Millius Laura, Riedo Erwin, Caron Thierry, Belissent Juliette, Fellay Benoît, Ribordy Vincent, Magnin Jean-Luc
HFR Fribourg, Hôpital Cantonal, Fribourg, FR, Switzerland.
Pract Lab Med. 2021 Jul 28;27:e00252. doi: 10.1016/j.plabm.2021.e00252. eCollection 2021 Nov.
Hemolytic blood samples are the number one cause for specimen rejection at emergency departments. Triggered by unsuitable blood sampling material or incorrect handling and a related strong vacuum force, hemolytic samples often must be retaken. The objective of this study was to assess whether correct manual aspiration using S-Monovette® could reduce the number of hemolytic samples.
Between January and April 2019, a head-to-head study was conducted. Whereas in the first eight weeks, all specimens were collected using Vacutainer®, in the second eight weeks, blood was taken using S-Monovette® in aspiration mode. Specimens were categorized into five classes (0-30, 31-50, 51-75, 76-100, and 101+ mg/dl of cell-free hemoglobin) and for the statistical analyses, all samples exceeding 30 mg/dl were classified as hemolytic.
Data were collected on 4794 blood specimens (Vacutainer®: 2634 samples, S-Monovette®: 2160 samples). While the percentage of non-hemolytic samples (HI of 0-30 mg/dl) was substantially higher for specimens drawn by S-Monovette® (95.7 %) than Vacutainer® (83.0 %), the opposite was true for all HI categories above 30 mg/dl. Importantly, the reduction of hemolytic samples took place immediately following the imposition of S-Monovette® and remained stable at a low level until the end of the study.
Based on our results, we conclude that switching to S-Monovette® in manual aspiration mode in the blood sampling process could be highly beneficial, not only from a financial point of view, but also with regards to reducing unnecessary tasks and stress for nursing staff and improving patient outcome overall.
溶血血样是急诊科标本拒收的首要原因。由于采血材料不合适、处理不当以及相关的强大真空力引发,溶血样本常常必须重新采集。本研究的目的是评估使用S-Monovette®进行正确的手动采血是否可以减少溶血样本的数量。
在2019年1月至4月期间进行了一项对比研究。在前八周,所有标本均使用Vacutainer®采集,而在后八周,血液采用S-Monovette®的抽吸模式采集。标本分为五类(无细胞血红蛋白0 - 30、31 - 50、51 - 75、76 - 100和101+mg/dl),为进行统计分析,所有超过30mg/dl的样本均被分类为溶血样本。
共收集了4794份血标本的数据(Vacutainer®:2634份样本,S-Monovette®:2160份样本)。虽然S-Monovette®采集的标本中,非溶血样本(血红蛋白指数为0 - 30mg/dl)的百分比(95.7%)显著高于Vacutainer®(83.0%),但在所有高于30mg/dl的血红蛋白指数类别中情况则相反。重要的是,在采用S-Monovette®后,溶血样本数量立即减少,并在研究结束前一直稳定在低水平。
根据我们的结果,我们得出结论,在采血过程中切换到手动抽吸模式的S-Monovette®可能非常有益,不仅从财务角度来看如此,而且在减少护理人员的不必要任务和压力以及总体改善患者结局方面也是如此。