Relevance of EDTA carryover during blood collection
-
Janne Cadamuro
,
Thomas Klaus Felder
Abstract
Background: The order of draw is regarded as a preanalytical issue to prevent carryover of additives during blood collection. Our objective was to prove the theory of ethylenediaminetetraacetic acid (EDTA) carryover for a closed vacuum system and the influence of EDTA on concentrations of selected biomarkers.
Methods: To test the carryover of EDTA, a blood collection with tripotassium EDTA (K3EDTA) and subsequent non-additive tubes was simulated using distilled water as substitute for blood. EDTA concentrations were measured by tandem mass spectrometry. Then we added increasing concentrations of EDTA to heparinized blood and measured routine biomarkers, thereby simulating a carryover of EDTA whole blood and pure EDTA, respectively. Additionally, we tested for EDTA contamination and biomarker alteration in samples collected from 10 healthy volunteers by a syringe with subsequent transfer into sample tubes.
Results: No EDTA contamination was detected in samples collected subsequent to a K3EDTA tube when adhering to guidelines of blood sampling. Magnesium, calcium, and potassium levels were altered by artificial K3EDTA whole-blood contamination as well as when adding 1 μL pure K3EDTA. Iron values were altered at EDTA concentrations of 4.4 mmol/L. All other parameters remained unaffected. A slight EDTA carryover was observed in syringe collection and subsequent transfer into EDTA and heparin tubes, however, without any biomarker alteration.
Conclusions: An EDTA carryover during blood collection using a closed vacuum system is highly unlikely. Even if carryover of EDTA whole blood occurs, an absolute volume larger than 10 μL would be necessary to alter test results. However, contamination of samples with preloaded pure K3EDTA solution by severe neglect of current recommendations in blood collection may significantly alter testing results.
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Articles in the same Issue
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Articles in the same Issue
- Frontmatter
- Editorials
- Once upon a time: a tale of ISO 15189 accreditation
- A new integrated tool for assessing and monitoring test comparability and stability
- Liver-FibroSTARD checklist and glossary: tools for standardized design and reporting of diagnostic accuracy studies of liver fibrosis tests
- Reviews
- Thromboembolic risk in hematological malignancies
- A review of the cut-off points for the diagnosis of vitamin B12 deficiency in the general population
- Opinion Paper
- Permissible limits for uncertainty of measurement in laboratory medicine
- EFLM Position Paper
- Flexible scope for ISO 15189 accreditation: a guidance prepared by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group Accreditation and ISO/CEN standards (WG-A/ISO)
- Genetics and Molecular Diagnostics
- Evaluation of a low-cost procedure for sampling, long-term storage, and extraction of RNA from blood for qPCR analyses
- Application of real-time PCR of sex-independent insertion-deletion polymorphisms to determine fetal sex using cell-free fetal DNA from maternal plasma
- General Clinical Chemistry and Laboratory Medicine
- The Empower project – a new way of assessing and monitoring test comparability and stability
- Comparison of four automated serum vitamin B12 assays
- Combined indicator of vitamin B12 status: modification for missing biomarkers and folate status and recommendations for revised cut-points
- INR vs. thrombin generation assays for guiding VKA reversal: a retrospective comparison
- Determination of dabigatran in plasma, serum, and urine samples: comparison of six methods
- Simple high-throughput analytical method using ultra-performance liquid chromatography coupled with tandem mass spectrometry to quantify total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol in urine
- Revival of physostigmine – a novel HPLC assay for simultaneous determination of physostigmine and its metabolite eseroline designed for a pharmacokinetic study of septic patients
- Relationship between antiphosphatidylserine/prothrombin and conventional antiphospholipid antibodies in primary antiphospholipid syndrome
- Reference Values and Biological Variations
- Relevance of EDTA carryover during blood collection
- Reference intervals for renal injury biomarkers neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in young infants
- Cardiovascular Diseases
- NT-proBNP levels and their relationship with systemic ventricular impairment in adult patients with transposition of the great arteries long after Mustard or Senning procedure
- Letters to the Editors
- Troponin T measured with highly sensitive assay (hsTnT) on admission does not reflect infarct size in ST-elevation myocardial infarction patients receiving primary percutaneous coronary intervention
- Analytical challenges related to the use of biomarker ratios for the biological diagnosis of Alzheimer’s disease
- Serum brain injury biomarkers as predictors of mortality after severe aneurysmal subarachnoid hemorrhage: preliminary results
- Tumor markers assay by the Lumipulse G
- Real-world costs of laboratory tests for non-small cell lung cancer
- Impact of stopping vitamin K antagonist therapy on concentrations of dephospho-uncarboxylated Matrix Gla protein
- Practicability of fetal scalp blood sampling during labor using microtubes and a point-of-care (POC) lactate testing device: difficulty assessment, sampling time and failure rates
- Establishing objective analytical quality requirements in the IgE specific assay: a message in a bottle
- Bacteria on a peripheral blood smear as presenting sign of overwhelming post-splenectomy infection in a patient with secondary acute myeloid leukemia
