Factors affecting blood sample haemolysis: a cross-sectional study
Ed B G Barnard1, David L Potter, Ruth M Ayling
1Departments of aEmergency bClinical Biochemistry, Derriford Hospital cCentre for Biostatistics, Bioinformatics and Biomarkers, Plymouth University, Plymouth dAcademic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Medical Directorate, Joint Medical Command, Birmingham, UK.
Summary
Blood samples drawn through intravenous catheters are more likely to be haemolysed than those collected by needle. For optimal blood sample quality, needle collection is preferred when feasible.
Area of Science:
- Emergency Medicine
- Clinical Pathology
Background:
- Blood sample quality is crucial for accurate laboratory diagnostics.
- Intravenous catheters are commonly used for both fluid administration and blood sampling in emergency departments.
Purpose of the Study:
- To compare the incidence of haemolysis in blood samples obtained via an intravenous catheter versus a needle.
- To identify factors influencing blood sample haemolysis in emergency department settings.
Main Methods:
- Prospective, cross-sectional study in a UK university teaching hospital Emergency Department.
- Analysis of 844 complete blood sample sets from 985 patients.
- Logistic regression used to compare haemolysis rates between catheter and needle sampling, with secondary analysis of other factors.
Main Results:
- Blood samples obtained via an intravenous catheter showed a significantly higher likelihood of haemolysis (odds ratio 5.63; P<0.001).
- Factors such as sampling site and tourniquet time were also investigated for their effect on haemolysis.
Conclusions:
- Blood sampling through an intravenous catheter is associated with increased haemolysis compared to needle sampling.
- Needle phlebotomy is recommended over intravenous catheter sampling for blood collection when practicable.
- Further research should explore economic and satisfaction aspects of separate procedures.
