scholarly journals The challenges associated with short volume sodium citrate blood samples

2019 ◽  
Vol 8 (3) ◽  
pp. 66-67
Author(s):  
Danny Gaskin ◽  
Ola Yahaya
Keyword(s):  
Sodium Citrate ◽  
Technical Error ◽  
Blood Samples ◽  
Phone Calls ◽  
Citrate Blood

In the laboratory, we often receive phone calls from our clinical colleagues with questions about decisions we have made that might affect their patient’s care. For example, enquiries about why we have rejected a sample or why we were unable to provide a particular result due to a pre-analytical or technical error. In this series of short articles, we want to try and address some of the most common questions we get asked, with the aim of educating the wider workforce in a way that is simple to understand, about the decisions we make in the laboratory. We hope that with a greater understanding, the number of avoidable errors might be reduced.In this article, we explore the pre-analytical challenges associated with short volume sodium citrate anti-coagulated blood samples and why these must be rejected.

1-Desamino-8-D-Arginine Vasopressin (DDAVP) Infusion in Type IIB von Willebrand’s Disease: Shortening of Bleeding Time and Induction of a Variable Pseudothrombocytopenia

1990 ◽  
Vol 64 (01) ◽  
pp. 117-120 ◽  
Author(s):  
Alessandra Casonato ◽  
M Teresa Sartori ◽  
Luigi de Marco ◽  
Antonio Girolami
Keyword(s):  
Monoclonal Antibody ◽  
Platelet Count ◽  
Arginine Vasopressin ◽  
Calcium Concentration ◽  
Sodium Citrate ◽  
Bleeding Time ◽  
Blood Collection ◽  
Von Willebrand's Disease ◽  
Blood Samples ◽  
Von Willebrand’S Disease

SummaryWe have investigated the effects of 1-desamino-8-D-arginine vasopressin (DDAVP) infusion on platelet count and bleeding time in 4 patients with type IIB von Willebrand’s disease (vWd). Three of four patients showed a normalization of the bleeding time within 1 h after the infusion, while bleeding time was not modified in the fourth. In accordance with the literature, thrombocytopenia was observed after DDAVP infusion, but this thrombocytopenia was due to the anticoagulants used for blood collection. In two patients (F. I., G. F.) no thrombocytopenia was observed when platelets were counted by fingerstick method but there was a 20% platelet decrease in blood samples collected in sodium citrate and a 50% decrease in samples collected in EDTA. Dramatic falls in platelet counts (70–95%) were observed in the additional two patients (C. A., D.Z.) after DDAVP infusion, when both sodium citrate or EDTA were used as anticoagulants. In the latter two patients there was also a 50% decrease in platelet count when the fingerstick method was used. The decrease in the patient’s platelet count in EDTA samples after DDAVP infusion could be prevented, in part, by the previous additions of an anti GPIb monoclonal antibody and an anti GPIIb-IIIa monoclonal antibody.Thus, the thrombocytopenia observed in the four IIB vWd patients studied after DDAVP infusion seems to be, at least partially, a pseudothrombocytopenia depending on the calcium concentration in the blood samples and the availability of GPIb and GPIIb-IIIa receptors. These findings and the normalization of the bleeding time observed in three of the four patients has led us to reconsider the possible use of DDAVP in the treatment of our IIB vWd patients.

Influence of Certain Drugs on the Adhesiveness of Human, Rat, and Rabbit Blood Platelets in Vitro

1965 ◽  
Vol 13 (02) ◽  
pp. 428-438 ◽  
Author(s):  
K Reber ◽  
A Studer
Keyword(s):  
Sodium Citrate ◽  
Blood Platelets ◽  
Drug Application ◽  
Normal Range ◽  
Blood Samples ◽  
Serotonin Antagonist ◽  
Thrombocyte Count ◽  
Particle Count ◽  
Rabbit Blood

