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The transition from gel separatory serum tubes to lithium heparin gel tubes in the clinical laboratory

Yıl 2023, Cilt: 6 Sayı: 5, 998 - 1009, 28.09.2023
https://doi.org/10.32322/jhsm.1341282

Öz

Aims: To assess the viability of replacing serum samples with plasma samples in various clinical chemistry and immunoassay tests and to examine the implications of turnaround time (TAT) and sample quality during the transition process.
Methods: We compared the results of 27 paired clinical chemistry and 13 immunoassay tests from samples obtained using gel separator serum and gel separator lithium heparinized plasma (LIH) tubes. We used regression analysis, bias values, and Bland-Altman plots to compare the performance of serum and LIH tubes in various clinical chemistry and immunoassay tests. We collected and evaluated sample aspiration errors, hemolysis index values, and TAT data from the laboratory information system before and after switching to plasma in our study.
Results: Most tests showed no significant difference between the serum and LIH. However, for some analytes, total error (TE) values exceeded the total allowable error (TEa) limits derived from the biological variation database. Notably, insulin TE value did not exceed TEa, but it consumed near all its error budget. Consequently, we determined the alternative allowable error limits for some tests and found that plasma tubes could be used instead of serum tubes for most tests, except for lactate dehydrogenase (LDH). Plasma tubes improved the sample quality, reduced the incidence of aspiration errors, and decreased TAT in the emergency laboratory. We observed significant reductions in TAT after switching to plasma tubes.
Conclusion: Our study showed that LIH tubes can replace serum tubes in most clinical chemistry and immunoassay tests. Using LIH tubes in clinical laboratories can improve healthcare quality and reduce the workload of the laboratory staff.

