title: Evaluation of the Becton-Dickinson rapid serum tube: does it provide a suitable alternative to lithium heparin plasma tubes?
abstract: BACKGROUND
  Obtaining a suitable specimen for analysis in a timely manner is pivotal in clinical chemistry service provision. Serum is recognized as the preferred specimen for most assays, but because of time constraints for completion of clotting and an increasing number of patients on anti-coagulant therapy, latent clotting or no clotting is an outcome which can lead to errors and delay in delivery of critical results. Although lithium heparin plasma has unique problems, it has become an alternative in hospital-based laboratories.
  
  
  METHODS
  The Becton-Dickinson (BD) rapid serum tube (RST) was evaluated in a hospital environment using a total of 53 participants, both healthy and anticoagulated, for 31 analytes against BD PST II and BD SST II tubes measured with Beckman DxC800 and DxI800 analyzers.
  
  
  RESULTS
  Most results from the RST tube were comparable with those from the SST II tube. Potassium results were closer to the PST II plasma concentrations. Incomplete and latent clotting was encountered in the RST specimens from participants (cardiac and dialysis) who had received a total of >7000 units of heparin [activated partial thromboplastin time (APTT) >150 s], warfarin/heparin combination, and specimens from cardiac surgery patients who had received a total of >25,000 units of heparin (APTT >200 s) at the time of collection of specimens.
  
  
  CONCLUSIONS
  The RST tube provides a suitable alternative to lithium heparin plasma tubes for most patients in a hospital environment. However, latent clotting continued to occur in specimens collected from participants who had received high concentrations of anticoagulants.
authors.affiliation: School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia. goce_dimeski@health.qld.gov.au
authors.forename: Goce
authors.initials: G
authors.lastname: Dimeski
authors.forename: Paul P
authors.initials: PP
authors.lastname: Masci
authors.forename: Manuela
authors.initials: M
authors.lastname: Trabi
authors.forename: Martin F
authors.initials: MF
authors.lastname: Lavin
authors.forename: John
authors.initials: J
authors.lastname: de Jersey
mesh_terms: D000925:Anticoagulants / Q000737:chemistry*; D001774:Blood Chemical Analysis; D001800:Blood Specimen Collection / Q000295:instrumentation*; D006493:Heparin / Q000737:chemistry*; D006801:Humans; D008094:Lithium / Q000737:chemistry*
chemical_list: D000925:Anticoagulants; D006493:Heparin; D008094:Lithium