SummaryThis is a comparative study of the methods described by H. P. Wright and O’Brien for determining the adhesiveness of thrombocytes. An attempt is made to characterize and statistically correlate both techniques. With the aid of a Coulter Counter for thrombocyte counts, a normal range is presented for human, rat, and rabbit blood. Anticoagulants used are sodium citrate and Heparin.The influence of Cocaine and the Serotonin antagonist Ro 3-0837 was studied on these same substrates, to determine a pharmacological interference with results of either Wright’s test or O’Brien’s. Both drugs are found to induce a statistically significant increase in the “thrombocyte count” as compared to the corresponding controls. These effects are not real but to be attributed to an increase in particle count due to thrombocyte fragmentation as a consequence of drug application. There is no evidence for the claim that these drugs decrease the adhesiveness of thrombocytes.Numerical results of both tests often show a high and statistically significant correlation, especially following the addition of Ro 3-0837. Such is not true of individual blood samples to which no drug has been added. Evidentally, both tests are not specific for the same characteristic of normal blood platelets. But, when Ro 3-0837 is added, the breakdown of unstable platelets is induced; and the corresponding increase in count of thrombocyte fragments is expressed by both tests in the same fashion.

EDTA‑dependent pseudothrombocytopenia in child (clinical case report)

2021 ◽  
pp. 51-54
Author(s):  
N. A. Sokolova ◽  
M. I. Savina ◽  
O. S. Shokhina
Keyword(s):  
Platelet Count ◽  
Clinical Case ◽  
Sodium Citrate ◽  
Ethylenediaminetetraacetic Acid ◽  
Hemorrhagic Diathesis ◽  
Platelet Dysfunction ◽  
Rare Presentation ◽  
Blood Samples ◽  
Low Platelet Count ◽  
Aggregation Of Platelets

Ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia is the phenomenon of a spurious low platelet count due to antiplatelet antibodies that cause platelet clumping in blood anticoagulated with EDTA. The aggregation of platelets in EDTA-dependent pseudothrombocytopenia is usually prevented by other anticoagulants, such as sodium citrate. EDTA-dependent pseudothrombocytopenia has never been associated with hemorrhagic diathesis or platelet dysfunction. In this article, a 2,5-year-old boy with EDTA-dependent pseudothrombocytopenia is presented because of rare presentation. We report that EDTA can induce platelet clumping, and thus spuriously low platelet counts. However, aggregation of platelets was not detected in blood samples with sodium citrate, and platelet count was normal.

Polymicrobial pseudobacteraemias associated with non-sterile sodium citrate blood collection tubes

1993 ◽  
Vol 25 (4) ◽  
pp. 297-299 ◽  
Author(s):  
P.G. Rathbone ◽  
V. Sinickas ◽  
V. Humphery ◽  
S. Graves ◽  
A. Hellyar
Keyword(s):  
Sodium Citrate ◽  
Blood Collection ◽  
Blood Collection Tubes ◽  
Citrate Blood

Induced Alkalosis and Gastrointestinal Symptoms After Sodium Citrate Ingestion: a Dose-Response Investigation

2016 ◽  
Vol 26 (6) ◽  
pp. 542-548 ◽  
Author(s):  
Charles S. Urwin ◽  
Dan B. Dwyer ◽  
Amelia J. Carr
Keyword(s):  
High Intensity ◽  
Sodium Citrate ◽  
Statistical Significance ◽  
Gastrointestinal Symptoms ◽  
Capillary Blood ◽  
Bicarbonate Concentration ◽  
Blood Samples ◽  
Blood Ph ◽  
Gastrointestinal Distress ◽  
Induced Alkalosis

Sodium citrate induces alkalosis and can provide a performance benefit in high-intensity exercise. Previous investigations have been inconsistent in the ingestion protocols used, in particular the dose and timing of ingestion before the onset of exercise. The primary aim of the current study was to quantify blood pH, blood bicarbonate concentration and gastrointestinal symptoms after ingestion of three doses of sodium citrate (500 mg⋅kg-1, 700 mg⋅kg-1 and 900 mg⋅kg-1). Thirteen participants completed four experimental sessions, each consisting of a different dose of sodium citrate or a taste-matched placebo solution. Blood pH and blood bicarbonate concentration were measured at 30-min intervals via analysis of capillary blood samples. Gastrointestinal symptoms were also monitored at 30-min intervals. Statistical significance was accepted at a level of p < .05. Both measures of alkalosis were significantly greater after ingestion of sodium citrate compared with placebo (p < .001). No significant differences in alkalosis were found between the three sodium citrate doses (p > .05). Peak alkalosis following sodium citrate ingestion ranged from 180 to 212 min after ingestion. Gastrointestinal symptoms were significantly higher after sodium citrate ingestion compared with placebo (p < .001), while the 900 mg.kg-1 dose elicited significantly greater gastrointestinal distress than 500 mg⋅kg-1 (p = .004). It is recommended that a dose of 500 mg⋅kg-1 of sodium citrate should be ingested at least 3 hr before exercise, to achieve peak alkalosis and to minimize gastrointestinal symptoms before and during exercise.

