Comparison of two blood sampling techniques for the determination of coagulation parameters in the horse: Jugular venipuncture and indwelling intravenous catheter

Mackenzie, Catriona; McGowan, Catherine; Pinchbeck, Gina; Carslake, Harry

doi:10.1111/evj.12764

Cited by 7 publications

(6 citation statements)

References 33 publications

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“…There was concern about using only paired t-test and Wilcoxon signed rank test comparison methods; often, the differences may be statistically significant yet not clinically meaningful. Therefore, agreement between the two methods is tested using the Bland-Altman plots [11][12][13]16,17 along with a clinically accepted interval (CAI) estimated a priori and based on clinical expertise. Bland-Altman plots (►Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In the Portacath study (5 mL vs. 2 mL, 3 mL, 4 mL, and 5 mL discarded volumes), the result indicates that there is lesser difference in the 3 mL and 5 mL discarded volumes. 1 While assessing the agreement between 3 mL and 5 mL discarded volume methods for the six parameters, the Bland-Altman agreement limits [11][12][13]16,17 for sodium, potassium, creatinine, and direct bilirubin were not found within the CAI (as defined a priori and based on clinical expertise). The percentage of samples resulting in such a deviation for sodium, potassium, and direct bilirubin are 6.25% (95% CI 2.46-15%) and for creatinine are 7.81% (95% CI 3.38-17%), which is considered small and clinically insignificant as the deviation is found in less than 10% of the samples.…”

Section: Discussionmentioning

confidence: 99%

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Performance of 3 mL versus 5 mL Discarded Volume for Blood Sampling from Central Venous Access Device

et al. 2021

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Background Central venous access devices (CVAD) are an essential part of safe practices in critical care, which enable effective venous access and help in avoiding repeated venipuncture. Discard method is widely practiced for blood sampling. A single occasion of blood sampling may cause minimal blood loss; however, the cumulative volume sequential sampling may become clinically signiﬁcant. The study aims to reduce diagnostic blood loss, ensuring that the subsequent blood sample is not diluted or contaminated by residual intraluminal ﬂuid. Patients and Methods Within-subjects comparative design was adopted for 64 adult patients in the medical intensive care unit of a tertiary hospital. Two blood samples, using 3 mL and 5 mL discarded volume methods, were collected from each patient. Six serum parameters were measured on each of the paired samples and compared. Statistical Analysis Used Paired t-test and Wilcoxon signed rank test were used for comparing the two methods. Bland–Altman plot analysis and intraclass correlation were used for clinically meaningful analysis. Results When tested for fixed bias, there is no statistically significant difference between the methods. Potassium and creatinine levels showed significant proportional bias. The agreement limits of sodium, potassium, creatinine, and direct bilirubin were outside the clinically accepted interval, but the proportion of samples outside these intervals was less than 10%. All serum parameters showed excellent reliability, except for sodium which demonstrated good reliability. Conclusions The practice of discarding 3 mL of blood for discard method is suggested, instead of the standard 5 mL to reduce iatrogenic blood loss. Thus, nurses in critical care are uniquely positioned to limit the diagnostic blood loss while obtaining blood samples.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Performance of 3 mL versus 5 mL Discarded Volume for Blood Sampling from Central Venous Access Device

et al. 2021

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“…This prospective study by Catriona Mackenzie and colleagues in the UK aimed to compare coagulation parameters of blood collected by direct jugular venipuncture and through an indwelling intravenous catheter (IVC) .…”

