Impact of blood collection devices on clinical chemistry assays.
Blood collection devices interact with blood to alter blood composition, serum, or plasma fractions and in some cases adversely affect laboratory tests. Vascular access devices may release coating substances and exert shear forces that lyse cells. Blood-dissolving tube additives can affect blood constituent stability and analytical systems. Blood tube stoppers, stopper lubricants, tube walls, surfactants, clot activators, and separator gels may add materials, adsorb blood components, or interact with protein and cellular components. Thus, collection devices can be a major source of preanalytical error in laboratory testing. Device manufacturers, laboratory test vendors, and clinical laboratory personnel must understand these interactions as potential sources of error during preanalytical laboratory testing. Although the effects of endogenous blood substances have received attention, the effects of exogenous substances on assay results have not been well described. This review will identify sources of exogenous substances in blood specimens and propose methods to minimize their impact on clinical chemistry assays.
Bowen
Raffick A R
RA
Department of Pathology, Stanford University, 300 Pasteur Drive, Room H1507 B, Stanford, CA 94305, USA. rbowen@stanfordmed.org
Hortin
Glen L
GL
Csako
Gyorgy
G
Otañez
Oscar H
OH
Remaley
Alan T
AT
D000925:Anticoagulants; D001681:Biological Assay; D001777:Blood Coagulation; D001800:Blood Specimen Collection / Q000266:history / Q000295:instrumentation* / Q000379:methods; D002404:Catheterization; D002624:Chemistry, Clinical / Q000295:instrumentation / Q000379:methods; D019411:Clinical Laboratory Techniques; D004202:Disinfectants; D049673:History, 20th Century; D006801:Humans; D009339:Needles; D013048:Specimen Handling / Q000295:instrumentation / Q000379:methods; D013501:Surface-Active Agents; D013594:Syringes
D000925:Anticoagulants; D004202:Disinfectants; D013501:Surface-Active Agents