VARIATION OF FUNCTIONAL PLATELET PARAMETERS DURING STORAGE AND DURING VENOUS OCCLUSSION MEASURED

1987 ◽  
Author(s):  
M Spannagl ◽  
G Valet ◽  
W Schramm
Keyword(s):  
Esterase Activity ◽  
Transmembrane Potential ◽  
Sodium Citrate ◽  
Bleeding Time ◽  
Blue Fluorescence ◽  
Platelet Volume ◽  
Blood Samples ◽  
The Mean ◽  
Variation Of Functional ◽  
Whole Blood Sample

Information on platelet function would be of great importance for many clinical situations in addition to platelet count and bleeding time. It was the purpose of this study to test Di0c6 (3,3-dihexyl-oxacarbocyanine: transmembrane potential), AO (acridine orange: granular content), and ADB (1,4-di-acetoxy-2,3-dicyanobenzene: intracellular esterase-activity and pH) stained platelets after 1 and 5 hours storage (anticoagulated with EDTA, Heparin and Sodium-Citrate) and 2, 6, 12 and 20 minutes after venous occlussion (immediately diluted in HEPES-Buffer (1:50)). A fresh whole blood sample diluted in Buffer served as control. All blood samples were gained from normal persons. Platelets were finally diluted 1:200 in HEPES buffered saline and stained. Cell volume, green and blue fluorescence were then measured in a Fluovo-Metricell-II flow cytometer.- The mean platelet volume increased to 111% (1 h) and 117% (5 h) of control during storage. The volume remained stable during venous occlussion. - The transmembrane potential (Di0c6) decreased to 52% of control after 5 hours storage. We saw an increase to 141% after 20 minutes venous occlussion.- The granular content (A0) decreased to 81% of control during storage. There was no variation during VOT.- Esterase activity (ADB) remained constant during storage and had the lowest coefficient of variation (CV = 51%). There was an increase to 132% after 20 minutes venous occlussion.- We saw most increase in volume and decrease in Di0c6 and A0 dye content after storage in EDTA compared to Citrate and Heparin.The present results show that the dyes of functional platelet parameters are sensitively picked up by flow cytometry. The methodology seems attractive for clinical purposes because measurements can be performed in diluted blood samples within less than five minutes after venipuncture.

Asymptomatic Factor VII Padua in African Americans.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4069-4069 ◽  
Author(s):  
Theresa M. Tidd ◽  
Beverly Ptashkin ◽  
Eleanor S. Pollak
Keyword(s):  
African American ◽  
Sodium Citrate ◽  
Factor Vii ◽  
Rabbit Brain ◽  
Activity Levels ◽  
Blood Samples ◽  
Black Patients ◽  
Coagulant Activity ◽  
Healthy Control ◽  
Fvii Deficiency

Abstract Background: Symptomatology in congenital human FVII deficiency with FVII:C (Factor VII Coagulant Activity) levels &lt; 1% ranges from asymptomatic to severe hemorrhagic problems. Additionally, FVII:C differs markedly depending upon the source of tissue factor (TF) in the thromboplastin utilized for measuring FVII:C. FVII deficiency reported in 1978 in patients from Padua, Italy was later shown to be associated with an arginine (R) to glutamine (Q) mutation at FVII amino acid 304. A study by Triplett et al. from 1985 reported FVII deficiency in 26 patients including 16 Caucasians, 1 Hispanic and 9 blacks. Of these patients, all 9 black patients were asymptomatic whereas the other 17 patients had a clinically relevant bleeding disorder. Since that time there have been no reports describing the genetic cause of FVII deficiency in asymptomatic African American individuals. Methods: Plasma was obtained from patient blood samples obtained in 3.2% sodium citrate. FVII:C levels were performed using one-stage clotting assays with either rabbit brain thromboplastin (Simplastin Excel, Biomerieux, Durham, NC) or lyophilized recombinant human TF (Innovin, Dade Behring, Inc., Newark, DE). Factor VII antigen levels (VII:Ag) were measured using an enzyme-linked immunoabsorbent assay (American Bioproducts Co, Parsippany, NJ). A normal pool was constructed by mixing equal volumes of plasma from greater than 20 healthy control subjects. Results Patient # Prothrombin Time in seconds FVII:C Simplastin Excel FVII:C Innovin FVII:Ag Genotype Phenotype 1-African American 15.6 16% 33% 61% Heterozygote R304Q Minor Nose Bleeds 2- African American Prolonged 26% 54% 67% Heterozygote R304Q Asymptomatic for bleeding 3- African American 14.5 21% 64% NA Heterozygote R304Q Asymptomatic for bleeding Conclusions: We show that FVII deficiency in three asymptomatic African American patients at our specialty laboratory was due to FVII-Padua (R304Q). An additional ten African American patients showed prolonged prothrombin times and FVII:C values consistent with the laboratory phenotype of FVII-Padua. This diagnosis prevented inappropriate blood transfusions prior to surgery in several of these patients.

