Effects of vigorous mixing of blood vacuum tubes on laboratory test results

被引：25

作者：

Lima-Oliveira, Gabriel ^{[1
,2
,3
,4
]}

Lippi, Giuseppe ^{[5
]}

Salvagno, Gian Luca ^{[1
]}

Montagnana, Martina ^{[1
]}

Gelati, Matteo ^{[1
]}

Volanski, Waldemar ^{[2
]}

Boritiza, Katia Cristina ^{[2
]}

Picheth, Gerald ^{[2
]}

Guidi, Gian Cesare ^{[1
,2
]}

机构：

[1] Univ Verona, Dept Life & Reprod Sci, Lab Clin Biochem, I-37100 Verona, Italy

[2] Univ Fed Parana, Dept Med Pathol, Postgrad Program Pharmaceut Sci, BR-80060000 Curitiba, Parana, Brazil

[3] MERCOSUL Sector Comm Clin Anal & Vitro Diagnost, Rio De Janeiro, Brazil

[4] Brazilian Soc Clin Anal Sao Paulo State, Sao Paulo, Brazil

[5] Acad Hosp Parma, Dept Pathol & Lab Med, Clin Chem & Hematol Lab, Parma, Italy

来源：

CLINICAL BIOCHEMISTRY | 2013年 / 46卷 / 03期

关键词：

Blood mixing; Blood specimen collection; Clinical laboratory techniques; Diagnostic errors; Reference values; Reproducibility of results; Quality control; Specimen handing; Vacuum tubes; TERM VENOUS STASIS; CLINICAL-CHEMISTRY; SAMPLE COLLECTION; ROUTINE; ERRORS; IMPACT; MANAGEMENT; FREQUENCY; QUALITY; ASSAYS;

D O I：

10.1016/j.clinbiochem.2012.10.033

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

Objective: To evaluate the effect of tubes mixing (gentle vs. vigorous) on diagnostic blood specimens collected in vacuum tube systems by venipuncture. Design and methods: Blood was collected for routine coagulation, immunochemistry and hematological testing from one hundred volunteers into six vacuum tubes: two 3.6 mL vacuum tubes containing 0.4 mL of buffered sodium citrate (9NC) 0.109 mol/L: 3.2 W/V%; two 3.5 mL vacuum tubes with clot activator and gel separator; and two 3.0 mL vacuum tubes containing 5.9 mg K(2)EDTA (Terumo Europe, Belgium). Immediately after the venipuncture all vacuum tubes (each of one additive type) were processed through two different procedures: i) Standard: blood specimens in K(2)EDTA- or sodium citrate-vacuum tubes were gently inverted five times whereas the specimens in tubes with clot activator and gel separator were gently inverted ten times, as recommended by the manufacturer; ii) Vigorous mix: all blood specimens were shaken up vigorously during 3-5 s independently of the additive type inside the tubes. The significance of the differences between samples was assessed by Student's t-test or Wilcoxon ranked-pairs test after checking for normality. The level of statistical significance was set at P<0.05. Results: No significant difference (P<0.05) was detected between the procedures for all tested parameters. Surprisingly only a visual alteration (presence of foam on the top) was shown by all the tubes mixed vigorously before centrifugation (Fig. 1 A, B and C). Moreover the serum tubes from vigorous mixing procedure shows a "blood ring" on the tube top after stopper removal (Fig. 1 D). Conclusion: Our results drop out a paradigm suggesting that the incorrect primary blood tubes mixing promotes laboratory variability. We suggest that similar evaluation should be done using other brands of vacuum tubes by each laboratory manager. (C) 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

引用

页码：250 / 254

页数：5

共 39 条

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