Blood gas analysis syringes containing spray-dosed droplet liquid heparin may decrease sample rejection ratios

Abstract

Aim: The objective of this study is to evaluate blood gas analysis (BGA) sample rejection ratios (SRRs) in our laboratory and investigate the effect of various BGA syringes on SRR. Material and Method: 3 groups were formed based on the type and use period of BGA syringes. Syringes containing spray-dosed droplet liquid Lithium Heparin were used in Group 1 (November 2018–May 2019), syringes containing lyophilized dried Lithium Heparin were used in Group 2 (July 2019–January 2020), and another syringes containing spray-dosed droplet liquid Lithium Heparin were used in Group 3 (March 2020–September 2020), and the groups were determined based on such use. SRRs of these groups were calculated, causes for sample rejection were identified, and department-based investigations were conducted. Comparisons between groups were performed according to the indicated variables. Results: Mean SRRs of the groups by percentage (%) were calculated as 6.1±1.5, 10.0±0.9, and 3.8±0.9, respectively, and showed a statistically significant difference (p<0.001). Based on the post-hoc Scheffé’s test, a lower SRR was calculated in Group 3 (P<0.05). The most frequent causes for sample rejection by percentage were found as clotted sample (73.4±10.7), insufficient sample (14.7±9.1), and inappropriate (nonconforming) sample (5.5±2.0). No statistically significant difference was observed based on the causes for sample rejection among the groups. Based on the frequency of SRRs by percentage, the departments were determined as the Emergency Department (ED) (44.3±11.6), Intensive Care Unit (ICU) (22.2±6.5), and Pediatric & Neonatal Emergency Department (PNED) (16.8±6.6). For department-based results among the groups, SRRs for ED and PNED were found to be higher in terms of statistical significance in Group 2 whereas a lower SRR for ICU was determined in Group 3 (P<0.05). Conclusion: It was observed that BGA syringes containing spray-dosed droplet liquid Lithium Heparin decreased SRRs. Therefore, SRR follow-up may help clinics and laboratories evaluate sample quality as well as developing solutions.

Keywords

• Blood gas analysis
• sample rejection ratio
• preanalytical phase
• blood collection device
• lithium heparin.

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