Routine coagulation testing in Vacutainer® Citrate Plus tubes filled at minimum or optimal volume.

Area of Science:

• Clinical Chemistry
• Hematology
• Diagnostic Testing

Background:

• Accurate blood volume in citrate tubes is critical for reliable coagulation test results.
• Variations in fill volume can potentially impact test accuracy.
• The new Becton Dickinson Vacutainer® Citrate Plus tubes require evaluation for fill volume impact.

Purpose of the Study:

• To assess if routine coagulation test results differ between minimum and optimal fill volumes in Vacutainer® Citrate Plus tubes.
• To determine the clinical comparability of coagulation testing using the new citrate tubes at varying fill levels.
• To validate the performance of Vacutainer® Citrate Plus tubes under different blood collection scenarios.

Main Methods:

• 133 patients (40 on oral anticoagulant therapy) had blood collected into two sequential Vacutainer® Citrate Plus tubes.
• Tubes were filled at minimum (aspirating air first) and optimal volumes.
• Experiments were conducted using both 2.7-mL and 1.8-mL tube sizes.

Main Results:

• Prothrombin time (PT) and fibrinogen levels were slightly decreased with minimum fill volume compared to optimal.
• Activated partial thromboplastin time (APTT) showed a slight, non-statistically significant prolongation at minimum fill.
• Correlations between fill volumes exceeded 0.94, with bias within quality specifications for both tube sizes.

Conclusions:

• Blood collection into Vacutainer® Citrate Plus tubes at minimum fill volume does not introduce clinically significant bias.
• Routine coagulation testing results remain reliable even with minimum fill volumes.
• The new Vacutainer® Citrate Plus tubes demonstrate acceptable performance across tested fill volumes.