scholarly journals POS1398 RHEUMATOLOGICAL PATIENTS PERFORMING BLOOD SELF-SAMPLING FOR DMARD THERAPY SAFETY: A PROOF OF CONCEPT STUDY COMPARING WITH VENOUS BLOOD SAMPLES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 982.1-982
Author(s):  
S. A. Just ◽  
P. Toftegaard ◽  
U. Jakobsen ◽  
T. R. Larsen
Keyword(s):  
Venous Blood ◽  
Automated Analysis ◽  
Blood Sampling ◽  
Differential Count ◽  
Blood Samples ◽  
Reactive Protein ◽  
Dmard Treatment ◽  
Patient Reported ◽  
Venous Sample ◽  
Treatment Safety

Background:Regular blood sampling is a requirement for rheumatological patients receiving csDMARD, bDMARD or tsDMARD therapies (1). The frequent blood sampling affects the patient’s life as they use a substantial amount of time at hospitals or by the general practitioner. Often visits are time-consuming with transport, waiting time, and for some patient’s costly long travels. Giving patients the option of taking the blood samples themself in their own home, as part of a patient-centred monitoring approach, could provide the patient much higher degree of independence. Further, it may increase the quality of life, cause higher compliance with taking the control samples and possibly reduce health care costs.Objectives:1. To investigate if rheumatological patients can take capillary blood samples and describe patient-reported outcomes (PRO) about the procedure. 2. Compare the venous and capillary samples’ results. 3. Test if the laboratory automated analysis equipment can handle the small capillary samples.Methods:21 rheumatological patients, underwent capillary and venous blood sampling at up to 4 occasions (1-2 months between). Instructions were available on a pictogram. PRO data were assessed by questionnaires. The patient performed blood extraction to the capillary samples from a finger after using a device making a small incision (2 mm depth and 3 mm width). Two capillary tubes (one Microtainer K2-EDTA and one Microtainer lithium heparin with gel) were filled with a total volume of approximately 1.0 mL blood. A phlebotomist took the venous sample. Blood samples were analyzed for alanine aminotransferase (ALAT), albumin, alkaline phosphatase (ALP), calcium, C-reactive protein (CRP), creatinine, potassium, lactate dehydrogenase (LDH), urate, hemolysis index, erythrocyte corpuscular volume (MCV), haemoglobin, leukocytes, differential count and platelets.Results:A total of 53 paired capillary (C) and venous (V) samples were taken. The average perceived pain of the procedure of C sampling was VAS: 10.3 (SD:14.4) (0-100) versus V sampling VAS: 8.5 (SD:11.7). 90% of patients would accept it as a future form of blood sampling.Differences in blood samples (C versus V) were: CRP (-3.4%); Hemoglobin (-1.4%); Creatinine (-4.4%), ALAT (-2.9%), neutrophils (1.43%), platelets (-16.9%).The index of hemolysis was on average 128.9 mg/dL (SD: 203) in C versus 6.7 mg/dL (SD: 4.6) in V. Results was evaluated by a rheumatologist, and 92.5% of capillary samples could be used to evaluate the safety of DMARD treatment based on the most critical samples for this: ALAT, creatinine, neutrophils and platelets (1). The 7.5 % not accepted were all due to aggregated platelets leading to low platelet count. There was hemolysis in 18% of the samples, but the analysis results could be used despite this.Conclusion:In the majority of rheumatological patients, capillary self-sampling is well tolerated.We show that it is possible to extract the needed results from the capillary samples to evaluate DMARD treatment safety, despite higher hemolysis index. Using capillary samples taken at home could be a central instrument in future rheumatological patient-centred monitoring.References:[1]Rigby WFC et al. Review of Routine Laboratory Monitoring for Patients with Rheumatoid Arthritis Receiving Biologic or Nonbiologic DMARDs. Int J Rheumatol. 2017Disclosure of Interests:None declared

scholarly journals Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thea Tislevoll Eide ◽  
Karl Ove Hufthammer ◽  
Atle Brun ◽  
Damien Brackman ◽  
Einar Svarstad ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Filtration Rate ◽  
Venous Blood ◽  
Reference Method ◽  
Blood Sampling ◽  
Clinical Trial Registration ◽  
Blood Samples ◽  
Intravenous Access ◽  
Time Points ◽  
Rank 2