Kaynakça

  • World Health Organization. Diagnostic Imaging and Laboratory Technology. (2002). Use of anticoagulants in diagnostic laboratory investigations. World Health Organization. Accessed May 3, 2023.https://apps.who.int/iris/handle/10665/65957
  • Valenstein P. Laboratory turnaround time. Am J Clin Pathol. 1996;105(6):676-688. doi:10.1093/ajcp/105.6.676
  • Güvenç Demirağcı Y. Laboratuvar sonuç verme sürelerinin değerlendirilmesi. ET J. 2018;5(3):54-58.
  • Arslan FD, Karakoyun I, Basok BI, et al. The local clinical validation of a new lithium heparin tube with a barrier: BD Vacutainer® Barricor LH plasma tube. Biochem Medica. 2017;27(3):030706. doi:10.11613/BM.2017.030706
  • Lippi G, Cornes MP, Grankvist K, Nybo M, Simundic AM. EFLM WG-Preanalytical phase opinion paper: local validation of blood collection tubes in clinical laboratories. Clin Chem Lab Med CCLM. 2016;54(5). doi:10.1515/cclm-2015-1274
  • CLSI. Validation and Verification of Tubes for Venous and Capillary Blood Specimen Collection; Approved Guideline. CLSI document GP34-A Wayne, PA: Clinical and Laboratory Standards Institute; 2010.
  • Quality Requirements-Westgard. Accessed February 5, 2023. https://www.westgard.com/quality-requirements.htm
  • Aarsand AK, Fernandez-Calle P, Webster C, et al. The EFLM Biological variation database. Accessed Jue 25, 2023. Available at: https://biologicalvariation.eu/
  • Sun H, Wang W, Zhao H, et al. Internal quality control status for BNP and NT-proBNP in China from 2014 to 2017. J Clin Lab Anal. 2019;33(1):e22643. doi:10.1002/jcla.22643
  • Oosterhuis WP, Coskun A, Sandberg S, Theodorsson E. Performance specifications for sodium should not be based on biological variation. Clin Chim Acta. 2023;540:117221. doi:10.1016/j.cca.2023.117221
  • Hétu PO, Hobeila S, Larivière F, Bélanger MC. Improved sample quality and decreased turnaround time when using plasma blood collection tubes with a mechanical separator in a large university hospital. J Appl Lab Med. 2021;6(2):409-420. doi:10.1093/jalm/jfaa111
  • Lima-Oliveira G, Monneret D, Guerber F, Guidi GC. Sample management for clinical biochemistry assays: Are serum and plasma interchangeable specimens? Crit Rev Clin Lab Sci. 2018;55(7):480-500. doi:10.1080/10408363.2018.1499708
  • Wang YS, Feng CF, Er TK, et al. Comparison of cardiac troponin I levels in serum and sodium-citrate plasma using the ACCESS 2 immunoassay. Ann Clin Lab Sci. 2005;35(4):453-454.
  • Ercan Ş. Comparison of test results obtained from lithium heparin gel tubes and serum gel tubes. Turk J Biochem. 2020;45(5):575-586. doi:10.1515/tjb-2019-0117
  • Ferrari D, Strollo M, Vidali M, Motta A, Pontillo M, Locatelli M. Biochemical, immunochemical and serology analytes validation of the lithium heparin BD Barricor blood collection tube on a highly automated Roche COBAS8000 instrument. Acta Bio Medica Atenei Parm. 2020;91(1):47-55. doi:10.23750/abm.v91i1.9195
  • Arslan FD, Karakoyun I, Basok BI, et al. The local clinical validation of a new lithium heparin tube with a barrier: BD Vacutainer® Barricor LH Plasma tube. Biochem Medica. 2017;27(3):030706. doi:10.11613/BM.2017.030706
  • Bockoven C, Granato M, Benirschke R, Lee H. Differing plasma and serum lactate dehydrogenase concentrations. Am J Clin Pathol. 2018;149(suppl_1):S13-S13. doi:10.1093/ajcp/aqx116.029
  • Consolidated Comparison of Chemistry Performance Specifications-Westgard. Accessed April 4, 2023. https://www.westgard.com/consolidated-goals-chemistry.htm
  • Kalra A. Decoding the bland-altman plot: basic review. J Pract Cardiovasc Sci. 2017;3(1):36. doi:10.4103/jpcs.jpcs_11_17
  • Orhan B, Mercan H, Deniz L, Erdogan Z, Bercik Inal B. Comparison of Barricor tube and serum separator tube in outpatients. Turk J Biochem. 2022;47(6):719-726. doi:10.1515/tjb-2022-0168
  • Cadamuro J, Mrazek C, Leichtle AB, et al. Influence of centrifugation conditions on the results of 77 routine clinical chemistry analytes using standard vacuum blood collection tubes and the new BD-Barricor tubes. Biochem Medica. 2018;28(1):010704. doi:10.11613/BM.2018.010704
  • Shin S, Oh J, Park HD. Comparison of three blood collection tubes for 35 biochemical analytes: the Becton Dickinson Barricor tube, serum separating tube, and plasma separating tube. Ann Lab Med. 2021;41(1):114-119. doi:10.3343/alm.2021.41.1.114
  • Kösem A, Topçuoğlu C, Sezer S, et al. Comparison of some biochemical tests in different blood collection tubes in hemodialysis patients. Turk J Biochem. 2020;45(1):26-36. doi:10.1515/tjb-2018-0341
  • Gawria G, Tillmar L, Landberg E. A comparison of stability of chemical analytes in plasma from the BD Vacutainer ® BarricorTM tube with mechanical separator versus tubes containing gel separator. J Clin Lab Anal. 2020;34(2). doi:10.1002/jcla.23060
  • Dimeski G, Johnston J. Is the BD Barricor tube the new standard for lithium heparin plasma. Developments Clin Med Pathol. 2018;1(3):1-5 doi: 10.31031/DCMP.2018.01.000514
  • Ryan J, Stuart L, Southby S, et al. Comparison of BD Vacutainer® rapid serum tube and plasma for haemolysis markers in the emergency department. Ann Clin Biochem Int J Lab Med. 2015;52(2):293-296. doi:10.1177/0004563214533317
  • Miles RR. Comparison of serum and heparinized plasma samples for measurement of chemistry analytes. Clin Chem. 2004;50(9):1703-1704. doi:10.1373/clinchem.2004.036483
  • Ramakers C, Meyer B, Yang W, et al. Switching from serum to plasma: Implementation of BD Vacutainer® BarricorTM plasma blood collection tubes improves sample quality and laboratory turnaround time. Pract Lab Med. 2020;18:e00149. doi:10.1016/j.plabm.2019.e00149
  • Badiou S, Vuillot O, Bargnoux AS, et al. Improved quality of samples and laboratory turnaround time using 3.5 mL low vacuum BD Vacutainer® Barricor tubes in the emergency department. Pract Lab Med. 2019;16:e00128. doi:10.1016/j.plabm.2019.e00128
Yıl 2023, Cilt: 6 Sayı: 5, 998 - 1009, 28.09.2023
https://doi.org/10.32322/jhsm.1341282

