title: The effects of different syringe volume, needle size and sample volume on blood gas analysis in syringes washed with heparin.
abstract: BACKGROUND
  We evaluated the effect of different syringe volume, needle size and sample volume on blood gas analysis in syringes washed with heparin.
  
  
  METHODS
  In this multi-step experimental study, percent dilution ratios (PDRs) and final heparin concentrations (FHCs) were calculated by gravimetric method for determining the effect of syringe volume (1, 2, 5 and 10 mL), needle size (20, 21, 22, 25 and 26 G) and sample volume (0.5, 1, 2, 5 and 10 mL). The effect of different PDRs and FHCs on blood gas and electrolyte parameters were determined. The erroneous results from nonstandardized sampling were evaluated according to RiliBAK's TEa.
  
  
  RESULTS
  The increase of PDRs and FHCs was associated with the decrease of syringe volume, the increase of needle size and the decrease of sample volume: from 2.0% and 100 IU/mL in 10 mL-syringe to 7.0% and 351 IU/mL in 1 mL-syringe; from 4.9% and 245 IU/mL in 26G to 7.6% and 380 IU/mL in 20 G with combined 1 mL syringe; from 2.0% and 100 IU/mL in full-filled sample to 34% and 1675 IU/mL in 0.5 mL suctioned sample into 10 mL-syringe. There was no statistical difference in pH; but the percent decreasing in pCO2,, K+, iCa2+, iMg2+; the percent increasing in pO2 and Na+ were statistical significance compared to samples full-filled in syringes. The all changes in pH and pO2 were acceptable; but the changes in pCO2, Na+, K+ and iCa2+ were unacceptable according to TEa limits except fullfilled-syringes.
  
  
  CONCLUSIONS
  The changes in PDRs and FHCs due nonstandardized sampling in syringe washed with liquid heparin give rise to erroneous test results for pCO2 and electrolytes.
authors: Dokuz Eylul University Medical School, Department of Medical Biochemistry, Izmir, Turkey. tuncay.kume@deu.edu.tr
authors: Tuncay
authors: T
authors: Küme
authors: Ali Riza
authors: AR
authors: Sişman
authors: Ahmet
authors: A
authors: Solak
authors: Birsen
authors: B
authors: Tuğlu
authors: Burcu
authors: B
authors: Cinkooğlu
authors: Canan
authors: C
authors: Coker
mesh_terms: D001784:Blood Gas Analysis; D001800:Blood Specimen Collection / Q000379:methods* / Q000592:standards*; D002138:Calibration; D002623:Chemistry Techniques, Analytical; D003951:Diagnostic Errors / Q000517:prevention & control; D004573:Electrolytes / Q000032:analysis; D004867:Equipment Design; D006493:Heparin / Q000737:chemistry*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D009339:Needles; D019095:Point-of-Care Systems; D013594:Syringes
chemical_list: D004573:Electrolytes; D006493:Heparin