Potential preanalytical errors in whole-blood analysis: effect of syringe sample volume on blood gas, electrolyte and lactate values.
Author(s): Hedberg P, Majava A, Kiviluoma K, Ohtonen P
Publication: Scand J Clin Lab Invest, 2009, Vol. 69, Page 585-91
PubMed ID: 19396657 PubMed Review Paper? No
Suggested by: ISBER
Purpose of Paper
The purpose of this paper was to evaluate the effects of partial tube filling and storage on blood gas parameters.
Conclusion of Paper
Filling the 3.0 mL tube to 1.5 or 1.8 mL resulted in changes of less than 10% in oxygen partial pressure (pO2), oxygen saturation (O2 sat), and sodium from both arterial and venous collections and a 14.8% decrease in carboxyhemoglobin in total hemoglobin (COHb) in 1.5 mL collections of arterial, but not venous blood. The use of 1.0 mL fill volume led to significant changes in most variables; however, only pO2, base excess in blood (BEvT) and CoHb were changed by more than 10% in venous and/or arterial blood specimens. Storage of 1 mL blood specimens at 4 or 23 degrees C for up to 90 minutes resulted in changes of more than 10% in partial pressure of carbon dioxide (pCO2), lactate, COHb, BEvt and methemoglobin in total hemoglobin (MetHb).
Studies
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Study Purpose
The purpose of this study was to evaluate the effects of partial tube filling on blood gas parameters.
Summary of Findings:
Filling the 3.0 mL tube to 1.8 mL resulted in significant changes of less than 10% in pO2, O2 sat, and sodium from both arterial and venous collections and in pH from arterial and calcium from venous collections. Using 1.5 mL caused similar changes of less than 10% in pO2, O2 sat, sodium and lactate in both arterial and venous specimens and a 14.8% decrease in COHB in arterial but not venous blood. The use of 1.0 mL fill volume led to significant changes in most variables, but only pO2, BEvT and CoHb were changed by more than 10% in venous and/or arterial blood specimens.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Gas Clinical chemistry/auto analyzer Small molecule Clinical chemistry/auto analyzer Protein Hematology/ auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Aliquots and Components Aliquot size/volume 3.0 mL fill volume
1.8 mL in 3.0 mL tube
1.5 mL in 3.0 mL tube
1.0 mL in 3.0 mL tube
Biospecimen Acquisition Anatomical location of blood draw Artery
Vein
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Study Purpose
The purpose of this study was to evaluate the effects of storage of partially filled tubes on blood gas parameters.
Summary of Findings:
pO2, pH, actual concentration of bicarbonate (HCO3 act), total hemoglobin (tHb), hematocrit (Hct), O2 sat, sodium, potassium and calcium remained within 5% of initial levels after storage at 23 or 4 degrees C for up to 90 minutes. In contrast pCO2 decreased slightly (4.4-10.8%), lactate decreased more significantly (20.5-51.7%), and COHb increased with 90 minutes of storage at 4 or 23 degrees C. Both BEvt and MatHb levels initially declined but then increased with additional storage.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Small molecule Clinical chemistry/auto analyzer Protein Hematology/ auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Gas Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Aliquots and Components Aliquot size/volume 1.0 mL in 3.0 mL tube
Storage Storage temperature 4 degrees C
23 degrees C
Storage Storage duration 1-5 min
15 min
30 min
60 min
90 min