Potassium Concentration In Samples Research Articles

Pseudohyperkalaemia in leukaemic patients: the effect of test tube type and form of transport to the laboratory

The present study was aimed at determining the effect of the tube type used for primary sample collection and the manner of transport prior to assessment (either manual or by pneumatic tube) on the degree of pseudohyperkalaemia in leukaemic patients. Blood from six leukaemic patients was collected into seven primary sample tubes (Monovette®, Sarstedt): sample A, heparinized blood gas syringe (potassium reference value); sample B, plasma Li-heparin without separator gel; sample C, plasma Li-heparin with separator gel; and sample D, serum with separator gel. The primary sample tubes designated B, C and D were transported to the laboratory manually. Duplicates of the same sample tubes, B(PT), C(PT) and D(PT), were sent to the laboratory by pneumatic tube. In patients with chronic lymphocytic leukaemia (CLL), there was no increase in the concentration of potassium in samples B, C and D when compared to the reference value. Transport of the samples by pneumatic tube led to a pronounced increase in potassium concentration in samples B(PT) and C(PT), whereas there was no increase in sample D(PT) when compared to the reference value. In the patient with chronic myeloid leukaemia (CML), an increase in potassium concentration occurred in sample D and in samples B(PT), C(PT) and D(PT). A similar finding was observed in the patient with acute lymphocytic leukaemia (ALL), furthermore with an extremely high concentration of potassium in samples C and C(PT). Manual transport of non-coagulable blood (plasma Li-heparin without separator gel) to the laboratory results in the least possible artificial increase in potassium concentration in the sample.

The impact of centrifugation in primary care on pseudohyperkalaemia: a retrospective evaluation

Spurious hyperkalaemia is a relatively common occurrence in samples originating from primary care. Failure to identify spurious hyperkalaemia carries a significant risk of patient mismanagement. We have carried out a retrospective evaluation to review the impact of the use of centrifuges in primary care for biochemistry blood samples on the management of hyperkalaemia. Serum potassium concentrations in samples received from primary care were reviewed for six months prior to and after the implementation of on-site centrifugation. Samples exhibiting significant hyperkalaemia (serum potassium >6.0 mmol/L) were further investigated to ascertain the degree of patient follow-up. There was a significant decrease in the number of samples exhibiting marked hyperkalaemia following the implementation (2244 versus 524; P < 0.0001). In terms of patient follow-up, we observed a reduction in the number of patients exhibiting pseudohyperkalaemia that previously had led to inappropriate hospital admissions over the same time period (6 cases postimplementation versus 22 cases preimplementation). We also observed an increase in the number of patients exhibiting true hyperkalaemia during the six-month period postimplementation (33 cases postimplementation versus 6 cases preimplementation). The centrifugation of serum samples in primary care improves the sample quality and the integrity of the potassium results reported. We have also demonstrated evidence of an improvement in patient management and quality of care.

Correction factors for estimating potassium concentrations in samples with in vitro hemolysis: a detriment to patient safety.

Abstract Context.—Correction factors have been proposed for estimating true potassium concentrations in blood samples with evidence of in vitro hemolysis. Objective.—We used 2 different models of true (ie, nonsimulated) in vitro hemolysis to evaluate the clinical utility of correction factors for estimating potassium concentrations in samples with evidence of in vitro hemolysis. Design.—Potassium correction factors were derived using 2 different models. In model 1, potassium and plasma hemoglobin were measured with the Hitachi 747 analyzer in 132 paired blood samples, with each pair consisting of 1 sample with evidence of hemolysis and 1 without, collected during the same phlebotomy procedure. The change in measured potassium concentration was plotted versus the change in plasma hemoglobin concentration for each pair of samples. In model 2, the potassium levels of 142 784 blood samples and the corresponding hemolytic index values were measured with the Beckman LX20 analyzer. Potassium concentrations at th...

