A comparative study of sample collection tubes for routine biochemical parameters.
DOI:
https://doi.org/10.47419/bjbabs.v4i01.203Keywords:
Anticoagulant; Clot activator; Sample collection tube; Turnaround time (TAT)Abstract
Background & Objectives: Turnaround time is one of the important indicators of the performance of a clinical laboratory and is the sum total of the pre-analytical, analytical and post analytical TAT. Pre-analytical TAT can be reduced by selection of appropriate sample collection tube. Our objective is to compare three such tubes for the biochemical parameters and pre-analytical TAT.
Methods: Samples were collected in Plain tube, BD SST and BD heparin tubes from 50 participants and were compared for the pre-analytical TAT and seventeen biochemical parameters. Taking BD SST tube as reference, plain tube and BD lithium heparin tube were compared for the tube bias.
Results: Serum LDH, AST, Potassium and phosphates were significantly higher (p=<0.05) while serum glucose and sodium were statistically significantly (p=<0.05) lower in plain tube as compared to the BD SST and bias for these parameters was clinically significant as well. Significant difference (p=<0.05) in concentration of total protein, potassium and glucose was observed between BD SST and BD heparin tube but bias was clinically insignificant. Pre-analytical TAT was drastically reduced with use of plasma tube followed by SST and plain tube.
Conclusion: We conclude that sample collection tubes contribute to the variation in the results of the biochemical parameter and TAT. During individual patient’s hospital stay samples for chemistry should always be collected into the same tube to ensure that variation in parameters are patient or disease related not tube related.
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References
Bergman B, Klefsjo B. Quality: from customer needs to customer satisfaction. Maidenhead, England: McGraw-Hill; 1994.
Li L, Georgiou A, Vecellio E, Eigenstetter A, Toouli G, Wilson R, Westbrook JI. The effect of laboratory testing on emergency department length of stay: a multihospital longitudinal study applying a cross-classified random-effect modeling approach. Acad Emerg Med. 2015 Jan;22(1):38-46. DOI: https://doi.org/10.1111/acem.12565
Hwang U, Baumlin K, Berman J, Chawla NK, Handel DA, Heard K, et al. Emergency department patient volume and troponin laboratory turnaround time. Acad Emerg Med. 2010 May;17(5):501-7. DOI: https://doi.org/10.1111/j.1553-2712.2010.00738.x
Hawkins RC. Laboratory turnaround time. Clin Biochem Rev. 2007 Nov;28(4):179-94.
Valenstein P. Turnaround time. Can we satisfy clinicians' demands for faster service? Should we try? Am J Clin Pathol. 1989 Nov;92(5):705-6. DOI: https://doi.org/10.1093/ajcp/92.5.705
Truchaud A, Le Neel T, Brochard H, Malvaux S, Moyon M, Cazaubiel M. New tools for laboratory design and management. Clin Chem. 1997 Sep;43(9):1709-15. DOI: https://doi.org/10.1093/clinchem/43.9.1709
Prusa R, Doupovcova J, Warunek D, Stankovic AK. Improving laboratory efficiencies through significant time reduction in the preanalytical phase. Clin Chem Lab Med. 2010 Feb;48(2):293-6. DOI: https://doi.org/10.1515/CCLM.2010.036
Mohri M, Rezapoor H. Effects of heparin, citrate, and EDTA on plasma biochemistry of sheep: comparison with serum. Res Vet Sci. 2009 Feb;86(1):111-4. DOI: https://doi.org/10.1016/j.rvsc.2008.05.010
Bowen RA, Remaley AT. Interferences from blood collection tube components on clinical chemistry assays. Biochem Med (Zagreb). 2014 Feb 15;24(1):31-44 DOI: https://doi.org/10.11613/BM.2014.006
Evans MJ, Livesey JH, Ellis MJ, Yandle TG. Effect of anticoagulants and storage temperatures on stability of plasma and serum hormones.
Desirable specifications for total Error, imprecision, and bias, derived from intra- and inter-individual biologic variation. https://www.westgard.com/biodatabase1.htm accessed on October, 2022.
