Department of Laboratories, Seattle Children's Hospital, Seattle, WA 98105, USA.
Int J Lab Hematol. 2010 Oct;32(5):491-7. doi: 10.1111/j.1751-553X.2009.01211.x. Epub 2009 Dec 23.
Current laboratory standards from Clinical Laboratory Standards Institute (CLSI) and manufacturer's (Becton Dickinson) data indicate that under-filling K(2)EDTA blood collection tubes can result in erroneous hematology values. To accommodate under-filled tubes and reduce collection volumes while optimizing our automation, we explored the acceptable limit of under-filled tubes for hematology values. We collected 8.0 ml of blood from 30 normal adult volunteers. Each donation was aliquoted in the following volumes: 4.0, 2.0, 1.0, 0.5 ml x 2. These samples were analyzed within 1 h of blood collection on Sysmex XE-2100 (Sysmex America Inc., Mundelein, IL, USA) for complete blood count, reticulocyte, and white blood cell differentials. Results of the under-filled tubes were compared to those of the standard volume. The Deming regression analysis show excellent correlation for all parameters between each under-filled blood collection volume compared to a standard 4 ml volume. The Bland and Altman analysis shows good agreement between both 1.0 and 2.0 ml compared to a 4.0 ml volume. The 0.5 ml compared to a 4.0 ml volume, however, shows increased variation on many parameters. In addition all three collection volumes show negative bias compared to the standard volume for platelet count, but the difference is considered insignificant with a percent difference of 5.5%, 3.2%, and 1.5% for 0.5, 1.0, and 2.0 ml collection volume respectively. Finally for 0.5 ml collection volume we noticed a low level of false positive flagging rate for white blood cell. Acceptable complete blood count values of under-filled powdered K(2)EDTA tubes can be obtained with as little as 1.0 ml of blood.
目前，临床实验室标准协会（CLSI）和制造商（BD）的数据表明，K2EDTA 血液采集管未充满会导致血液学值出现错误。为了适应未充满的采血管并在优化自动化操作的同时减少采集量，我们探索了血液学值可接受的未充满采血管下限。我们从 30 名正常成年志愿者中采集了 8.0 毫升血液。每个献血者的样本均按以下体积等分：4.0、2.0、1.0、0.5 ml×2。这些样本在采血后 1 小时内使用 Sysmex XE-2100（Sysmex America Inc.，Mundelein，IL，USA）进行全血细胞计数、网织红细胞和白细胞分类分析。将未充满的采血管结果与标准体积的结果进行比较。Deming 回归分析显示，与标准 4 ml 体积相比，所有参数在每个未充满的采血管体积之间均具有极好的相关性。Bland 和 Altman 分析显示，与 4.0 ml 体积相比，1.0 和 2.0 ml 体积之间具有良好的一致性。然而，与 4.0 ml 体积相比，0.5 ml 体积在许多参数上显示出更大的变化。此外，与标准体积相比，所有三个采集体积的血小板计数都存在负偏倚，但差异被认为不显著，分别为 0.5、1.0 和 2.0 ml 采集体积的 5.5%、3.2%和 1.5%。最后，对于 0.5 ml 采集体积，我们注意到白细胞的假阳性标记率较低。使用少至 1.0 毫升的血液即可获得可接受的未充满粉末状 K2EDTA 采血管的全血细胞计数值。
