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lüll Role of fibrin D-dimer testing in emergency medicine Wakai A; Gleeson A; Winter DEmerg Med J 2003[Jul]; 20 (4): 319-25OBJECTIVES: Systemic values of the fibrinolytic plasma marker fibrin D-dimer are raised in a variety of acute clinical conditions. D-dimer values can now be rapidly determined and used to aid diagnosis in emergency medicine. However, despite clinical guidelines, inappropriate and unnecessary measurement of D-dimer values is a significant clinical problem. An understanding of the pathophysiological basis and limitations of the value of D-dimer values may help reduce this problem. This review discusses the pathophysiology of the fibrinolytic system. The currently used assays, clinical indications, and limitations of D-dimer measurement are reviewed. Finally, the potential future clinical indications for measurement of D-dimer values in emergency medicine are discussed. METHODS: Literature on D-dimer was identified from Medline, along with cross referencing from the reference lists of major articles on the subject RESULTS: and conclusions: Systemic D-dimer values aids diagnosis, and is potentially a prognostic indicator, in a variety of clinical conditions in emergency medicine. However, it has limited specificity in patients with comorbid conditions. Although, currently, there is no standard D-dimer assay, immunoturbidimetric assays are the most suitable for use in emergency medicine|Biomarkers/blood[MESH]|Emergency Medicine/methods[MESH]|Fibrin Fibrinogen Degradation Products/*analysis/physiology[MESH]|Humans[MESH]|Myocardial Ischemia/diagnosis[MESH]|Prognosis[MESH]|Pulmonary Embolism/diagnosis[MESH]|Venous Thrombosis/*diagnosis[MESH] |