AbstractMeasurement of glomerular filtration rate (GFR) in children by iohexol injection and blood sampling from the contralateral arm is widely used. A single intravenous access for iohexol injection and subsequent blood sampling has the obvious advantages of being less painful and easier to perform. The purpose of our study was to determine if blood samples drawn from the injection access are feasible and accurate for iohexol GFR (iGFR) measurements. Thirty-one children, median age 10.5 (range 6–17) years, with chronic kidney disease were given a bolus of iohexol followed by extended saline flushing and subsequent venous blood samples collected from the injection access as well as from a cannula in the contralateral arm, the latter serving as the reference method. Paired venous blood samples were collected at four time points (2, 3, 3.5 and 4 h) after the iohexol bolus. Blood sample discarding preceded and saline flushing followed each blood sampling to avoid marker contamination. iGFR based on samples drawn from the injection access at 2 and 3 h showed significantly lower iGFR than measurement from the contralateral arm (p < 0.01). Singlepoint iGFR did not differ significantly after 3–4 repeated procedures of blood discarding and saline flusing (3.5 and 4 h). Despite thorough saline flushing there is still a relatively high risk of falsely low iGFR due to marker contamination in blood samples from the injection site. Hence, blood sampling from a second intravenous access is recommended for routine iohexol GFR measurements in children.Clinical trial registration: ClinicalTrials.gov, Identifier NCT01092260, https://clinicaltrials.gov/ct2/show/NCT01092260?term=tondel&rank=2.

scholarly journals Day-to-day variation in iron-status measures in young iron-deplete women

2005 ◽  
Vol 94 (4) ◽  
pp. 551-556 ◽  
Author(s):  
Anita Belza ◽  
Marianne Henriksen ◽  
Annette K Ersbøll ◽  
Shakuntala H Thilsted ◽  
Inge Tetens
Keyword(s):  
Menstrual Cycle ◽  
Observational Studies ◽  
Iron Status ◽  
Venous Blood ◽  
Blood Sampling ◽  
Volume Distribution ◽  
Distribution Width ◽  
Blood Samples ◽  
Significance Level ◽  
True Value

In intervention and observational studies, it is necessary to determine the number of blood samples required to estimate the true value of Fe-status measures. The aim of the present study was to determine the number of days for blood sampling required in order to measure the ‘true value’ of five Fe-status parameters in young Fe-depleted women and to investigate the effect of menstrual cycle on these measures. Twelve women (aged 23–30 years), non-anaemic but with low Fe stores, participated in the study. Venous blood samples were collected under standardised conditions on fifteen non-consecutive days during a 5-week period. All blood samples were analysed for Hb, serum ferritin (SF), serum transferrin receptors (sTfR), red blood cell volume distribution width (RDW) and reticulocytes (RET), and body Fe stores were calculated as the ratio between sTfR and SF. No systematic changes were found in the investigated parameters during the study. When analytical variations were accounted for, the day-to-day variations (CV%) were as follows: Hb 2·9 %, SF 8·2 %, RET 26·0 %, RDW 2·4 % and sTfR 8·1 %. Calculating the ‘true value’ with a 5 % significance level and 80 % power showed that one blood sample was sufficient for Hb, SF, sTfR and RDW, whereas seven blood-sampling days were needed for RET. In this study, no significant differences in Fe status were found across the menstrual cycle. The conclusions from this study are valid for studies conducted under similar strict conditions.

Effects of Electrostimulation Therapy on Recovery From Acute Team-Sport Activity

2013 ◽  
Vol 8 (3) ◽  
pp. 293-299 ◽  
Author(s):  
Matthew Finberg ◽  
Rebecca Braham ◽  
Carmel Goodman ◽  
Peter Gregory ◽  
Peter Peeling
Keyword(s):  
Venous Blood ◽  
Sport Activity ◽  
C Reactive Protein ◽  
Male Athletes ◽  
Blood Samples ◽  
Reactive Protein ◽  
Team Game ◽  
Water Therapy ◽  
Contrast Water Therapy ◽  
Circulating Levels

Purpose:To assess the efficacy of a 1-off electrostimulation treatment as a recovery modality from acute teamsport exercise, directly comparing the benefits to contrast water therapy.Methods:Ten moderately trained male athletes completed a simulated team-game circuit (STGC). At the conclusion of exercise, participants then completed a 30-min recovery modality of either electrostimulation therapy (EST), contrast water therapy (CWT), or a passive resting control condition (CON). Twenty-four hours later, participants were required to complete a modified STGC as a measure of next-day performance. Venous blood samples were collected preexercise and 3 and 24 h postexercise. Blood samples were analyzed for circulating levels of interleukin-6 (IL-6) and C-reactive protein (CRP).Results:The EST trial resulted in significantly faster sprint times during the 24-h postrecovery than with CON (P < .05), with no significant differences recorded between EST and CWT or between CWT and CON (P > .05). There were no differences in IL-6 or CRP across all trials. Finally, the perception of recovery was significantly greater in the EST trial than in the CWT and CON (P < .05).Conclusions:These results suggest that a 1-off treatment with EST may be beneficial to perceptual recovery, which may enhance next-day performance.

