Impact of blood collection devices on clinical chemistry assays

• Published in: Clinical biochemistry Vol. 43; no. 1; pp. 4 - 25
• Main Authors: Bowen, Raffick A.R., Hortin, Glen L., Csako, Gyorgy, Otañez, Oscar H., Remaley, Alan T.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 2010; Elsevier
• Subjects: Anticoagulants; Biological and medical sciences; Biological Assay; Blood Coagulation; Blood collection devices; Blood Specimen Collection - history; Blood Specimen Collection - instrumentation; Blood Specimen Collection - methods; Catheterization; Chemistry, Clinical - instrumentation; Chemistry, Clinical - methods; Clinical assay; Clinical chemistry; Clinical Laboratory Techniques; Disinfectants; History, 20th Century; Humans; Interference; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Miscellaneous. Technology; Needles; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Phlebotomy; Preanalytical; Specimen Handling - instrumentation; Specimen Handling - methods; Surface-Active Agents; Surfactant; Syringes; Tube; CLSI; PP; BD; Tube; Clinical chemistry; Interference; Phlebotomy; Blood collection devices; Clinical assay; PVP; EDTA; Surfactant; OSCS; SST; OSHA; PET; TBEP; Preanalytical; Human; Device; Samplings; Review; Laboratory; Blood; Assay; Pre analytical step; Laboratory investigations; Clinical biology
• ISSN: 0009-9120; 1873-2933
• DOI: 10.1016/j.clinbiochem.2009.10.001

Blood collection devices interact with blood to alter blood composition, serum, or plasma fractions and in some cases adversely affect laboratory tests. Vascular access devices may release coating substances and exert shear forces that lyse cells. Blood-dissolving tube additives can affect blood constituent stability and analytical systems. Blood tube stoppers, stopper lubricants, tube walls, surfactants, clot activators, and separator gels may add materials, adsorb blood components, or interact with protein and cellular components. Thus, collection devices can be a major source of preanalytical error in laboratory testing. Device manufacturers, laboratory test vendors, and clinical laboratory personnel must understand these interactions as potential sources of error during preanalytical laboratory testing. Although the effects of endogenous blood substances have received attention, the effects of exogenous substances on assay results have not been well described. This review will identify sources of exogenous substances in blood specimens and propose methods to minimize their impact on clinical chemistry assays.