Abstract
Objective: to review and to systematize the recommendations on reducing the incidence of defects occurring with a sample of blood after its sampling in the preanalytical phase and the impact of these shifts on the correct interpretation of a patient’s clinical status in the postanalytical phase of a study. Materials and methods. The review considers reports on the occurrence of the most common defects at blood sampling to evaluate acid-base, electrolytic, gas, and metabolic states and methods for their prevention and elimination. These measures are based on the determination of clinical indications for a blood test, the choice of a source of blood sampling, the preparation of a patient for this procedure, and the timing of its performance. The maximally possible agreement between the study parameters in the taken blood sample and their actual values in vitro can be achieved by following a number of technical factors, including the provision of anaerobic conditions for sampling the blood, its adequate mixing and homogenization, the prophylaxis of dilution and the prevention of clot formation and hemolysis, as well as by the consideration of their influence on a heparin solution sample and the time of its storage. A clear idea on the influence of sampling conditions on the sample taken to study blood, a patient’s status, and changes occurring with sample storage allows a clinician to have the maximally possible reliable information on acid-base balance, gaseous, electrolytic, and metabolic homeostasis and to take their based weighed decisions to perform or correct intensive care. Key words: blood sampling rules, blood sampling defects, preanalytical study phase, blood gas composition, acid-base balance, blood electrolyte levels.
Highlights
ГОУ ВПО Кубанский государственный медицинский университет, кафедра анестезиологии, реаниматологии и трансфузиологии факультета повышения квалификации и профессиональной переподготовки специалистов, Краснодар
Objective: to review and to systematize the recommendations on reducing the incidence of defects occurring with a sam ple of blood after its sampling in the preanalytical phase and the impact of these shifts on the correct interpretation of a patient's clinical status in the postanalytical phase of a study
The review considers reports on the occurrence of the most common defects at blood sampling to evaluate acid base, electrolytic, gas, and metabolic states and methods for their prevention and elimination. These measures are based on the determination of clinical indi cations for a blood test, the choice of a source of blood sampling, the preparation of a patient for this procedure, and the timing of its performance
Summary
Представлен обзор и систематизация рекомендаций, касающихся снижения количества дефектов, происходящих с пробой крови после ее забора в преаналитической фазе, и влияния этих сдвигов на правильность интерпретации клинического состояния больного в постаналитической фазе исследования. В обзорной ста тье рассмотрены публикации, касающиеся вопросов появления наиболее частых дефектов при заборе крови для оценки кислотно основного, электролитного, газового и метаболического состояний, а также методы их профилак тики и устранения. В связи с этим, целью статьи является обзор и сис тематизация рекомендаций, касающихся снижения ко личества дефектов, происходящих с пробой крови после ее забора в преаналитической фазе и влияния этих сдви гов на правильность интерпретации клинического состо яния больного в постаналитической фазе исследования.
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