Öz

Kaynakça

  • World Health Organization. Diagnostic Imaging and Laboratory Technology. (2002). Use of anticoagulants in diagnostic laboratory investigations. World Health Organization. Accessed May 3, 2023.https://apps.who.int/iris/handle/10665/65957
  • Valenstein P. Laboratory turnaround time. Am J Clin Pathol. 1996;105(6):676-688. doi:10.1093/ajcp/105.6.676
  • Güvenç Demirağcı Y. Laboratuvar sonuç verme sürelerinin değerlendirilmesi. ET J. 2018;5(3):54-58.
  • Arslan FD, Karakoyun I, Basok BI, et al. The local clinical validation of a new lithium heparin tube with a barrier: BD Vacutainer® Barricor LH plasma tube. Biochem Medica. 2017;27(3):030706. doi:10.11613/BM.2017.030706
  • Lippi G, Cornes MP, Grankvist K, Nybo M, Simundic AM. EFLM WG-Preanalytical phase opinion paper: local validation of blood collection tubes in clinical laboratories. Clin Chem Lab Med CCLM. 2016;54(5). doi:10.1515/cclm-2015-1274
  • CLSI. Validation and Verification of Tubes for Venous and Capillary Blood Specimen Collection; Approved Guideline. CLSI document GP34-A Wayne, PA: Clinical and Laboratory Standards Institute; 2010.
  • Quality Requirements-Westgard. Accessed February 5, 2023. https://www.westgard.com/quality-requirements.htm
  • Aarsand AK, Fernandez-Calle P, Webster C, et al. The EFLM Biological variation database. Accessed Jue 25, 2023. Available at: https://biologicalvariation.eu/
  • Sun H, Wang W, Zhao H, et al. Internal quality control status for BNP and NT-proBNP in China from 2014 to 2017. J Clin Lab Anal. 2019;33(1):e22643. doi:10.1002/jcla.22643
  • Oosterhuis WP, Coskun A, Sandberg S, Theodorsson E. Performance specifications for sodium should not be based on biological variation. Clin Chim Acta. 2023;540:117221. doi:10.1016/j.cca.2023.117221
  • Hétu PO, Hobeila S, Larivière F, Bélanger MC. Improved sample quality and decreased turnaround time when using plasma blood collection tubes with a mechanical separator in a large university hospital. J Appl Lab Med. 2021;6(2):409-420. doi:10.1093/jalm/jfaa111
  • Lima-Oliveira G, Monneret D, Guerber F, Guidi GC. Sample management for clinical biochemistry assays: Are serum and plasma interchangeable specimens? Crit Rev Clin Lab Sci. 2018;55(7):480-500. doi:10.1080/10408363.2018.1499708
  • Wang YS, Feng CF, Er TK, et al. Comparison of cardiac troponin I levels in serum and sodium-citrate plasma using the ACCESS 2 immunoassay. Ann Clin Lab Sci. 2005;35(4):453-454.
  • Ercan Ş. Comparison of test results obtained from lithium heparin gel tubes and serum gel tubes. Turk J Biochem. 2020;45(5):575-586. doi:10.1515/tjb-2019-0117
  • Ferrari D, Strollo M, Vidali M, Motta A, Pontillo M, Locatelli M. Biochemical, immunochemical and serology analytes validation of the lithium heparin BD Barricor blood collection tube on a highly automated Roche COBAS8000 instrument. Acta Bio Medica Atenei Parm. 2020;91(1):47-55. doi:10.23750/abm.v91i1.9195
  • Arslan FD, Karakoyun I, Basok BI, et al. The local clinical validation of a new lithium heparin tube with a barrier: BD Vacutainer® Barricor LH Plasma tube. Biochem Medica. 2017;27(3):030706. doi:10.11613/BM.2017.030706
