title: Comparison of laboratory values obtained by means of routine venipuncture versus peripheral intravenous catheter after a normal saline solution bolus.
abstract: OBJECTIVE
  This study compares selected laboratory values of blood samples obtained by means of venipuncture and by means of a peripheral intravenous catheter after a normal saline solution bolus.
  
  
  METHODS
  In this prospective experimental study, each participant served as his or her own control. Hospital employees volunteered in the emergency department of a tertiary-care teaching hospital. Participants had a peripheral catheter placed in one upper extremity and received a 200-mL bolus of normal saline solution during a 10-minute period. After a 2-minute wait period, a 12-mL aspirate was withdrawn directly from the saline solution lock. A second 12-mL aspirate was also obtained. Concurrently, venipuncture was performed on the other upper extremity. All 3 samples were analyzed for CBC, electrolytes, blood urea nitrogen, creatinine, glucose, liver function tests, and prothrombin time/international normalized ratio (PT/INR). Limits of agreement analysis based on the definition of clinical equivalence, as determined by surveying residency-trained and board-certified emergency physicians, was used to compare the results of catheter aspirates with those of venipuncture aspirates.
  
  
  RESULTS
  Thirty-three volunteers participated. When comparing venipuncture versus first aspirate, 16 of the 19 laboratory tests evaluated had 99% agreement intervals that were within the predetermined definition of clinical equivalence. Potassium, bicarbonate, and glucose did not demonstrate clinical equivalence, and this difference persisted after a 12-mL discard volume.
  
  
  CONCLUSIONS
  This study supports the use of blood samples obtained by means of aspiration from a peripheral catheter when testing for CBC, blood urea nitrogen, creatinine, liver function tests, and PT/INR in healthy-appearing patients. Catheter aspiration, when testing for electrolytes and glucose, may be reasonable in a more select group of patients.
authors.affiliation: Department of Emergency Medicine, Geisinger Health System, Danville, PA 17822, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Zlotowski
authors.forename: D F
authors.initials: DF
authors.lastname: Kupas
authors.forename: G C
authors.initials: GC
authors.lastname: Wood
mesh_terms: D000328:Adult; D001774:Blood Chemical Analysis; D002406:Catheterization, Peripheral; D002408:Catheters, Indwelling; D003955:Diagnostic Tests, Routine; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage
chemical_list: D012965:Sodium Chloride