Agós M D, Lizarraga R, Gambra D, Marañón A, Orozco C, Díaz E
Servicio de Urgencias, Hospital Virgen del Camino, Pamplona, Spain.
An Sist Sanit Navar. 2008 May-Aug;31(2):153-8. doi: 10.4321/s1137-66272008000300005.
The choice of a venous access system to provide safe blood collection and reliable analytical results for that sample is of paramount importance in any accident and emergency department. The objective of this study was to identify the factors associated with haemolysis in venous blood samples, where the variables studied were: type of venipuncture (needle and catheter), type of catheter (3 catheters of 3 different materials) and diameter of the catheter. The sample was obtained from all patients who required a blood test in the accident and emergencies department of the Virgen del Camino Hospital over 34 days, collected in 3 different periods (September-November), involving a total of 1.933 procedures. Positive haemolysis determined by laboratory technicians was found in 2% (7/348) of samples obtained by needle compared to 14% (222/1585) obtained by catheter. We observe an 8% (39/475) of haemolysis in the samples taken by protective Teflon catheter, 18% (77/426) by Protectiv plus polyurethane and 15% (106/684) by BD-Nexiva Vialone. The haemolysis index fell with an increase in the size of the catheter, those of 18G showing 13% (115/867) and those of 20G showing 15% (107/708). The combination of catheter type and size maintains the smallest percentages of haemolysis in Teflon catheters and high diameters of 18G with 6% (19/301), less than half the haemolysis of the polyurethane catheters and a third of that for Vialone catheters respectively.
在任何急诊部门，选择一个能提供安全采血并确保样本分析结果可靠的静脉通路系统至关重要。本研究的目的是确定与静脉血样溶血相关的因素，所研究的变量包括：静脉穿刺类型（针头和导管）、导管类型（3种不同材质的3种导管）以及导管直径。样本取自维根德尔卡米诺医院急诊科34天内所有需要进行血液检测的患者，分3个不同时间段（9月至11月）采集，共涉及1933次操作。实验室技术人员判定，通过针头采集的样本中有2%（7/348）出现阳性溶血，而通过导管采集的样本中有14%（222/1585）出现阳性溶血。我们观察到，使用特氟龙保护导管采集的样本中有8%（39/475）出现溶血，使用Protectiv plus聚氨酯导管的为18%（77/426），使用BD - Nexiva Vialone导管的为15%（106/684）。溶血指数随导管尺寸增大而降低，18G导管的溶血指数为13%（115/867），20G导管的为15%（107/708）。导管类型和尺寸的组合使得特氟龙导管的溶血百分比最低，18G大直径导管的溶血率为6%（19/301），分别不到聚氨酯导管溶血率的一半和Vialone导管溶血率的三分之一。