  • Bockoven C, Granato M, Benirschke R, Lee H. Differing plasma and serum lactate dehydrogenase concentrations. Am J Clin Pathol. 2018;149(suppl_1):S13-S13. doi:10.1093/ajcp/aqx116.029
  • Consolidated Comparison of Chemistry Performance Specifications-Westgard. Accessed April 4, 2023. https://www.westgard.com/consolidated-goals-chemistry.htm
  • Kalra A. Decoding the bland-altman plot: basic review. J Pract Cardiovasc Sci. 2017;3(1):36. doi:10.4103/jpcs.jpcs_11_17
  • Orhan B, Mercan H, Deniz L, Erdogan Z, Bercik Inal B. Comparison of Barricor tube and serum separator tube in outpatients. Turk J Biochem. 2022;47(6):719-726. doi:10.1515/tjb-2022-0168
  • Cadamuro J, Mrazek C, Leichtle AB, et al. Influence of centrifugation conditions on the results of 77 routine clinical chemistry analytes using standard vacuum blood collection tubes and the new BD-Barricor tubes. Biochem Medica. 2018;28(1):010704. doi:10.11613/BM.2018.010704
  • Shin S, Oh J, Park HD. Comparison of three blood collection tubes for 35 biochemical analytes: the Becton Dickinson Barricor tube, serum separating tube, and plasma separating tube. Ann Lab Med. 2021;41(1):114-119. doi:10.3343/alm.2021.41.1.114
  • Kösem A, Topçuoğlu C, Sezer S, et al. Comparison of some biochemical tests in different blood collection tubes in hemodialysis patients. Turk J Biochem. 2020;45(1):26-36. doi:10.1515/tjb-2018-0341
  • Gawria G, Tillmar L, Landberg E. A comparison of stability of chemical analytes in plasma from the BD Vacutainer ® BarricorTM tube with mechanical separator versus tubes containing gel separator. J Clin Lab Anal. 2020;34(2). doi:10.1002/jcla.23060
  • Dimeski G, Johnston J. Is the BD Barricor tube the new standard for lithium heparin plasma. Developments Clin Med Pathol. 2018;1(3):1-5 doi: 10.31031/DCMP.2018.01.000514
  • Ryan J, Stuart L, Southby S, et al. Comparison of BD Vacutainer® rapid serum tube and plasma for haemolysis markers in the emergency department. Ann Clin Biochem Int J Lab Med. 2015;52(2):293-296. doi:10.1177/0004563214533317
  • Miles RR. Comparison of serum and heparinized plasma samples for measurement of chemistry analytes. Clin Chem. 2004;50(9):1703-1704. doi:10.1373/clinchem.2004.036483
  • Ramakers C, Meyer B, Yang W, et al. Switching from serum to plasma: Implementation of BD Vacutainer® BarricorTM plasma blood collection tubes improves sample quality and laboratory turnaround time. Pract Lab Med. 2020;18:e00149. doi:10.1016/j.plabm.2019.e00149
  • Badiou S, Vuillot O, Bargnoux AS, et al. Improved quality of samples and laboratory turnaround time using 3.5 mL low vacuum BD Vacutainer® Barricor tubes in the emergency department. Pract Lab Med. 2019;16:e00128. doi:10.1016/j.plabm.2019.e00128
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıbbi Biyokimya ve Metabolomik (Diğer)
Bölüm Orijinal Makale
Yazarlar

Oğuzhan Zengi 0000-0002-4614-5235

Erken Görünüm Tarihi 26 Eylül 2023
Yayımlanma Tarihi 28 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 6 Sayı: 5

Kaynak Göster

AMA Zengi O. The transition from gel separatory serum tubes to lithium heparin gel tubes in the clinical laboratory. J Health Sci Med /JHSM /jhsm. Eylül 2023;6(5):998-1009. doi:10.32322/jhsm.1341282

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