Collection of Blood Specimens by Venipuncture for Plasma-Based Coagulation Assays
| Autor: | Huib L. Vader, Maarten T M Raijmakers, Fedde van der Graaf, Carolien H.F. Menting |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Prothrombin time
medicine.medical_specialty Venipuncture medicine.diagnostic_test business.industry Antithrombin General Medicine Surgery Coagulation Anesthesia Blood plasma Coagulation testing medicine Thromboplastin business circulatory and respiratory physiology Partial thromboplastin time medicine.drug |
| Zdroj: | American Journal of Clinical Pathology. 133:331-335 |
| ISSN: | 1943-7722 0002-9173 |
| Popis: | The Clinical and Laboratory Standards Institute (CLSI) recently abandoned its recommendation for drawing a discard tube when performing a prothrombin time (PT)/international normalized ratio (INR) or an activated partial thromboplastin time (APTT). Because there is currently no evidence that a discard tube is necessary for more specialized coagulation assays, we studied the need for a discard tube for some of these tests. Blood was obtained from 88 subjects in 2 subsequent citrate tubes. Platelet-free plasma was tested for PT, APTT, antithrombin, protein C, and factors II, V, VIII, IX, and X. Difference and bias between tubes were tested using the Wilcoxon signed rank test and Bland-Altman plots. For only APTT, antithrombin, and protein C was a small, statistically significant mean bias found (0.5 seconds; P = .001; –0.7%, P = .002; and –0.8%, P < .0001, respectively), but the bias of individual samples was not clinically relevant. This was also true for the other parameters tested. The recent CLSI recommendation that a discard tube is not necessary for PT/INR and APTT can be extended to include more specialized plasma-based coagulation assays as identified in this study. Preanalytic variables may affect test results. In particular, coagulation assays are sensitive to variation in conditions during the collection, transport, and processing of blood specimens. During the last few years, there has been much debate whether a discard tube should be drawn for plasma-based coagulation assays when using a standard evacuated tube collection system. The rationale for a discard tube is based on historic coagulation testing using the whole blood clotting time, in which tissue thromboplastin released and activated during venipuncture could lead to erroneous results. A few studies have already shown that with today’s coagulation reagents and venipuncture procedures, using extremely sharp low-resistance needles, a discard tube is not necessary for prothrombin time (PT) and activated partial thromboplastin |
| Databáze: | OpenAIRE |
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