Blood collection tube-related alterations in analyte concentrations in quality control material and serum specimens

Abstract

Objectives Several previous studies have described the effects of interfering substances on clinical assay results; however, the effects of exogenous substances, particularly additives from blood collection tubes on quality control (QC) specimens and serum specimens have not been well examined. This study examines the effects of blood-collection tube additives on total triiodothyronine (TT3), and thyroxine (TT4), cortisol, and routine clinical chemistry tests in QC and serum specimens from apparently healthy volunteers. Methods QC and serum specimens were poured or collected into different blood collection tubes. TT3 and TT4, cortisol, and routine chemistry tests were analyzed from the different blood-collection tube types. Results The findings of this study demonstrate clinically and/or statistically significant blood collection tube-related alterations in the TT3, TT4, and cortisol concentrations of QC specimens and TT4 concentrations from serum specimens. Conclusions These findings have important implications for clinical laboratories, demonstrating that QC specimens should ideally, like patients’ specimens, be poured into blood collection tubes. This strategy would reveal any adverse effects caused by blood collection tubes, which otherwise would not likely be detected by most routine QC practices. The results of this study also show the importance of producing blood collection tubes that contain additives that are truly inert and do not adversely affect clinical laboratory testing.

Comparison of Improvacuter™ tubes with BD Vacutainer™ tubes for various hormones in the aspects of stability and influence of gel separators

“…The results of our study were compatible with the study reported by Reinartz et al for cortisol, progesterone and estradiol, but controversial with testosterone results. In contrast to our results for cortisol, Bowen et al reported cortisol results exceeding maximum desirable bias (12.5%) when BD serum separator tubes used on IMMULITE 1000 [18].…”

Comparison of Six Automated Immunoassays With Isotope-Diluted Liquid Chromatography–Tandem Mass Spectrometry for Total Thyroxine Measurement

“…Further, we did not evaluate whether blood collection devices or storage at −80℃ affected immunohistochemical TT4 detection. A previous study using VACUETTE tubes with separator gel and clot activator from Greiner Bio-One showed that the tubes did not affect TT4 results [25]; however, the study evaluated the effect of the tubes on TT4 detection only for Immulite 1000 (Siemens). Burtis et al [21] reported that gel barrier collection devices do not have an apparent adverse effect on TT4 detection, and TT4 is stable up to 30 days when frozen.…”

Shaking Red Cap-Blood Collection Tube Without Additive Substances Is Recommended to Accelerate the Blood Clotting Process

“…The purpose of shaking blood collection tubes is to mix additives with blood such as anticoagulants (1). Red-cap collecting tubes are generally used for clinical chemistry and immunoserology to obtain serum specimens and to incubate the specimen allowed to clot in this tube (2).…”