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Recentrifugation of Lithium Heparin Gel Separator Tubes up to 8 h after Blood Collection Has No Relevant Influence on the Stability of 30 Routine Biochemical Analytes.

Author(s): van Balveren JA, Gemen EFA, Kusters R

Publication: J Appl Lab Med, 2019, Vol. 3, Page 864-869

PubMed ID: 31639761 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to investigate the effects of storing blood and plasma in lithium heparin gel tubes at room temperature before centrifugation/recentrifugation using two different protocols on the levels of 30 clinical chemistry analytes. Blood from 10 healthy volunteers was collected into lithium heparin gel tubes. Blood was centrifuged immediately after collection with or without a second centrifugation step 4 or 8 h later and 4 h after collection with or without a second centrifugation step 8 h after collection. Centrifugation was performed for each of the different timepoints using two different protocols: at 1650 x g for 10 min (BD settings) or at 3000 x g for 8 min. Levels of alanine aminotransferase (ALT), albumin, alkaline phosphatase, amylase, aspartate aminotransferase (AST), bicarbonate, bilirubin direct, bilirubin total, calcium, chloride, cholesterol, creatinine, C-reactive protein (CRP), ferritin, folic acid, free thyroxine 4, gamma-glutamyl transferase, glucose, lactate dehydrogenase, lipase, magnesium, phosphate, potassium, sodium, triglycerides, troponin I, thyroid stimulating hormone (TSH), urea nitrogen, uric acid, and vitamin B₁₂ were analyzed by a Dimension VISTA 1500 clinical chemistry analyzer.

   Summary of Findings:

   When blood was stored for 4 or 8 h before centrifugation using either protocol, the deviation in glucose levels exceeded the TEa from those in the immediately centrifuged specimen. The deviation in phosphate levels exceeded the TEa when blood was stored for 4 h and centrifuged at 1650 x g for 10 min or stored for 8 h and centrifuged using either protocol. The deviation in calcium levels exceeded the TEa compared to immediately centrifuged specimens when blood was stored for 8 h and centrifuged at 1650 x g for 10 min. When plasma was stored in the tube after immediate centrifugation and centrifuged again at 1650 x g for 10 min  after 8 h after of storage, the mean deviation in the calcium levels from specimens analyzed after the first centrifugation exceeded the TEa (2.55%), but the variation in calcium levels was within the acceptable range when specimens centrifuged at 3000 x g for 8 min were recentrifuged after 4 or 8 h. The variation in all other analytes was within previously determined TEa when recentrifuged and analyzed 4 or 8 h after the initial centrifugation, regardless of centrifugation protocol.

   Biospecimens

   • Bodily Fluid - Plasma
   • Bodily Fluid - Blood

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Normal

   Platform:

   Analyte	Technology Platform
   Carbohydrate	Clinical chemistry/auto analyzer
   Electrolyte/Metal	Clinical chemistry/auto analyzer
   Glycoprotein	Clinical chemistry/auto analyzer
   Small molecule	Clinical chemistry/auto analyzer
   Peptide	Clinical chemistry/auto analyzer
   Protein	Clinical chemistry/auto analyzer
   Lipoprotein	Clinical chemistry/auto analyzer
   Lipid	Clinical chemistry/auto analyzer

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Aliquots and Components	Centrifugation	Centrifugation delays investigated Multiple durations compared Multiple speeds compared
   Storage	Storage conditions	Uncentrifuged (blood) Centrifuged (plasma)
   Storage	Storage duration	0 h 4 h 8 h

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