scholarly journals Evaluation of Serum Interleukin-6 and C-Reactive Protein Levels among Women During Term Labour

2020 ◽  
pp. 69-76
Author(s):  
Ubongabasi A. James ◽  
John O. Imaralu ◽  
Ijeoma Esiaba
Keyword(s):  
Interleukin 6 ◽  
Venous Blood ◽  
University Teaching ◽  
Enzyme Linked Immunosorbent Assay ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Blood Samples ◽  
Reactive Protein ◽  
Significant Difference ◽  
Term Labour

Aims: To determine the serum concentrations of C-reactive protein (CRP) and interleukin 6 (IL-6) as well as level of leukocytosis, as inflammatory contributory factors in women with uncomplicated term pregnancies before, during and after labour. Study Design:  This is a cross-sectional study. Place and Duration of Study: The study was carried out in the Department of Obstetrics and Gynaecology of Babcock University Teaching Hospital (BUTH) and Department of Biochemistry, Babcock University, Ogun State Nigeria between June 2019 and February 2020. Methodology: 45 venous blood samples were obtained from 34 selected women and grouped into three; prenatal (≥ 32 weeks, n = 18), labour (4 to 6 cm dilation, n = 12) and postnatal (≤ 24 hour postpartum, n = 15). Sixteen blood samples were also obtained from the umbilical cord. Levels of CRP and IL-6 were determined by Enzyme Linked Immunosorbent Assay (ELISA) techniques and the leukocyte count, by hematologic method. Differences in statistical mean were evaluated by one way analysis of variance (ANOVA) with Bonferroni post hoc comparison. The level of significance was set at P < 0.05. Results: Concentration of serum IL-6 was significantly high during labour (1354.79 ± 189.16 pg/mL) compared to the prenatal (14.94 ± 4.86 pg/mL, P < .001) and postnatal (13.17 ± 3.06 pg/mL, P < .001) periods. The low level of CRP observed during active labour compared to the prenatal and postnatal periods did not reach significant difference. The levels of these inflammatory markers were low in the cord blood. Leukocyte counts (P = .011) as well as neutrophils (P = .014) and MID cell fractions (P = .004) were significantly higher during the postnatal period. Conclusion: The high levels of serum IL-6 observed in this study supports human term labour as an inflammatory event not associated with increased leukocytosis.

scholarly journals The Biochemical parameters in venous blood sampling by direct venipuncture and peripheral intravenous catheter

2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Fatemeh Jaafaraghaei ◽  
Monireh Aghajany-Nasab ◽  
Mahsa Aghaei ◽  
Nazila Javadi pashaki ◽  
Ehsan Kazemnejhad Leili
Keyword(s):  
Venous Blood ◽  
Venous Catheter ◽  
Cross Sectional Study ◽  
Blood Sampling ◽  
Cross Sectional ◽  
Sodium Potassium ◽  
Blood Samples ◽  
Peripheral Venous Catheter ◽  
Peripheral Intravenous Catheter ◽  
Sodium And Potassium

Objective: The aim of this study was to compare the results of some biochemical values in venous blood samples obtained by direct venipuncture (DV) and peripheral venous catheter (PVC). Methods: In this cross-sectional study, 78 hospitalized patients in different wards of Poor-Sina Medical and Educational Center of Rasht in 2017 were divided into three equal groups, including patients who were treated with normal saline and dextrose saline and those who did not receive this solution. Two separate blood samples were obtained from each patient, one from PVC and the other from DV. The levels of sodium, potassium, creatinine and blood urea nitrogen (BUN) were measured and compared. Results: Difference of PVC with DV in BUN was generally 0.32±3.18 mg/dl; creatinine, sodium and potassium were 0.02±0.12 mg/dl, 1.00±2.49 mEq/L and 0.15±0.48 mEq/L respectively. There were no statistically significant differences between the two methods in relation to BUN and creatinine (P = 0.377 and P = 0.149, respectively), but significant differences in levels of sodium and potassium were observed between the two blood sampling methods (P = 0.001 and P = 0.008, respectively). Conclusion: According to the results of this study and other studies, PVC can be used to measure BUN and creatinine, not so for sodium and potassium. For other parameters, further investigation is needed.

