Comparative Evaluation of Centrifugation Speed and Its Impact on Diagnostic Accuracy.
Author(s): Jeraiby MA, Moshi JM, Dar SA, Habibullah MM, Yahia M, Abdalla SEB, Balkhtab RM, Saigh RA, Burayk NS
Publication: J Clin Lab Anal, 2025, Vol. , Page e70120
PubMed ID: 41065293 PubMed Review Paper? No
Purpose of Paper
This study compared hemolysis, lipemia, icterus, and the levels of 34 clinical chemistry and 3 coagulation analytes in plasma (lithium heparin and sodium citrate tubes) and serum (without gel or clot activator) obtained by fast (4000 g for 5 min) and standard (3200 g for 10 min) centrifugation.
Conclusion of Paper
When all specimens were considered none were classified as icteric, and mean levels of all analytes remained within clinically acceptable ranges regardless of centrifugation speed. While the authors state that none of the differences observed were clinically significant, differences were statistically significant in some cases; specimens (plasma and serum) obtained by high-speed centrifugation had higher mean levels of sodium (P=0.003), alkaline phosphatase (ALP, P=0.001) and free thyroxine (P<0.001) and lower mean levels of creatine kinase MB (CKMB, P=0.044) and alanine transaminase (ALT, P=0.011) than specimens processed at a standard centrifugation speed (4000 versus 3200 g). Additionally, specimens centrifuged at high speed had longer mean prothrombin time (PT, P=0.008) and a higher International Normalized Ratio (P=0.003), but the Activated Partial Thromboplastin Time (APTT) was comparable to that obtained at a standard centrifugation speed. As a result, there were slight negative biases in sodium (-2.70), low density lipoprotein (-4.5) and prothrombin time (-0.19), and positive biases in ALT (1.91) and CKMB (1.82) in specimens obtained by high-speed centrifugation in comparison to those obtained at a standard centrifugation speed. Compared to standard centrifugation, high-speed centrifugation reduced the coefficients of variance (CV) of CKMB (38.5% versus 66.73%), creatinine (23.79% versus 180.56%), dialysate bicarbonate concentration (DBIC,52.82% versus 136.25%), potassium (30.8% versus 77.34%), and phosphorus (33.34% versus 62.57%).
When the effect of centrifugation was compared between lithium heparin plasma and no additive serum separately, levels of sodium were higher in serum obtained by high-speed centrifugation than in lithium heparin plasma (either speed) or serum obtained by low-speed centrifugation (P=0.003), but none of the other analytes were significantly affected. As a result, the bias in sodium between specimen types (serum versus plasma) was small under standard centrifugation (-0.31) but was higher after high-speed centrifugation (3.21). Interestingly, the direction of the bias in ALT and CKMB between specimen types depended on the centrifugation speed, with higher levels of ALT (1.34) and lower levels of CKMB (-0.45) in serum processed by standard centrifugation, but lower levels of ALT (-2.92) and higher levels of CKMB (2.76) when obtained by high-speed centrifugation. Notably, the CV for ALT bias between serum and plasma was high under both centrifugation speeds (88.95% and 88.46%), and the CVs of CKMB and creatinine bias between serum and plasma increased was higher after high-speed centrifugation than standard centrifugation (68.8% from 47.16% and 197.64% from 26.09%, respectively). The authors conclude that higher-speed centrifugation (4000 g for 5 min) is an acceptable alternative to standard-speed centrifugation (3200 g for 10 min) and reduces turnaround time.
