Abstract
Improvement in the turnaround time (TAT) of results for stat chemistry tests is especially important on tests ordered by emergency department (ED) physicians. Extended waiting times for patients in the ED can be due to a prolonged TAT for stat chemistry results. Although serum and heparinized plasma are considered suitable samples for many stat chemistry tests, differences in the results obtained between these 2 sample types have been reported. 1,2 The principal advantages of heparinized plasma over serum are the reduction in specimen processing time related to not having to wait for the blood specimen to clot prior to centrifugation, reduced centrifugation time, and the avoidance of microclots that can obstruct sample aspiration probes in automated chemistry instruments. To evaluate heparinized plasma as a suitable substitute for serum for stat chemistry tests, we compared the results from serum and heparinized plasma samples for 16 chemistry tests, some of which are frequently ordered stat (Table 1). Methods We collected blood samples in a clot tube (Vacutainer Tube, Becton Dickinson, Franklin Lakes, NJ) and in a blood collection tube containing lithium heparin anticoagulant [Vacutainer Plasma Separator Tube (PST) II] during a single venipuncture of 100 patients admitted to our ED. All blood samples were centrifuged immediately after collection and aliquots of serum and heparinized plasma samples were assayed singly for glucose (Glu), blood urea nitrogen (BUN), sodium (Na), potassium (K), chloride (Cl), alanine aminotransferase (ALT), aspartate aminotransferase (AST), amylase (AMY), lipase (LIP), total bilirubin (TBili), creatine kinase (CK), C-reactive protein (CRP), lactate dehydrogenase (LD), albumin (ALB), and uric acid (UA) using the SYNCHRON LX-20 PRO analyzer (Beckman Coulter, Brea, CA) and reagents from Beckman Coulter. Data were analyzed by Student’s paired t-test, and P<0.05 was considered statistically significant.
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