A Comparison of Venous versus Capillary Blood Samples when Measuring Blood Glucose Using a Point-of-Care, Capillary-Based Glucometer

2019 ◽  
Vol 34 (05) ◽  
pp. 506-509
Author(s):  
Jessica Topping ◽  
Matthew Reardon ◽  
Jake Coleman ◽  
Brian Hunter ◽  
Haruka Shojima-Perera ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Point Of Care ◽  
Research Question ◽  
Venous Blood ◽  
Hospital Setting ◽  
Capillary Blood ◽  
Needle Stick Injury ◽  
Blood Samples ◽  
Significant Difference ◽  
Venous Sample

AbstractBackground:Blood glucose level (BGL) is routinely assessed by paramedics in the out-of-hospital setting. Most commonly, BGL is measured using a blood sample of capillary origin analyzed by a hand-held, point-of-care glucometer. In some clinical circumstances, the capillary sample may be replaced by blood of venous origin. Given most point-of-care glucometers are engineered to analyze capillary blood samples, the use of venous blood instead of capillary may lead to inaccurate or misleading measurements.Hypothesis/Problem:The aim of this prospective study was to compare mean difference in BGL between venous and capillary blood from healthy volunteers when measured using a capillary-based, hand-held, point-of-care glucometer.Methods:Using a prospective observational comparison design, 36 healthy participants provided paired samples of blood, one venous and the other capillary, taken near simultaneously. The BGL values were similar between the two groups. The capillary group had a range of 4.3mmol/l, with the lowest value being 4.4mmol/l and 8.7mmol/l the highest. The venous group had a range of 2.7mmol/l, with the lowest value being 4.1mmol/l and 7.0mmol/l the highest.For the primary research question, the mean BGL for the venous sample group was 5.3mmol/l (SD = 0.6), compared to 5.6mmol/l (SD = 0.8) for the capillary group. This represented a statistically significant difference of 0.3mmol/l (P = .04), but it did not reach the a priori established point of clinical significance (1.0mmol/l). Pearson’s correlation coefficient for capillary versus venous indicated moderate correlation (r = 0.42).Conclusion:In healthy, non-fasted people in a non-clinical setting, a statistically significant, but not clinically significant, difference was found between venous- and capillary-derived BGL when measured using a point-of-care, capillary-based glucometer. Correlation between the two was moderate. In this context, using venous samples in a capillary-based glucometer is reasonable providing the venous sample can be gathered without exposure of the clinician to risk of needle-stick injury. In clinical settings where physiological derangement or acute illness is present, capillary sampling would remain the optimal approach.

Physiological Responses to Cold Water Immersion Following Cycling in the Heat

2008 ◽  
Vol 3 (3) ◽  
pp. 331-346 ◽  
Author(s):  
Shona L. Halson ◽  
Marc J. Quod ◽  
David T. Martin ◽  
Andrew S. Gardner ◽  
Tammie R. Ebert ◽  
...  
Keyword(s):  
Heart Rate ◽  
Inflammatory Responses ◽  
Cold Water ◽  
Water Immersion ◽  
Scientific Information ◽  
Venous Blood ◽  
Blood Gases ◽  
Cold Water Immersion ◽  
Blood Samples ◽  
Reactive Protein

Cold water immersion (CWI) has become a popular means of enhancing recovery from various forms of exercise. However, there is minimal scientific information on the physiological effects of CWI following cycling in the heat.Purpose:To examine the safety and acute thermoregulatory, cardiovascular, metabolic, endocrine, and inflammatory responses to CWI following cycling in the heat.Methods:Eleven male endurance trained cyclists completed two simulated ~40-min time trials at 34.3 ± 1.1°C. All subjects completed both a CWI trial (11.5°C for 60 s repeated three times) and a control condition (CONT; passive recovery in 24.2 ± 1.8°C) in a randomized cross-over design. Capillary blood samples were assayed for lactate, glucose, pH, and blood gases. Venous blood samples were assayed for catecholamines, cortisol, testosterone, creatine kinase, C-reactive protein, IL-6, and IGF-1 on 7 of the 11 subjects. Heart rate (HR), rectal (Tre), and skin temperatures (Tsk) were measured throughout recovery.Results:CWI elicited a significantly lower HR (CWI: Δ116 ± 9 bpm vs. CONT: Δ106 ± 4 bpm; P = .02), Tre (CWI: Δ1.99 ± 0.50°C vs. CONT: Δ1.49 ± 0.50°C; P = .01) and Tsk. However, all other measures were not significantly different between conditions. All participants subjectively reported enhanced sensations of recovery following CWI.Conclusion:CWI did not result in hypothermia and can be considered safe following high intensity cycling in the heat, using the above protocol. CWI significantly reduced heart rate and core temperature; however, all other metabolic and endocrine markers were not affected by CWI.