Zhang DJ, Elswick RK, Miller WG, Bailey JL. Effect of serum-clot con¬tact time on clinical chemistry laboratory results. Clin Chem 1998;44: 1325-33. DOI: https://doi.org/10.1093/clinchem/44.6.1325
Ono T, Kitaguchi K, Takehara M, Shiiba M, Hayami K. Serum-constituents analyses: effect of duration and temperature of storage of clotted blood. Clin Chem. 1981 Jan;27(1):35-8. DOI: https://doi.org/10.1093/clinchem/27.1.35
Rehak NN, Chiang BT. Storage of whole blood: effect of temperature on the measured concentration of analytes in serum. Clin Chem. 1988 Oct;34(10):2111-4. DOI: https://doi.org/10.1093/clinchem/34.10.2111
Chan AY, Swaminathan R, Cockram CS. Effectiveness of sodium fluoride as a preservative of glucose in blood. Clin Chem. 1989 Feb;35(2):315-7. DOI: https://doi.org/10.1093/clinchem/35.2.315
Danowski TS. The transfer of potassium across the human blood cell membrane. J Biol Chem.1941;139:693-705. DOI: https://doi.org/10.1016/S0021-9258(18)72942-6
Goodman JR, Vincent J, Rosen I. Serum potassium changes in blood clots. Am J Clin Pathol. 1954 Jan;24(1):111-3. DOI: https://doi.org/10.1093/ajcp/24.1_ts.111
Yücel D, Dalva K. Effect of in vitro hemolysis on 25 common biochemical tests. Clin Chem. 1992 Apr;38(4):575-7. DOI: https://doi.org/10.1093/clinchem/38.4.575
Mensel B, Wenzel U, Roser M, Lüdemann J, Nauck M. considerably reduced centrifugation time without increased hemolysis: evaluation of the new BD Vacutainer SSTTMII Advance. Clin Chem. 2007 Apr;53(4):794-5. DOI: https://doi.org/10.1373/clinchem.2006.079582
Lippi G, Salvagno GL, Montagnana M, Brocco G, Guidi GC. Influence of hemolysis on routine clinical chemistry testing. Clin Chem Lab Med. 2006;44(3):311-6. DOI: https://doi.org/10.1515/CCLM.2006.054
Delgado JA, Morell-Garcia D, Bauça JM. Hemolysis Interference Studies: The Particular Case of Sodium Ion. EJIFCC. 2019 Mar 1;30(1):25-34.
Lippi G, Cervellin G, Favaloro EJ, Plebani M. In vitro and in vivo hemolysis. An unresolved dispute in laboratory medicine. Berlin, Germany: Walter de Gruyter GmbH, 2012. DOI: https://doi.org/10.1515/9783110246148
Sonntag O. Haemolysis as an interference factor in clinical chemistry. J Clin Chem Clin Bioc hem 1986;24:127-39.
van der Woerd-de Lange JA, Guder WG, Schleicher E, Paetzke I, Schleithoff M, Wieland OH. Studies on the interference by haemoglobin in the determination of bilirubin. J Clin Chem Clin Biochem. 1983 Jul;21(7):437-43. DOI: https://doi.org/10.1515/cclm.1983.21.7.437
Koseoglu M, Hur A, Atay A, Cuhadar S. Effects of hemolysis interferences on routine biochemistry parameters. Biochem Med (Zagreb). 2011;21(1):79-85. DOI: https://doi.org/10.11613/BM.2011.015
Jay DW, Provasek D. Characterization and mathematical correction of hemolysis interference in selected Hitachi 717 as says. Clin Chem 1993;39:1804-10. DOI: https://doi.org/10.1093/clinchem/39.9.1804
Randall AG, Garcia-Webb P, Beil by JB. Interference by haemolysis, icterus and lipaemia in assays on the Beckman Synchron CX5 and methods for correction. Ann Clin Biochem 1990;27:345-52. DOI: https://doi.org/10.1177/000456329002700411
Barelli S, Crettaz D, Thadikkaran L, Rubin O, Tissot J-D. Plasma/serum proteomics: pre-analytical issues. Expert Rev Proteomics. 2007;4:363–370. DOI: https://doi.org/10.1586/14789450.4.3.363
World Health Organization. Use of anticoagulants in diagnostic laboratory investigations. World Health Organization; 2002;5-7.
Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, McDonald JM, et al. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Clin Chem. 2002;48:436–472. DOI: https://doi.org/10.1093/clinchem/48.3.436
Ladenson JH, Tsai LM, Michael JM, Kessler G, Joist JH. Serum versus heparinized plasma for eighteen common chemistry tests: is serum the appropriate specimen? Am J Clin Pathol. 1974;62:545–552. DOI: https://doi.org/10.1093/ajcp/62.4.545
Yu Z, Kastenmüller G, He Y, Belcredi P, Möller G, Prehn C, et al. Differences between human plasma and serum metabolite profiles. PLoS One. 2011;6(7):e21230. DOI: https://doi.org/10.1371/journal.pone.0021230
World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation.
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