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Interference in ionized calcium measurements by heparin salts
M Landt1, G L Hortin, C H Smith
1Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, MO 63110.
Clinical Chemistry
|April 1, 1994
Summary
New CNLZ heparin minimizes interference in ionized calcium measurements, unlike lithium or zinc heparin. This advancement improves accuracy for blood gases and electrolytes in clinical settings.
Area of Science:
- Clinical Chemistry
- Analytical Chemistry
- Biochemistry
Background:
- Heparin anticoagulants are crucial for whole-blood specimen analysis.
- Standard heparin salts can interfere with measurements of ionized calcium (iCa), blood gases, and electrolytes.
- Existing heparin formulations may alter iCa concentrations due to cation binding.
Purpose of the Study:
- To evaluate the suitability of various heparin salts for anticoagulating whole-blood specimens.
- To assess the interference of different heparin formulations, particularly a novel zinc-lithium heparin (CNLZ heparin), on iCa, blood gas, and electrolyte measurements.
- To compare CNLZ heparin with conventional heparin preparations.
Main Methods:
- Comparative analysis of heparin salts (lithium, zinc, and CNLZ heparin) for anticoagulation.
- Measurement of ionized calcium (iCa), blood gases, and electrolytes in whole-blood specimens.
- Assessment of interference at varying heparin concentrations and comparison with unheparinized and EB heparinized controls.
Main Results:
- Lithium heparin significantly decreased iCa concentrations, even at low doses.
- Zinc heparin initially increased but then decreased iCa concentrations.
- CNLZ heparin largely eliminated interference in iCa measurements and showed good correlation with unheparinized controls for iCa, blood gases, and electrolytes.
- CNLZ heparin did not interfere with total calcium measurements, unlike EB heparin.
Conclusions:
- CNLZ heparin offers a significant advantage by minimizing heparin-induced interference in iCa, blood gas, and electrolyte measurements.
- This novel heparin formulation provides reliable results comparable to unheparinized samples.
- CNLZ heparin is a suitable alternative for anticoagulation in clinical chemistry analyses, especially when accurate iCa and total calcium levels are critical.