Biological variation of plasma osmolality obtained with capillary versus venous blood

Matthew T. Wittbrodt; Sofia Espinoza; Mindy L. Millard-Stafford

doi:10.1515/cclm-2014-1006

Article

Biological variation of plasma osmolality obtained with capillary versus venous blood

Matthew T. Wittbrodt , Sofia Espinoza and Mindy L. Millard-Stafford

Published/Copyright: February 6, 2015

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 53 Issue 10

Abstract

Background: Plasma osmolality (POsm) is a gold standard to assess hydration status but requires venipuncture. POsm obtained by lancing a digit, a source of capillary puncture blood (CAP), has not been validated. This study compared POsm from CAP versus venous blood (VEN) and validated its sensitivity to detect dehydration.

Methods: Healthy young adults (Study A: n=20 men, 22 women; Study B: n=23 men, 23 women) participated. In Study A, CAP and VEN were compared under controlled euhydration meeting dietary reference intakes for water (3.7 L men, 2.7 L women). In Study B, CAP was assessed for sensitivity to detect dehydration with receiver operating characteristic analysis over two 24 h periods: euhydration for 24 h followed by water restriction over 24 h. POsm was measured using freezing point depression.

Results: For all subjects, CAP POsm (283.0±3.9 mOsm/kg) was not significantly different (p=0.07) from VEN (284.2±3.5) during euhydration and met analytical goals for individuality and heterogeneity. When outliers (n=3) were eliminated, mean difference was –1.6 (±3.2) lower (p<0.01) with CAP. Fluid restriction increased (p<0.001) CAP POsm (284.0±4.4 to 292.8±5.2 mOsm/kg), achieving excellent accuracy (0.92) and sensitivity (89.1%) to predict mild dehydration (2% body mass loss).

Conclusions: POsm via CAP exhibited similar coefficients of variation and analytical goals compared to VEN combined with excellent accuracy and sensitivity to detect dehydration. Although CAP values were approximately 2 mOsm/kg lower than VEN, CAP appears an adequate substitute for tracking changes in non-clinical settings.

Keywords: capillary puncture; hydration; plasma osmolality; venipuncture; water intake

Corresponding author: Matthew T. Wittbrodt, School of Applied Physiology, Georgia Institute of Technology, Atlanta, GA 30332, USA, Phone: +1 231 590-8940, Fax: +1 404 8940-9982, E-mail: mwittbrodt3@gatech.edu

Acknowledgments

The authors appreciate the editorial comments of Dr. Michael N. Sawka in developing the manuscript and Michael L. Jones and Namrita Kumar in assisting with the data collection. The study was supported, in part, with funding obtained by The Coca-Cola Company, Atlanta, GA. There are no conflicts of interest for any of the authors in regards to this study.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Financial support: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2014-10-13

Accepted: 2015-1-1

Published Online: 2015-2-6

Published in Print: 2015-9-1

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Articles in the same Issue

https://doi.org/10.1515/cclm-2014-1006

Keywords for this article

capillary puncture; hydration; plasma osmolality; venipuncture; water intake