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The stability of 65 biochemistry analytes in plasma, serum, and whole blood

  • Janet Zhou ORCID logo , Anselmo Fabros , Sarah Jane Lam , Anna Coro , Rajeevan Selvaratnam ORCID logo , Davor Brinc and Ashley Di Meo EMAIL logo
Published/Copyright: March 7, 2024
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 62 Issue 8

Abstract

Objectives

The pre-analytical stability of various biochemical analytes requires careful consideration, as it can lead to the release of erroneous laboratory results. There is currently significant variability in the literature regarding the pre-analytical stability of various analytes. The aim of this study was to determine the pre-analytical stability of 65 analytes in whole blood, serum and plasma using a standardized approach.

Methods

Blood samples were collected from 30 healthy volunteers (10 volunteers per analyte) into five vacutainers; either SST, Li-heparin, K2-EDTA, or Na-fluoride/K-oxalate. Several conditions were tested, including delayed centrifugation with storage of whole blood at room temperature (RT) for 8 h, delayed centrifugation with storage of whole blood at RT or 4 °C for 24 h, and immediate centrifugation with storage of plasma or serum at RT for 24 h. Percent deviation (% PD) from baseline was calculated for each analyte and compared to the maximum permissible instability (MPI) derived from intra- and inter-individual biological variation.

Results

The majority of the analytes evaluated remained stable across all vacutainer types, temperatures, and timepoints tested. Glucose, potassium, and aspartate aminotransferase, among others, were significantly impacted by delayed centrifugation, having been found to be unstable in whole blood specimens stored at room temperature for 8 h.

Conclusions

The data presented provides insight into the pre-analytical variables that impact the stability of routine biochemical analytes. This study may help to reduce the frequency of erroneous laboratory results released due to exceeded stability and reduce unnecessary repeat phlebotomy for analytes that remain stable despite delayed processing.

Keywords: delayed centrifugation; pre-analytical stability; refrigerated stability; room temperature serum and plasma stability; whole blood stability
Corresponding author: Ashley Di Meo, PhD, FCACB, Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada; and Department of Clinical Biochemistry, University Health Network, 200 Elizabeth Street, Room 3 EB 362A, Toronto, ON M5G 2C4, Canada, Phone: +416 340 4800, Ext: 2540, Fax: +416 340 4215, E-mail:

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflicts of interest.

  5. Research funding: None declared.

  6. Data availability: Not applicable.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/cclm-2023-1192).

Received: 2023-10-24
Accepted: 2024-02-06
Published Online: 2024-03-07
Published in Print: 2024-07-26

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Analytical performance specifications – moving from models to practical recommendations
  4. Opinion Papers
  5. What the Milan conference has taught us about analytical performance specification model definition and measurand allocation
  6. The role of analytical performance specifications in international guidelines and standards dealing with metrological traceability in laboratory medicine
  7. How clinical laboratories select and use Analytical Performance Specifications (APS) in Italy
  8. Outcome-based analytical performance specifications: current status and future challenges
  9. Analytical performance specifications based on biological variation data – considerations, strengths and limitations
  10. State-of-the-art model for derivation of analytical performance specifications: how to define the highest level of analytical performance technically achievable
  11. Analytical performance specifications for combined uncertainty budget in the implementation of metrological traceability
  12. When bias becomes part of imprecision: how to use analytical performance specifications to determine acceptability of lot-lot variation and other sources of possibly unacceptable bias
  13. Using analytical performance specifications in a medical laboratory
  14. Issues in assessing analytical performance specifications in healthcare systems assembling multiple laboratories and measuring systems
  15. Applying the Milan models to setting analytical performance specifications – considering all the information
  16. Guidelines and Recommendations
  17. Recommendations for blood sampling in emergency departments from the European Society for Emergency Medicine (EUSEM), European Society for Emergency Nursing (EuSEN), and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase. Executive summary
  18. General Clinical Chemistry and Laboratory Medicine
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  35. AWMF statement on medical services in laboratory diagnostics and pathology with regard to the IVDR
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https://doi.org/10.1515/cclm-2023-1192
Keywords for this article
delayed centrifugation; pre-analytical stability; refrigerated stability; room temperature serum and plasma stability; whole blood stability

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Analytical performance specifications – moving from models to practical recommendations
  4. Opinion Papers
  5. What the Milan conference has taught us about analytical performance specification model definition and measurand allocation
  6. The role of analytical performance specifications in international guidelines and standards dealing with metrological traceability in laboratory medicine
  7. How clinical laboratories select and use Analytical Performance Specifications (APS) in Italy
  8. Outcome-based analytical performance specifications: current status and future challenges
  9. Analytical performance specifications based on biological variation data – considerations, strengths and limitations
  10. State-of-the-art model for derivation of analytical performance specifications: how to define the highest level of analytical performance technically achievable
  11. Analytical performance specifications for combined uncertainty budget in the implementation of metrological traceability
  12. When bias becomes part of imprecision: how to use analytical performance specifications to determine acceptability of lot-lot variation and other sources of possibly unacceptable bias
  13. Using analytical performance specifications in a medical laboratory
  14. Issues in assessing analytical performance specifications in healthcare systems assembling multiple laboratories and measuring systems
  15. Applying the Milan models to setting analytical performance specifications – considering all the information
  16. Guidelines and Recommendations
  17. Recommendations for blood sampling in emergency departments from the European Society for Emergency Medicine (EUSEM), European Society for Emergency Nursing (EuSEN), and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase. Executive summary
  18. General Clinical Chemistry and Laboratory Medicine
  19. Assessment of accuracy of laboratory testing results, relative to peer group consensus values in external quality control, by bivariate z-score analysis: the example of D-Dimer
  20. The stability of 65 biochemistry analytes in plasma, serum, and whole blood
  21. Assessment of the 2023 European Kidney Function Consortium (EKFC) equations in a Chinese adult population
  22. In vitro, in vivo metabolism and quantification of the novel synthetic opioid N-piperidinyl etonitazene (etonitazepipne)
  23. Quantification of blood glial fibrillary acidic protein using a second-generation microfluidic assay. Validation and comparative analysis with two established assays
  24. Association of prehospital lactate levels with base excess in various emergencies – a retrospective study
  25. Reference Values and Biological Variations
  26. Stability of ten serum tumor markers after one year of storage at −18°C
  27. Variations in tumor growth, intra-individual biological variability, and the interpretation of changes
  28. Cancer Diagnostics
  29. N-linked glycosylation of the M-protein variable region: glycoproteogenomics reveals a new layer of personalized complexity in multiple myeloma
  30. Cardiovascular Diseases
  31. Reference intervals for high sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide in children and adolescents on the Siemens Atellica
  32. Infectious Diseases
  33. Fetal chronic hypoxia does not affect urinary presepsin levels in newborns at birth
  34. Letters to the Editor
  35. AWMF statement on medical services in laboratory diagnostics and pathology with regard to the IVDR
  36. An outline of measurement uncertainty of total protein in urine estimated according to the ISO Technical Specification 20914
  37. Early diagnosis of severe illness in an outpatient – the Sysmex XN’s neutrophil reactivity parameter
  38. Analytical and diagnostic performance of Theradiag i-Tracker assays on IDS-iSYS for infliximab and adalimumab therapeutic drug monitoring
  39. Improving the diagnosis of AATD with aid of serum protein electrophoresis: a prospective, multicentre, validation study
  40. Cerebrospinal fluid kappa free light chains in patients with tumefactive demyelination
  41. Diagnostic value of quantitative chemiluminescence immunoassay for anti-gp210 and anti-sp100 antibodies in primary biliary cholangitis
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