the sample may alter results.

• Suspected abnormal fibrinolytic activity as indicated by lysis of the clot within about 1 hour
• Differentiation of primary fibrinolysis from DIC, which usually presents with a normal euglobulin lysis time
• Monitoring of effects of fibrinolytic therapy on normal coagulation

Nursing Care Before the Procedure

Client preparation is the same as that for any study involving the collection of a peripheral blood sample (see Appendix I).

• If the individual is receiving anticoagulant therapy, the time and the amount of the last dose should be noted.

A venipuncture is performed and the sample collected in a light-blue-topped tube. As with other coagulation studies, traumatic venipuncture and excessive agitation of the sample should be avoided. The sample should be sent to the laboratory promptly.

Nursing Care After the Procedure

Care and assessment after the procedure are essentially the same as for any study involving the collection of a peripheral blood sample.

• Because the client may have a coagulation deficiency, maintain digital pressure directly on the puncture site for 3 to 5 minutes after the needle is withdrawn.
• Inspect the site for excessive bruising after the procedure.
• Clot lysis: Note and report decreases in lysis level during fibrinolytic therapy. Monitor client response and effect of therapy on coagulation.