Effects of tourniquet technique, order of draw, and sample storage on plasma fibrinogen.

Author(s): Rosenson RS, Staffileno BA, Tangney CC

Publication: Clin Chem, 1998, Vol. 44, Page 688-90

PubMed ID: 9510890 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to determine the effects of tourniquet pressure and duration, sequential collection, and refrigerated storage of plasma on fibrinogen levels. During collection, a sphygmomanometer was used to standardize tourniquet pressure with low pressure defined as 40 mmHg and high pressure defined as mean arterial pressure + 10 mmHg for each volunteer. Tourniquet times of 0-1 min, 2-3 min, and 4-5 min were used. All blood was collected into citrate tubes. The first-stick effect was analyzed by comparing fibrinogen levels from the first specimen with the average fibrinogen levels from the next 4 specimens.

   Summary of Findings:

   There were no significant differences in fibrinogen concentrations between the first collected specimen and the average concentration of the next 4 specimens. When low tourniquet pressure was applied (40 mmHg), fibrinogen concentrations progressively increased with the duration of tourniquet application (p<0.00005), but there was no statistically significant difference between specimens obtained with 2-3 min tourniquet application and those obtained with 4-5 min tourniquet application. When high tourniquet pressure was applied (mean arterial pressure + 10 mmHg), fibrinogen concentrations also progressively increased with the duration of tourniquet application (p<0.00005), but there was no statistically significant difference between specimens obtained with 2-3 min tourniquet application and those obtained with 0-1 min tourniquet application. Changing the tourniquet pressure did not affect the average fibrinogen concentrations, as long as the tourniquet time was similar. Storage of plasma at 4 degrees C for up to 48 hours did not affect fibrinogen concentrations.

   Biospecimens

   • Bodily Fluid - Plasma
   • Bodily Fluid - Blood

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Normal

   Platform:

   Analyte	Technology Platform
   Glycoprotein	Clinical chemistry/auto analyzer

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Acquisition	Method of fluid acquisition	Tourniquet pressures compared Tourniquet times compared
   Biospecimen Aliquots and Components	Aliquot sequential collection	1st collection Not first collection
   Storage	Storage duration	<10 min 6 h 24 h 48 h

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