Comparison of PT and aPTT values drawn by venipuncture and arterial line using three discard volumes.
BACKGROUND
Blood samples obtained through heparinized arterial catheters are used routinely for a variety of laboratory tests. Accuracy of coagulation studies performed from samples obtained in this fashion continues to be questioned, particularly in regard to the minimum discard volume necessary to clear the catheter of heparinized solution.


OBJECTIVE
To examine differences between prothrombin time and activated partial thromboplastin time values obtained from blood drawn by venipuncture and from an indwelling intra-arterial line using three discard volumes.


METHODS
Prothrombin time and activated partial thromboplastin time samples were drawn by venipuncture from 41 critically ill adult patients. Simultaneously, three consecutive blood samples of 2.3 mL were drawn from the arterial line after an initial discard volume of 3 mL (discard volumes of 3.0, 5.3 and 7.6 mL).


RESULTS
Significant differences were found between arterial and venous prothrombin time values for the 3-mL discard volume group, as well as between arterial and venous activated partial thromboplastin time values for all three discard volume groups (paired t-test, Bonferroni correction).


CONCLUSIONS
We recommend that when drawing prothrombin time and activated partial thromboplastin time samples from an arterial line, a 5.3-mL discard volume be used.
Konopad
E
E
Department of Nursing, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Grace
M
M
Johnston
R
R
Noseworthy
T
T
Shustack
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015982:Bias; D001800:Blood Specimen Collection / Q000295:instrumentation / Q000379:methods*; D001810:Blood Volume; D001815:Bloodletting / Q000295:instrumentation / Q000379:methods; D002408:Catheters, Indwelling; D003422:Critical Care; D005260:Female; D006493:Heparin; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D015203:Reproducibility of Results
D006493:Heparin