Correction Factors for Estimating Potassium Concentrations in Samples With In Vitro Hemolysis: A Detriment to Patient Safety

Correction factors have been proposed for estimating true potassium concentrations in blood samples with evidence of in vitro hemolysis. We used 2 different models of true (ie, nonsimulated) in vitro hemolysis to evaluate the clinical utility of correction factors for estimating potassium concentrations in samples with evidence of in vitro hemolysis. Potassium correction factors were derived using 2 different models. In model 1, potassium and plasma hemoglobin were measured with the Hitachi 747 analyzer in 132 paired blood samples, with each pair consisting of 1 sample with evidence of hemolysis and 1 without, collected during the same phlebotomy procedure. The change in measured potassium concentration was plotted versus the change in plasma hemoglobin concentration for each pair of samples. In model 2, the potassium levels of 142 784 blood samples and the corresponding hemolytic index values were measured with the Beckman LX20 analyzer. Potassium concentrations at the 10th, 25th, 50th, 75th, and 90th percentiles were calculated for each hemolysis index category. From our 2 models, we derived correction factors expressing an increase in potassium concentration of 0.51 and 0.40 mEq/L for every increase in plasma hemoglobin concentration of 0.1 g/dL. These correction factors are much higher than those reported in studies that simulated in vitro hemolysis by freeze-thaw lysis or osmotic disruption of whole blood. Use of correction factors for estimating the true potassium concentration in samples with evidence of in vitro hemolysis is not recommended. Derivation of correction factors by using samples with nonsimulated in vitro hemolysis suggests that the actual increase in potassium in hemolyzed samples is much higher than that reported in previous studies that produced hemolysis with artificial means.

Seasonal pseudohyperkalaemia

Aims: To investigate the relation between ambient temperature and serum potassium concentrations in samples from primary care. Methods: Potassium concentrations were estimated on general practitioner and hospital ward samples taken...

Postnatal maturation of potassium transport in rabbit cortical collecting duct.

Clearance studies in newborns demonstrate low rates of urinary excretion of potassium, suggesting that the neonatal kidney contributes to the conservation of potassium necessary for growth. Because the cortical collecting duct (CCD) is a primary site for potassium secretion in the adult, we sought to examine the transport capacity of this segment for potassium during postnatal maturation. CCDs isolated from rabbits of various ages (5-6 animals/age group) were microperfused in vitro with solutions simulating plasma. The concentrations of potassium in samples of collected fluid, measured by helium glow photometry, were used to calculate net transport. At a flow rate of approximately 1.6 nl.min-1 x mm-1 net potassium secretion was absent at birth, first became evident at 4 wk of age (-11.08 +/- 2.39 pmol.min-1 x mm-1), and increased sharply thereafter to reach mature rates (-23.08 +/- 3.47 pmol.min-1 x mm-1; P < 0.05) by 6 wk of age. To determine whether low distal tubular flow rates limit net potassium secretion in the neonate, we perfused CCDs at two or more flow rates in the 0.5-5 nl.min-1 x mm-1 range. In CCDs taken from animals > or = 6 wk of age, potassium secretion showed a significant linear correlation with flow rate (y = -10.0x - 7.45; r = 0.87; n = 12).(ABSTRACT TRUNCATED AT 250 WORDS)

Trace elements in the otoliths of yellow-eye mullet ( Aldrichetta forsteri) as an aid to stock identification

Concentrations of trace elements in the sagittal otoliths of yellow-eye mullet from three (1986) and four (1988) locations along the coast of southwestern Australia, including two neighbouring estuaries, were determined by inductively coupled plasma-atomic emission spectrometry (ICP-AES). Canonical variate (discriminant) analyses of the elemental concentrations showed these to be specific to the location of capture of the fish, although, with the exception of Swan River samples, there was a considerable overlap of data points. There were substantial (and unexplained) differences in the potassium concentrations in samples taken in 1986 and 1988, but other aspects of the accumulation patterns appeared to persist through time. Populations of yellow-eye mullet in the Swan River might, therefore, be regarded as essentially separate for some fisheries management purposes, but the similarity in element accumulation patterns for the other locations suggested that further evidence would be required before they could be regarded as demographically isolated.