Comparison of the influence of EDTA-K3 and sodium citrate on haematology analysis in healthy dogs

2012 ◽  
Vol 15 (2) ◽  
pp. 391-392 ◽  
Author(s):  
M. Żmigrodzka ◽  
A. Winnicka ◽  
M. Guzera
Keyword(s):  
Platelet Count ◽  
Sodium Citrate ◽  
Ethylenediaminetetraacetic Acid ◽  
Haemoglobin Concentration ◽  
Healthy Dogs ◽  
Citrate Blood

Comparison of the influence of EDTA-K3 and sodium citrate on haematology analysis in healthy dogs The study was carried out on 30 clinically healthy dogs of various breeds. Haemoglobin concentration, haematocrit, platelet count and platelet haematocrit were significantly lower in citrate blood than in tripotassium ethylenediaminetetraacetic acid (EDTA-K3) blood. The study confirmed the limited usage of sodium citrate in haematology analysis, unless canine EDTA-dependent thrombocytopenia is suspected.

scholarly journals Thrombin generation in different commercial sodium citrate blood tubes

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Gian Luca Salvagno ◽  
Davide Demonte ◽  
Matteo Gelati ◽  
Giovanni Poli ◽  
Emmanuel J. Favaloro ◽  
...  
Keyword(s):  
Thrombin Generation ◽  
Sodium Citrate ◽  
Multiple Comparisons ◽  
Lag Time ◽  
Peak Height ◽  
Blood Collection ◽  
Reference Ranges ◽  
Becton Dickinson ◽  
The Mean ◽  
Citrate Blood

Summary Background This study aimed to verify whether blood drawn into six different commercial coagulation tubes generated comparable results of thrombin generation. Methods Blood was sequentially collected from 20 healthy subjects into different brand and draw volume 3.2% sodium citrate tubes (4.3 mL Sarstedt, 3.0 mL Greiner, 2.7 mL Becton Dickinson, 2.0 mL Kima, 1.8 mL Sarstedt and 1.0 mL Greiner). Thrombin generation was measured in plasma with the fully-automated ST Genesia analyzer using the weakest trigger (STG-BleedScreen). Results Different values of lag time (LT), time to reach thrombin peak (TP), thrombin peak height (PH) and endogenous thrombin potential (ETP) were commonly found in different tubes. Thrombin generation was the lowest in 4.3 mL Sarstedt tubes and the highest in 1.0 mL Greiner tubes. Other tubes displayed intermediate values. In multiple comparisons, LT was significantly different in 6/15 cases (40%), whilst PH, TP and ETP were significantly different in 14/15 (93%), 13/15 (87%) and 13/15 (87%) cases. The mean percent bias of LT, PH, TP and ETP ranged between -6% and +1%, -27% and +116%, -22% and +8%, and between -18% and +65%. The intra-assay imprecision of LT, PH, TP and ETP was exceeded in 0/15 (0%), 13/15 (87%), 6/15 (40%) and 13/15 (87%) comparisons. The correlation of LT, PH, TP and ETP values in different tubes ranged between 0.718–0.971, 0.570–0.966, 0.725–0.977 and 0.101–0.904. Conclusions Blood collection for thrombin generation assays requires local standardization using identical tubes for brand and draw volume, and reference ranges calculated according to type of tubes.

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