A Comparison of Coagulation Study Results Between Heparinized Peripherally Inserted Central Catheters and Venipunctures

Humphries, Linda; Baldwin, K. M.; Clark, Kirstena L.; Tenuta, Vivian; Brumley, Kimberly

doi:10.1097/nur.0b013e31826e3efb

Cited by 11 publications

(12 citation statements)

References 12 publications

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“…Studies comparing coagulation values from heparinized catheters (venous or arterial) and peripheral samples do not agree on whether accurate values can be obtained from heparinized catheters or what discard volume is sufficient to prevent sample contamination. 21–24 Push-pull coagulation values in this project were considered reliable based on comparisons to samples drawn from CVCs according to standard practice (discard method), not to peripheral draws. However, push-pull values were all within either normal or clinically expected limits, which also supports the reliability of samples drawn using this method.…”

Section: Discussionmentioning

confidence: 99%

A Standard Push-Pull Protocol for Waste-Free Sampling in the Pediatric Intensive Care Unit

McBride

Miller-Hoover

Proudfoot

2018

Journal of Infusion Nursing

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Blood sampling is a major source of blood loss in the pediatric intensive care unit (PICU). Blood-sparing sampling techniques such as the push-pull method can significantly reduce sampling-related blood loss and protect patients from anemia and blood transfusions. The push-pull method is supported by research evidence for central venous catheter (CVC) sampling, but research protocols differ and not all CVCs and laboratory tests have been studied. A standard push-pull protocol for the PICU was developed, implemented, and evaluated in this evidence-based practice project. Results show that the protocol can be used safely and reliably as a standard waste-free sampling method in the PICU.

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Section: Discussionmentioning

confidence: 99%

A Standard Push-Pull Protocol for Waste-Free Sampling in the Pediatric Intensive Care Unit

McBride

Miller-Hoover

Proudfoot

2018

Journal of Infusion Nursing

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“…Physicians previously recognized the Discard method [1][2][3] as having the same accuracy as standard. However, to avoid unnecessary blood loss (waste volume) from the Discard method, physicians usually re-infuse the waste blood back into the central lines 4 .…”

Section: The Accuracymentioning

confidence: 99%

“…Our study highlights the use of control group blood samples drawn from the same CVC line before ushing normal saline 10 ml, then the Pull-push method, which is consistent with routine clinical practice. Our study design has an advantage over other studies using blood samples from peripheral phlebotomy as a control, where the values are signi cantly different 2,3,15,17 .…”

Section: The Accuracymentioning

confidence: 99%

Accuracy of Laboratory Tests Drawn by Pull-push Method from Central Venous Catheterization After Routine Flushing with 10 ml Normal Saline.

Lokeskrawee

Muengtaweepongsa

Sawaengrat

et al. 2021

Preprint

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Background: Central venous catheterization (CVC) remains a common practice in the emergency setting. Routine flushing 10 - 20 ml of normal saline to maintain the patency of CVC could affect the accuracy of laboratory tests. Typically, physicians require peripheral vein phlebotomy when more blood sampling is needed. One of the alternative methods, the Pull-push method, could avoid too much pain and unnecessary peripheral vein phlebotomy. However, there has been no recent study analyzing the accuracy of blood sampling using this technique. Objective: We evaluate laboratory tests' accuracy between blood samples drawn by the Pull-push method from CVC after routine flushing with 10 ml of normal saline versus control. Methods: We conducted a diagnostic accuracy study from May to September 2019. After exclusion, 72 patients were eligible for analysis. Promptly after central venous catheterization, we drew blood samples, stored them in blood collecting tubes, and labeled them for the gold standard group. We flushed with 10 ml of normal saline before blood sampling using the Pull-push method's completed three times; then, we drew blood samples again, labeled Pull-push group. We compared the laboratory results between two groups by paired t-test. The accuracies were analyzed based on an allowable error by Clinical Laboratory Improvement Amendments (CLIA) and presented by a modified Bland-Altman plot. Results: The 72 patients were primarily male (n=47, 65.3%), had a mean age 60.1±14.0 years, and were diagnosed with sepsis (n=4, 5.6%) or septic shock (n=65, 90.3%). For almost all the laboratory values, including hemoglobin, hematocrit, white blood cell count, platelet count, blood urea nitrogen, creatinine, sodium, potassium, chloride, bicarbonate, prothrombin time, international normalized ratio, and blood sugar, the accuracy was more than 90% (92.8-98.6%), except aPTT (85.5%) and aPTT ratio (86.7%) Conclusion: Laboratory tests drawn by the Pull-push method could replace peripheral vein phlebotomy to avoid too much pain and infection risk.

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“…13 There is no evidence-based literature about obtaining urine specimen from urethral catheters. In this study, sterile urine specimens collected using both the vacuum tube and the injector techniques were compared with respect to the contamination rate and frequency of minor adverse events.…”

mentioning

confidence: 99%

Comparison of 2 Techniques Used to Obtain Sterile Urine Specimens From Urethral Catheters

Başak

Uzun

2013

Clinical Nurse Specialist

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A Comparison of Coagulation Study Results Between Heparinized Peripherally Inserted Central Catheters and Venipunctures

Abstract: Drawing blood samples from heparinized PICCs for coagulation tests using the evidence-based procedure developed for this study resulted in accurate coagulation test results in 4 of the 5 tests: prothrombin time, partial thromboplastin time, and fibrinogen in seconds and in milligrams.

Cited by 11 publications

References 12 publications

A Standard Push-Pull Protocol for Waste-Free Sampling in the Pediatric Intensive Care Unit

A Standard Push-Pull Protocol for Waste-Free Sampling in the Pediatric Intensive Care Unit

Accuracy of Laboratory Tests Drawn by Pull-push Method from Central Venous Catheterization After Routine Flushing with 10 ml Normal Saline.

Comparison of 2 Techniques Used to Obtain Sterile Urine Specimens From Urethral Catheters

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