Cancer Diagnosis Program | Biorepositories and Biospecimen Research Branch

Search BRD Papers

The influence of dead space in blood sampling needle on FVIII level and pharmacokinetic profiles in children with hemophilia.

Author(s): Zhen Y, Ai D, Huang K, Li G, Chen Z, Wu R

Publication: Hematology, 2024, Vol. 29, Page 2314871

PubMed ID: 38346146 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to investigate the potential impact of dead space from the sampling needle on the quantification of FVIII levels and APTT in specimens collected pre-infusion and post FVIII-infusion from boys with hemophilia. Blood was collected from nineteen boys (3-14 years of age) with hemophilia before and 1 h, 3 h, 9 h, 24 h and 48 h after infusion of standard half-life FVIII. At each timepoint, two specimens were collected into trisodium citrate tubes. Because the first specimen was collected directly, the space in the needle resulted in “dead space” in the first tube that was not there for the second tube. Immediately after collection, plasma was separated by centrifugation at 2500 g for 15 min at room temperature and stored frozen at -80°C. Factor VIII activity and APTT were quantified using an ACL TOP-700 analyzer.

   Summary of Findings:

   The median APTT was longer in tubes with a dead space than in case-matched properly filled tubes at each timepoint (pre-infusion: 124.3 versus 108.6s, P< 0.0001; 1 h: 40.6 versus 36.6s, P< 0.001; 3 h: 39.0 versus 35.1, P< 0.001; 9 h: 42.5 versus 41.4, P< 0.01; 24 h: 51.9 versus 48.9, P< 0.01; and 48 h: 65.9 versus. 65.8, P< 0.01). Correspondingly, the median FVIII levels were lower in plasma from tubes with a dead space than case-matched properly filled tubes at each timepoint (pre-infusion: 0.5 versus 0.6 IU/dL; P< 0.01, at 1 h: 96.5 versus 102.4 IU/dL, P< 0.01; at 3 h: 78.2 versus 87.2 IU/dL, P< 0.0001; at 9 h: 49.2 versus 51.3 IU/dL, P< 0.001; at 24 h: 14.7 versus 20.1 IU/dL, P< 0.001; and at 48 h: 4.2 versus 4.7 IU/dL, P< 0.05). The biases in APTT and FVIII levels observed in tubes containing a dead space were correlated with the level of APTT and FVIII, respectively, in the properly filled tube (r=0.44, P<0.0001 and r=0.68, P<0.0001, respectively), but the percentage of bias in APTT was not correlated with APTT in the properly filled tube. The measured half-life of FVIII post-infusion was shorter in the tubes containing dead space than the properly filled tubes (9.0 versus 9.75 h, P<0.001), resulting in a shorter time to 5, 2 or 1 IU/dL (41.13 versus 43.38 h, P<0.0001; 55.13 versus 59.0 h, P<0.001; and 68.88 versus 74.63 h, P<0.0001).

   Biospecimens

   • Bodily Fluid - Plasma
   • Bodily Fluid - Blood

   Preservative Types

   • Frozen

   Diagnoses:

   • Hemophilia

   Platform:

   Analyte	Technology Platform
   Protein	Hematology/ auto analyzer
   Morphology	Hematology/ auto analyzer

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Acquisition	Method of fluid acquisition	Properly filled tube Improperly filled tube
   Biospecimen Aliquots and Components	Aliquot size/volume	Tube partially filled due to needle dead space Properly filled tube
   Biospecimen Acquisition	Time of biospecimen collection	Pre-infusion 1 h post-infusion 3 h post-infusion 9 h post-infusion 24 h post-infusion 48 h post-infusion

   View more