The importance of blood sampling site for determination of hemoglobin and biochemistry values in major abdominal and orthopedic surgery.
OBJECTIVE
To determine whether sampling of blood from different sites influences laboratory results.


METHODS
Prospective, double-blind study.


METHODS
University-affiliated hospital in Israel.


METHODS
100 ASA physical status I, II, and III patients undergoing major orthopedic or colon surgery (total hip and revision of total hip replacement, colon resection, or radical cystectomy).


METHODS
Blood was sampled simultaneously for hemoglobin, electrolytes, glucose, pH, blood gases, and lactate from three sampling sites (peripheral vein, central vein, and radial artery) at 5 time frames (after induction of anesthesia [baseline], one hr after induction of anesthesia, at the end of surgery, after one hr in the recovery room, and 4 hrs after surgery). At the same time points, recorded rectal temperature, mean arterial pressure, heart rate, and central venous pressure were recorded. Anesthesia, monitoring, and dwell volumes before sampling were standardized.


RESULTS
There were no significant differences between the results of hemoglobin, electrolytes, glucose, pH, and blood gases obtained from different sampling sites and at different time frames. Lactate level (mmol/L) was higher in peripheral venous blood than it was in either the central vein or radial artery (<0.05), and higher in central venous blood compared with arterial blood (P < 0.05; 2.04 +/- 1.16, 1.74 +/- 0.78, and 1.54 +/- 0.68, respectively).


CONCLUSIONS
Under stable hemodynamics and in the absence of hypothermia, serum lactate level was higher in peripheral venous blood than it was in the central vein or radial artery.
Evron
Shmuel
S
Department of Anesthesia, Edith Wolfson Medical Center, Holon 58100, Israel.
Tress
Vladimir
V
Ezri
Tiberiu
T
Szmuk
Peter
P
Landau
Ofer
O
Hendel
David
D
Schechter
Pinhas
P
Medalion
Benjamin
B
D000368:Aged; D001158:Arteries; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001784:Blood Gas Analysis / Q000379:methods; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D001800:Blood Specimen Collection / Q000379:methods*; D003106:Colon / Q000601:surgery*; D004311:Double-Blind Method; D004573:Electrolytes / Q000097:blood; D005260:Female; D006339:Heart Rate; D006454:Hemoglobins / Q000032:analysis*; D006785:Hospitals, University; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007557:Israel; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D014680:Veins
D001786:Blood Glucose; D004573:Electrolytes; D006454:Hemoglobins; D019344:Lactic Acid