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Studies
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Study Purpose
This study compared hemolysis, lipemia, icterus, and the levels of 34 clinical chemistry and 3 coagulation analytes in plasma (lithium heparin and sodium citrate tubes) and serum (without gel or clot activator) obtained by fast (4000 g for 5 min) and standard (3200 g for 10 min) centrifugation. Blood was collected from 150 patients (diagnosis not specified) into two each of lithium heparin tubes, sodium citrate tubes, and serum tubes without gel or clot activator. One tube of each type from each patient was centrifuged using the standard protocol (3200 g for 10 min), and the other was centrifuged at 4000 g for 5 min. Hemolysis, lipemia, icterus, clotting and fibrin were characterized by visual inspection. Levels of sodium potassium, chloride, albumin, CKMB, high density lipoprotein, Unsaturated Iron Binding Capacity (UIBC), phosphorous, ALP, ALT, iron, magnesium, uric acid, rheumatoid factor, DBIC, aspartate aminotransferase (AST), ferritin, total bilirubin, total protein, gamma-glutamyl transferase (GGT), cholesterol, creatine kinase, glucose, triglycerides, urea, calcium, creatinine, GLUB (not defined), LDL, Total iron binding capacity (TIBC), free Thyroxine, thyroid stimulating hormone (TSH), vitamin B12, and Vitamin D were quantified using Beckman Coulter DXC 700 AU and DXI 600 analyzers. Coagulation tests were performed using a STAGO Compact analyzer.
Summary of Findings:
When all specimens were considered, none were classified as icteric, and mean levels of all analytes remained within clinically acceptable ranges regardless of centrifugation speed. While the authors state that none of the differences observed were clinically significant, differences were statistically significant in some cases; specimens (plasma and serum) obtained by high-speed centrifugation had higher mean levels of sodium (P=0.003), alkaline phosphatase (ALP, P=0.001) and free thyroxine (P<0.001) and lower mean levels of creatine kinase MB (CKMB, P=0.044) and alanine transaminase (ALT, P=0.011) than specimens processed at a standard centrifugation speed (4000 versus 3200 g). Additionally, specimens centrifuged at high speed had longer mean prothrombin time (PT, P=0.008) and a higher International Normalized Ratio (P=0.003), but the Activated Partial Thromboplastin Time (APTT) was comparable to that obtained at a standard centrifugation speed. As a result, there were slight negative biases in sodium (-2.70), low density lipoprotein (-4.5) and prothrombin time (-0.19), and positive biases in ALT (1.91) and CKMB (1.82) in specimens obtained by high-speed centrifugation in comparison to those obtained at a standard centrifugation speed. Compared to standard centrifugation, high-speed centrifugation reduced the coefficients of variance (CV) of CKMB (38.5% versus 66.73%), creatinine (23.79% versus 180.56%), dialysate bicarbonate concentration (DBIC,52.82% versus 136.25%), potassium (30.8% versus 77.34%), and phosphorus (33.34% versus 62.57%).
When the effect of centrifugation was compared between lithium heparin plasma and no additive serum separately, levels of sodium were higher in serum obtained by high-speed centrifugation than in lithium heparin plasma (either speed) or serum obtained by low-speed centrifugation (P=0.003), but none of the other analytes were significantly affected. As a result, the bias in sodium between specimen types (serum versus plasma) was small under standard centrifugation (-0.31) but was higher after high-speed centrifugation (3.21). Interestingly, the direction of the bias in ALT and CKMB between specimen types depended on the centrifugation speed, with higher levels of ALT (1.34) and lower levels of CKMB (-0.45) in serum processed by standard centrifugation, but lower levels of ALT (-2.92) and higher levels of CKMB (2.76) when obtained by high-speed centrifugation. Notably, the CV for ALT bias between serum and plasma was high under both centrifugation speeds (88.95% and 88.46%), and the CVs of CKMB and creatinine bias between serum and plasma increased was higher after high-speed centrifugation than standard centrifugation (68.8% from 47.16% and 197.64% from 26.09%, respectively). The authors conclude that higher-speed centrifugation (4000 g for 5 min) is an acceptable alternative to standard-speed centrifugation (3200 g for 10 min) and reduces turnaround time.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Small molecule Clinical chemistry/auto analyzer Lipoprotein Clinical chemistry/auto analyzer Lipid Clinical chemistry/auto analyzer Protein Macroscopic observation Morphology Hematology/ auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Protein Clinical chemistry/auto analyzer Carbohydrate Clinical chemistry/auto analyzer Steroid Clinical chemistry/auto analyzer Small molecule Macroscopic observation Lipid Macroscopic observation Cell count/volume Macroscopic observation Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Type of collection container/solution Lithium heparin Tube
No additive serum tube
Biospecimen Aliquots and Components Centrifugation Multiple durations compared
Multiple speeds compared
Biospecimen Aliquots and Components Blood and blood products Plasma
Serum