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Maria Stella Graziani

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Martina Zaninotto

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Giuseppe Agosta

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da N. Scarzello

La riduzione della pressione di aspirazione diminuisce l’emolisi nei prelievi da catetere intravenoso
Reducing stress shear may decrease hemolysis associated to intravenous catheter blood collection
<p>Blood&nbsp;collection through intravenous (IV) catheter is one of the most frequent causes of hemolysis and stress shear is&nbsp;reported to have an important role in that. Aim of this work was to determine whether the hemolysis rate of blood&nbsp;samples drawn through IV catheter may decrease by using 2.5 mL vacuum collection tubes instead of 5 mL tubes,&nbsp;currently in use. Consecutive samples collected at the emergency department to measure potassium using a 18&nbsp;gauge IV catheter were evaluated for the presence of hemolysis in the 5 mL lithium heparin with separator gel tubes.&nbsp;The same samples were retested in a similar tube with 2.5 mL aspiration volume, collected at the same time.&nbsp;Hemolysis was evaluated spectrophotometrically on Siemens Advia 2400 analyzer as hemolysis index (HI) in the&nbsp;same run on the two types of tubes for the potassium array. Using a 150 HI cut-off, 48 (6%) of the 798 5 mL&nbsp;specimens were hemolysed, with median HI of 278 (95% confidence interval: 228&divide;362, range 153&divide;1146). Using the&nbsp;2.5 mL tubes, only 6 samples of these 48 had an HI &gt;150 (P &lt;0.0001). On average, the percentage of reduction of&nbsp;HI values was 86% (range, 44&divide;98). These data confirm that shear stress due to the strength of aspiration is an&nbsp;important cofactor of the hemolysis induced by IV catheter. Last generation analyzers require few microliters of&nbsp;sample to perform a lot of tests. The use of tubes with lower filling volume and consequently lower negative pressure&nbsp;could reduce the rate of samples to be rejected for hemolysis that can delay patient care in overcrowded emergency&nbsp;departments.</p>
Biochimica Clinica ; 37(4) 283-286
Contributi Scientifici - Scientific Papers