Comparison of blood collection tubes for 29 biochemical analytes in pediatric patients with central venous catheters.
Author(s): Kang H, Cho HW, Rim JH, Hahn SM, Han JW, Lee SG, Lyu CJ, Lim JB
Publication: Clin Biochem, 2022, Vol. 107, Page 73-79
PubMed ID: 35545160 PubMed Review Paper? No
Purpose of Paper
This paper compared levels of 29 clinical chemistry analytes in paired serum and lithium heparin plasma specimens from pediatric oncology patients.
Conclusion of Paper
Lithium heparin plasma had clinically higher levels (bias exceeded the total allowable error) of total protein and albumin and lower levels of sodium and potassium than serum specimens. Passing and Bablok regression analysis showed that bias in all total protein, albumin, sodium, and potassium levels were constant and not proportional. The bias in all other analytes evaluated was less than the total allowable error.
Studies
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Study Purpose
This study compared levels of 29 clinical chemistry analytes in paired serum and lithium heparin plasma specimens from pediatric oncology patients. Blood was collected from 52 (25 male and 27 female) pediatric oncology patients (43 patients were < 17 years of age and nine were 18-41 years of age) diagnosed with acute leukemia (19 patients), neuroblastoma (7 patients), medulloblastoma (5 patients), retinoblastoma (five patients), rhabdomyosarcoma (5 patients), Ewing’s sarcoma (3 patients), Wilms’ tumor (2 patients), or other diagnosis (6 patients). After discarding the first 5-8 mL of heparin locked blood, blood was collected via chemoports or Hickman catheters into matched SST and lithium heparin gel tubes. Serum tubes were allowed to clot for 20 min before separation of serum. Serum and plasma were separated by centrifugation at 2,456 × g for 10 min at 25°C. Levels of calcium, inorganic phosphate, glucose, blood urea nitrogen (BUN), creatinine, uric acid, cholesterol, total protein, albumin, alkaline phosphatase, aspartate transaminase (AST), alanine transaminase (ALT), total bilirubin, direct bilirubin, gamma-glutamyl transferase (GGT), lactate dehydrogenase, creatine kinase triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, sodium, potassium, chloride, total carbon dioxide, iron, amylase, lipase, and C-reactive protein (CRP) were quantified in serum and plasma using a Cobas c702 instrument. Clinical significance was defined as a change greater than the smallest total allowable error specified in the desirable biological variation database or the Clinical Laboratory Improvement Amendments.
Summary of Findings:
Lithium heparin plasma had slightly higher levels of calcium (+0.8%), glucose (+0.9%), creatinine (+1.0%), total protein (+3.8%), alanine transaminase (+0.1%), direct bilirubin (+0.5%), glutamyl transferase (+0.6%), chloride (+0.2%), tCO2 (+1.5%), magnesium (+1.0%), amylase (+0.3%), and lipase (+0.3%) and lower levels of inorganic phosphate (-1.59%), blood urea nitrogen (- 0.3%), cholesterol (-1.2%), albumin (- 3.0%), alkaline phosphatase (- 1.8%), aspartate transaminase (-0.6%), total bilirubin (- 1.0%), lactate dehydrogenase (-0.1%), creatinine kinase (-1.1%), triglycerides (-0.1%), high-density lipoprotein cholesterol (-1.7%), low-density lipoprotein cholesterol (-0.9%), sodium (- 0.3%), iron (-1.7%), C-reactive protein (-4.8%), and potassium (-5.3%) than matched serum specimens . However, only differences in total protein, albumin, sodium, and potassium exceeded the desirable bias limit. Passing and Bablok regression analysis revealed that bias in all total protein, albumin, sodium, and potassium were constant and not proportional.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Neoplastic - Pediatric
- Neoplastic - Leukemia
- Neoplastic - Sarcoma
Platform:
Analyte Technology Platform Carbohydrate Clinical chemistry/auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Gas Clinical chemistry/auto analyzer Lipid Clinical chemistry/auto analyzer Steroid Clinical chemistry/auto analyzer Protein Clinical chemistry/auto analyzer Peptide Clinical chemistry/auto analyzer Small molecule Clinical chemistry/auto analyzer Lipoprotein Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Aliquots and Components Blood and blood products Plasma
Serum
Biospecimen Acquisition Type of collection container/solution SST
Lithium heparin tube