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评估贝克顿·迪金森快速血清管:它是否能替代肝素锂血浆管?

Evaluation of the Becton-Dickinson rapid serum tube: does it provide a suitable alternative to lithium heparin plasma tubes?

机构信息

School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia.

出版信息

Clin Chem Lab Med. 2010 May;48(5):651-7. doi: 10.1515/CCLM.2010.141.

DOI:10.1515/CCLM.2010.141
PMID:20218902
Abstract

BACKGROUND

Obtaining a suitable specimen for analysis in a timely manner is pivotal in clinical chemistry service provision. Serum is recognized as the preferred specimen for most assays, but because of time constraints for completion of clotting and an increasing number of patients on anti-coagulant therapy, latent clotting or no clotting is an outcome which can lead to errors and delay in delivery of critical results. Although lithium heparin plasma has unique problems, it has become an alternative in hospital-based laboratories.

METHODS

The Becton-Dickinson (BD) rapid serum tube (RST) was evaluated in a hospital environment using a total of 53 participants, both healthy and anticoagulated, for 31 analytes against BD PST II and BD SST II tubes measured with Beckman DxC800 and DxI800 analyzers.

RESULTS

Most results from the RST tube were comparable with those from the SST II tube. Potassium results were closer to the PST II plasma concentrations. Incomplete and latent clotting was encountered in the RST specimens from participants (cardiac and dialysis) who had received a total of >7000 units of heparin [activated partial thromboplastin time (APTT) >150 s], warfarin/heparin combination, and specimens from cardiac surgery patients who had received a total of >25,000 units of heparin (APTT >200 s) at the time of collection of specimens.

CONCLUSIONS

The RST tube provides a suitable alternative to lithium heparin plasma tubes for most patients in a hospital environment. However, latent clotting continued to occur in specimens collected from participants who had received high concentrations of anticoagulants.

摘要

背景

及时获得适合分析的标本对于临床化学服务的提供至关重要。血清被认为是大多数检测的首选标本,但由于凝血完成时间的限制以及越来越多的抗凝治疗患者,潜在的凝血或无凝血是可能导致错误和关键结果延迟的结果。尽管锂肝素血浆有其独特的问题,但它已成为医院实验室的替代选择。

方法

在医院环境中使用总共 53 名健康和抗凝患者评估了 Becton-Dickinson(BD)快速血清管(RST),针对 31 个分析物进行了 31 项分析,与 BD PST II 和 BD SST II 管相比,使用 Beckman DxC800 和 DxI800 分析仪测量。

结果

RST 管的大多数结果与 SST II 管的结果相当。钾的结果更接近 PST II 血浆浓度。在接受了总共 >7000 单位肝素的参与者(心脏和透析)的 RST 标本中遇到了不完全和潜在的凝血[活化部分凝血活酶时间(APTT)>150 s],华法林/肝素联合治疗,以及接受了总共 >25000 单位肝素的心脏手术患者的标本采集时的 APTT >200 s)。

结论

在医院环境中,RST 管为大多数患者提供了替代锂肝素血浆管的合适选择。然而,在接受高浓度抗凝剂的参与者的标本中仍继续发生潜在的凝血。

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