scholarly journals Comparison of Hematological and Biochemical Results Derived from Arterial and Venous Blood Samples in Post-Anesthetic Dogs

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 2069
Author(s):  
Song Mi Lee ◽  
Byung-Jae Kang ◽  
Sungin Lee ◽  
Wan Hee Kim
Keyword(s):  
Total Error ◽  
Venous Blood ◽  
Gamma Glutamyl Transpeptidase ◽  
Blood Samples ◽  
Gamma Glutamyl ◽  
Paired Samples ◽  
Arterial Blood ◽  
Venous Sample ◽  
Biochemical Testing ◽  
Glutamyl Transpeptidase

Collecting blood from an indwelling arterial catheter may reduce stress from repeated venipuncture in patients requiring serial monitoring, but the use of arterial blood for hematological and biochemical testing remains understudied. Here, we compared hematological and biochemical results of arterial and venous blood and evaluated their clinical interchangeability. Blood samples from dogs who had recovered from anesthesia, collected by both arterial catheterization and venipuncture, were analyzed. To assess clinical acceptance between paired samples, the limit of agreement between the values derived from the arterial and venous blood samples was compared with the allowable total error (TEa) recommended for each parameter. We found no significant differences between the arterial and venous sample results for red/white blood cell and platelet counts and hematocrit, blood urea nitrogen, phosphate, total protein, albumin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, sodium, potassium, and chloride levels, whereas hemoglobin, glucose, creatinine, and calcium levels differed significantly (p < 0.05). Moreover, only gamma-glutamyl transpeptidase and potassium exceeded the recommended TEa. Hematological and biochemical results derived from venous and arterial blood samples are clinically interchangeable in post-anesthetic dogs, with the exception of gamma-glutamyl transpeptidase and potassium; thus, these values should be used with caution.

scholarly journals Potential of Dried Blood Self-Sampling for CyclosporineC2Monitoring in Transplant Outpatients

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Alexander Benedikt Leichtle ◽  
Uta Ceglarek ◽  
Helmut Witzigmann ◽  
Gábor Gäbel ◽  
Joachim Thiery ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Venous Blood ◽  
Dried Blood Spots ◽  
Capillary Blood ◽  
Blood Sampling ◽  
Therapeutic Drug ◽  
Blood Collection ◽  
Blood Samples ◽  
Drug Levels ◽  
Finger Prick

Background. Close therapeutic drug monitoring of Cyclosporine (CsA) in transplant outpatients is a favourable procedure to maintain the long-term blood drug levels within their respective narrow therapeutic ranges. Compared to basal levels (C0), CsA peak levels (C2) are more predictive for transplant rejection. However, the application ofC2levels is hampered by the precise time of blood sampling and the need of qualified personnel. Therefore, we evaluated a newC2self-obtained blood sampling in transplant outpatients using dried capillary and venous blood samples and compared the CsA levels, stability, and clinical practicability of the different procedures.Methods. 55 solid organ transplant recipients were instructed to use single-handed sampling of each 50μL capillary blood and dried blood spots by finger prick using standard finger prick devices. We used standardized EDTA-coated capillary blood collection systems and standardized filter paper WS 903. CsA was determined by LC-MS/MS. The patients and technicians also answered a questionnaire on the procedure and sample quality.Results. TheC0andC2levels from capillary blood collection systems (C0[ng/mL]:114.5±44.5;C2:578.2±222.2) and capillary dried blood (C0[ng/mL]:175.4±137.7;C2:743.1±368.1) significantly(P<.01)correlated with the drug levels of the venous blood samples (C0[ng/mL]:97.8±37.4;C2:511.2±201.5). The correlation atC0wasρcap.-ven.= 0.749, andρdried blood-ven= 0.432; atC2:  ρcap.-ven.= 0.861 andρdried blood-ven= 0.711. The patients preferred the dried blood sampling because of the more simple and less painful procedure. Additionally, the sample quality of self-obtained dried blood spots for LC-MS/MS analytics was superior to the respective capillary blood samples.Conclusions.C2self-obtained dried blood sampling can easily be performed by transplant outpatients and is therefore suitable and cost-effective for close therapeutic drug monitoring.

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