Exact time of venous blood sample collection – an unresolved issue, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE)

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_cclm-2020-0273_s_999_w2aab3b7b1b1b6b1aab1c12b1Aa"><jats:title>Objectives</jats:title><jats:p>An accurate knowledge of blood collection times is crucial for verifying the stability of laboratory analytes. We therefore aimed to (i) assess if and how this information is collected throughout Europe and (ii) provide a list of potentially available solutions.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0273_s_998_w2aab3b7b1b1b6b1aab1c12b2Aa"><jats:title>Methods</jats:title><jats:p>A survey was issued by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group on Preanalytical Phase (WG-PRE) in 2017, aiming to collect data on preanalytical process management, including sampling time documentation, in European laboratories. A preceding pilot survey was disseminated in Austria in 2016. Additionally, preanalytical experts were surveyed on their local setting on this topic. Finally, the current scientific literature was reviewed on established possibilities of sampling time collection.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0273_s_997_w2aab3b7b1b1b6b1aab1c12b3Aa"><jats:title>Results</jats:title><jats:p>A total number of 85 responses was collected from the pilot survey, whilst 1347 responses from 37 European countries were obtained from the final survey. A minority (i.e. ~13%) of responders to the latter declared they are unaware of the exact sampling time. The corresponding rate in Austria was ~70% in the pilot and ~30% in the final survey, respectively. Answers from 17 preanalytical experts from 16 countries revealed that sampling time collection seems to be better documented for out- than for in-patients. Eight different solutions for sample time documentation are presented.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0273_s_996_w2aab3b7b1b1b6b1aab1c12b4Aa"><jats:title>Conclusions</jats:title><jats:p>The sample collection time seems to be documented very heterogeneously across Europe, or not at all. Here we provide some solutions to this issue and believe that laboratories should urgently aim to implement one of these.</jats:p></jats:sec>

Potential Application of Recombinant Snake Prothrombin Activator Ecarin in Blood Diagnostics

“…Decreased clotting time in the presence of rEcarin is an important advantage in blood collection since attention has been drawn to the unreliability of sample collection and processing, which may impact on the stability of analytes [ 48 , 49 ]. For example, accurate registration of collection time is necessary for determining whether some tests should be performed or not (e.g., glucose, hormones, drug monitoring) [ 50 ]. We have shown that the quality of serum and analyte determination are unaffected by the inclusion of the snake venom prothrombin activator, OSPA [ 5 , 6 ].…”

Uncertainty From Sampling

“…Sub-clause 5.4.4.2 f) of ISO 15189 specifies that, when needed, the sample collection time is recorded. However, according to a survey carried out by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) in 2017, this is not homogeneously addressed by laboratories in Europe (von Meyer et al, 2020). On the other hand, it was realised that standardised protocols for patient preparation (fasting) for laboratory examination were lacking (Simundic et al, 2014).…”

Laboratory Testing and Preanalytical Errors: Where Are We in 2022?

“…Progesterone may adsorb separating gel in a few days if left in tubes [26]. Parameter stability finally can be influenced by fundamental elements such as time of collection and transportation conditions from collecting point to the laboratory [28]. A new sample is required and should be monitored to ensure a valid analysis if a preanalytical error is recognized earlier before the analytical phase [27].…”