Section: Blood Coagulation Parametersmentioning

confidence: 99%

Highlights of recent clinically relevant papers

Wright¹

2018

Equine Veterinary Education

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In recent studies on horses and ponies with gastrointestinal disease blood L-lactate and glucose concentrations were higher in ponies than in horses, possibly because of differences in body condition (BC). In this study, Bettina Dunkel and colleagues in the UK investigated the correlation between L-lactate and glucose concentrations and BC score in healthy horses and ponies.Breed, weight, height, and subjective and objective measures of BC were recorded for systemically healthy clientowned ponies (n = 101) and horses (n = 51) and L-lactate and glucose concentrations were measured. The association between L-lactate concentrations, equid type (pony or horse), BC, age, and glucose concentrations was investigated using a multivariable model.Weak but significant negative correlations were detected between L-lactate concentration and average BC score, heart girth:height ratio, and age. Glucose concentrations were significantly positively correlated with neck length:heart girth ratio and heart girth:height ratio. L-lactate and glucose concentrations were weakly correlated. In the final multivariable model, age and heart girth:height ratio were significantly associated with the natural logarithm of L-lactate concentration, representing a 2% decrease in L-lactate concentration per year increase in age and 10% decrease in L-lactate concentration per 0.06 unit increase in heart girth:height ratio.These results indicate that age and BC significantly influence L-lactate concentrations in healthy horses and ponies.

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“…In horses, May et al 7 demonstrated that haematological and biochemical values obtained from blood samples collected via IVC are comparable to those obtained from blood collected by direct venipuncture. Clinical equivalence of coagulation parameters has been reported between the two techniques in dogs and horses 3,5,8,10 …”

Section: Introductionmentioning

confidence: 98%

“…There are some existing veterinary studies on the effect of blood collection by IVC on blood parameters 3,5‐10 . In horses, May et al 7 demonstrated that haematological and biochemical values obtained from blood samples collected via IVC are comparable to those obtained from blood collected by direct venipuncture.…”

Section: Introductionmentioning

confidence: 99%

Venous blood gas parameters, electrolytes, glucose and lactate concentration in sick neonatal foals: Direct venipuncture versus push‐pull technique

Prete

Lanci

Cocchia

et al. 2020

Equine Veterinary Journal

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Background Blood collection by indwelling intravenous catheter (IVC) avoids repeated venipuncture, which could cause thrombophlebitis risk, anxiety and pain in patients. Objectives To compare blood gas parameters, electrolytes, glucose, lactate and haematocrit concentration obtained from venous blood samples collected via a jugular IVC by push‐pull (PP) technique to those obtained by venipuncture in hospitalised foals, at the time of catheter placement (T0) and 24 hours after the beginning of intravenous therapy (T24). Study design Prospective observational study. Methods Paired blood samples were drawn from hospitalised foals at T0 and T24. In each foal, one venous blood sample was collected via IVC by the following PP technique: 2.4 mL of blood was aspirated and immediately reinfused through the catheter three times consecutively, then 1 mL of blood was collected using a 1 mL heparinised syringe. Thereafter, another sample was collected by direct venipuncture of the contralateral jugular vein, with an identical 1 mL heparinised syringe, with a 1‐inch, 20‐G needle. All samples were analysed with an automated blood gas analyser within 10 minutes of collection. The agreement between the two techniques was assessed by Bland‐Altman analysis and intraclass correlation coefficient (ICC). Results The level of agreement of blood gas values obtained by the two different techniques was high with very small bias and clinically acceptable ICC (>0.907 at T0; >0.794 at T24) for all variables, except for haematocrit (bias −3.52 at T0; −2.44 at T24) and PvO2 at T0 and T24 (ICC 0.669 and 0.733, respectively). Main limitations Potential sub‐clinical catheter‐related complications were not investigated by ultrasound or bacterial culture of the catheter; short duration of the study. Conclusions PP technique appears to be acceptable for collection of blood samples for venous blood gas parameters, as well as electrolytes, glucose and lactate in sick neonatal foals.

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Comparison of two blood sampling techniques for the determination of coagulation parameters in the horse: Jugular venipuncture and indwelling intravenous catheter

Abstract: With the exception of AT and D-dimers, coagulation parameters measured on blood samples obtained via an IVC have clinically equivalent values to those obtained by jugular venipuncture.

Cited by 7 publications

References 33 publications

Performance of 3 mL versus 5 mL Discarded Volume for Blood Sampling from Central Venous Access Device

Performance of 3 mL versus 5 mL Discarded Volume for Blood Sampling from Central Venous Access Device

Highlights of recent clinically relevant papers

Venous blood gas parameters, electrolytes, glucose and lactate concentration in sick neonatal foals: Direct venipuncture versus push‐pull technique

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