Kinetic Immunoassay (KIMS)
Diagnosis of digoxin toxicity, monitor therapeutic drug level.
0.5 - 1.5 ng/mL. Note that in the setting of chronic heart failure, retrospective analysis of data from a randomized clinical trial revealed the following associations between serum digoxin concentrations and all-cause mortality: 0.5 to 0.8 ng/mL, lower risk than placebo; 0.9 to 1.1 ng/mL, similar risk to placebo; 1.2 ng/mL and above, higher risk than placebo. Critical Value: >2.0 ng/mL.
Administration of Digibind will interfere with the assay. Administration of fluorescent dyes may interfere with this assay. Samples from patients receiving digitoxin or crude digitalis therapy will show falsely elevated values for digoxin. The sera from patients in specific populations (i.e., patients with renal and/or hepatic failure, newborn infants, and pregnant women) have been reported to contain an unidentified component that gives positive results for digoxin with this assay. This component has been called digoxin-like immunoreactive factor (DLIF) or substance (DLIS). The presence of DLIF in a sample can result in falsely elevated digoxin results.
- DIGOXIN LEVEL
STAT requests for this test will be performed on a STAT basis (supervisory staff approval is not required).
Collect blood in a red top tube. Centrifuge, aliquot serum into a plastic vial, and refrigerate. Blood specimen should be drawn at least 8 hours after the administration of the last dose (falsely elevated results may occur if blood is drawn less than eight hours after last dose).
Digoxin is a potent cardiac glycoside widely prescribed for the treatment of patients suffering from congestive heart failure, as well as some types of cardiac arrhythmias.