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Reducing blood sample hemolysis in the emergency department using S-Monovette® in aspiration mode
Eunizar Omar1, John Carson Allen2, Ahmad Khairil Bin Mohamed Jamil1
1Department of Emergency Medicine, Sengkang General Hospital, Singapore.
Background:
Blood sample hemolysis continues to be a significant problem in clinical practice. In vitro hemolysis rates up to 77% have been reported in literature. The use of manual aspiration techniques for blood sampling has previously been shown to reduce the burden of erythrocyte injury in the pre-analytical phase compared to the vacuum collection technique. This study compares the hemolysis rates between two blood sampling methods: 5.0 ml BD Vacutainer® SST™ (BDV) and 4.9 ml S-Monovette® serum gel tubes in aspiration mode (SMA).
Methods:
This was a prospective randomised controlled study conducted in an Emergency department (ED). A convenience sample of 191 adult patients, aged 18-90 years old, presenting at the ED and requiring blood samples for serum electrolyte was included in the study. Paired blood samples were obtained through an intravenous cannula from each patient with randomised order of blood draw using SMA or BDV. Patient data was obtained and hemolysis index (HI), serum lactate dehydrogenase (LDH), and serum potassium (K) levels measured.
Results:
The adjusted mean HI (35.2 vs 21.5 mg/dL, p < 0.001), serum K (4.38 vs 4.16 mmol/L, p < 0.001) and LDH levels (259.6 vs 228.4 U/L, p < 0.001) were significantly higher in blood samples taken using BDV compared to SMA. The frequency of severely hemolyzed (>150 mg/dL) samples was also higher in blood collected using BDV (16.2%) compared to SMA (0%).
Conclusions:
The burden of hemolysis in blood samples taken from IV cannulae can be effectively reduced with the use of manual aspiration using the S-Monovette® blood collection system as compared to BD-Vacutainer.
Insights
Manual aspiration blood collection using S-Monovette significantly reduces hemolysis compared to BD Vacutainer. This improves sample quality for critical lab tests, especially in emergency departments.
Area of Science:
- Clinical Diagnostics
- Pre-analytical Phase Optimization
- Laboratory Medicine
Background:
- Blood sample hemolysis is a prevalent issue in clinical settings, with reported rates up to 77%.
- Manual aspiration techniques for blood sampling have shown potential in reducing erythrocyte injury compared to vacuum collection.
- This study evaluates hemolysis rates between two specific blood collection systems: BD Vacutainer® SST™ (BDV) and S-Monovette® serum gel tubes in aspiration mode (SMA).
Purpose of the Study:
- To compare the hemolysis rates between the BD Vacutainer® SST™ and S-Monovette® serum gel tubes in aspiration mode.
- To assess the impact of different blood collection methods on hemolysis index (HI) and key biochemical markers.
- To determine the optimal blood sampling technique for minimizing pre-analytical errors in emergency department settings.
Main Methods:
- A prospective randomized controlled study was conducted in an Emergency Department (ED).
- 191 adult patients requiring serum electrolyte analysis provided paired blood samples via an intravenous cannula.
- Blood samples were collected using either SMA or BDV in a randomized order, with subsequent measurement of HI, serum lactate dehydrogenase (LDH), and serum potassium (K).
Main Results:
- Significantly higher adjusted mean HI (35.2 vs 21.5 mg/dL), serum K (4.38 vs 4.16 mmol/L), and LDH levels (259.6 vs 228.4 U/L) were observed with BDV compared to SMA (p < 0.001 for all).
- The frequency of severely hemolyzed samples (>150 mg/dL) was substantially higher in BDV (16.2%) than in SMA (0%).
Conclusions:
- Manual aspiration using the S-Monovette® system effectively reduces the burden of hemolysis in blood samples collected via IV cannulae.
- The S-Monovette® aspiration mode offers a superior alternative to the BD Vacutainer® for minimizing pre-analytical hemolysis.
- Implementing manual aspiration techniques can improve the quality and reliability of laboratory test results.
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