Effects Of Blood Collection Tubes Research Articles

Hierarchical Classification of Factors Associated With Noninvasive Prenatal Testing Failures and Its Impact on Pregnancy Outcomes

Abstract Objective To conduct a hierarchical classification analysis of the nonreportable results of noninvasive prenatal testing in an attempt to reduce failure rates and provide pregnant women with accurate information to alleviate their anxiety. Methods In this study, 30,039 singleton pregnancies who underwent noninvasive prenatal testing in a single center from May 2019 to April 2022 were collected, and 811 samples with initial noninvasive prenatal testing failure were retrospectively analyzed. Grouping was based on the reasons for initial test failure; tracking the noninvasive prenatal testing results and prenatal diagnosis results (if any) of the “z-scores in the gray area” group and analyzing the possible influencing factors of the “low fetal fraction” group in the pre-experimental and experimental period by using one-way analysis of variance, Mann-Whitney U test, and χ2 test; and tracking the pregnancy outcomes of the test failures samples to analyze the risk of perinatal complications and adverse pregnancy outcomes of the different types of test failures. Results None of the samples' initial inconclusive results because of z-scores in the gray area were found to have chromosomal aneuploidy. However, pregnancy complications (P = 0.018) and a high likelihood of adverse pregnancy outcomes (P = 0.048) may still occur. Maternal gestational age (P < 0.001), body mass index (P < 0.001), library concentration (P < 0.001), and fetal gender (P < 0.001) were considered to be the associated factors for the initial low fetal fraction results. This may be associated with pregnancy complications (P < 0.001) and a high likelihood of adverse pregnancy outcomes (P = 0.034). The body mass index (P = 0.015) and time between draws (P = 0.001) were associated with the second test’s success. The incidence of low fetal fraction samples was more frequent with blood collection tubes of the G type than with the K type (P < 0.001). Conclusion Initial inconclusive results because of z-scores in the gray area did not imply an increased risk of aneuploidy, but vigilance is needed for an increased risk of pregnancy complications and adverse pregnancy outcomes. Because of the low fetal fraction, the initial absence of results may be related to the assay method, as well as the effect of blood collection tubes and the need to be alert to the risk of pregnancy complications and adverse pregnancy outcomes.

Effect of blood collection tubes containing separation gels on the measurement of drug concentrations in clinical toxicology

Effect of blood collection tubes containing separation gels on the measurement of drug concentrations in clinical toxicology

Defective determination of synthetic cathinones in blood for forensic investigation

Antemortem specimens are sometimes the sole sources available for forensic investigation, and samples collected in nonideal ways are inevitably employed to achieve toxicological analysis. It is essential to assess the effects of blood collection tubes on the recoveries of emerging synthetic cathinones (SC) to estimate actual drug concentrations, and no such systematic investigations have been previously carried out. Seventy-one SC with various LogP values were employed to examine commonly used blood collection tubes, including plasma tubes, serum tubes and gel-containing tubes in recoveries which determined by a reliable LC-MS/MS method. Significantly poor recoveries for hydrophobic SC were obtained using serum separating tubes (SST). Notably, the suppressed recoveries in SST can be reversed by adding anticoagulants. Adding a procoagulant to a plasma separating tube (PST) considerably reduced recoveries, which indicated that clotting processes in the presence of polymeric gels contributed to poor recoveries of these hydrophobic drugs. In this study, we find that clotting formation in the presence of polymeric gels could significantly affect the determination of hydrophobic drugs. However, in real-world scenarios, nonideal collection methods are inevitably employed for antemortem specimens. Thus, it is important to rigorously interpret forensic toxicological results, especially for susceptible species.

A comparative study on the effect of blood collection tubes on stress oxidative markers.

Oxidative stress has a major role in disease pathogenesis. However, limited studies have investigated the effect of various sample collection tubes on oxidative biomarkers. The present study aimed to evaluate the effect of different collection tubes on the variation of malondialdehyde (MDA), nitric oxide (NO), total thiol (t-SH), and ferric reducing ability of plasma (FRAP) levels. A total of 35 individuals participated in this study and each collected sample was separated into three different tubes: glass tubes (GTs), plain plastic tubes (PTs), and gel separator tubes (GSTs). The results of PTs and GSTs were compared to those of GTs as the reference tube. The comparison between the means of biomarkers in various tubes indicated that there was no significant difference in MDA results between tubes. In contrast, t-SH and NO content were significantly decreased in GSTs and PTs compared to GTs. However, the Bland-Altman analysis showed an acceptable concordance for the mentioned analytes and the statistically significant differences were not clinically significant for NO, MDA, and t-SH antioxidant parameters. Moreover, the FRAP level was considerably lower in GSTs compared to GTs. Nevertheless, the Bland-Altman analysis showed a high bias percentage for the FRAP assay when using PTs and GSTs. According to the present results, it can be concluded that switching to plastic blood collection tubes or serum separation tubes could influence the FRAP results. However, there was no interference for the interpretation of other antioxidant assays in different types of collection tubes. Hence, it is suggested to use GTs for total antioxidant capacity evaluations, especially the FRAP assay.

Serum or Plasma (and Which Plasma), That Is the Question.

Blood derivatives are the biofluids of choice for metabolomic clinical studies since blood can be collected with low invasiveness and is rich in biological information. However, the choice of the blood collection tubes has an undeniable impact on the plasma and serum metabolic content. Here, we compared the metabolomic and lipoprotein profiles of blood samples collected at the same time and place from six healthy volunteers but using different collection tubes (each enrolled volunteer provided multiple blood samples at a distance of a few weeks/months): citrate plasma, EDTA plasma, and serum tubes. All samples were analyzed via nuclear magnetic resonance spectroscopy. Several metabolites showed statistically significant alterations among the three blood matrices, and also metabolites’ correlations were shown to be affected. The effects of blood collection tubes on the lipoproteins’ profiles are relevant too, but less marked. Overcoming the issue associated with different blood collection tubes is pivotal to scale metabolomics and lipoprotein analysis at the level of epidemiological studies based on samples from multicenter cohorts. We propose a statistical solution, based on regression, that is shown to be efficient in reducing the alterations induced by the different collection tubes for both the metabolomic and lipoprotein profiles.

Genome-wide study of the effect of blood collection tubes on the cell-free DNA methylome

ABSTRACT The methylation pattern of cfDNA, isolated from liquid biopsies, is gaining substantial interest for diagnosis and monitoring of diseases. We have evaluated the impact of type of blood collection tube and time delay between blood draw and plasma preparation on bisulphite-based cfDNA methylation profiling. Fifteen tubes of blood were drawn from three healthy volunteer subjects (BD Vacutainer K2E EDTA spray tubes, Streck Cell-Free DNA BCT tubes, PAXgene Blood ccfDNA tubes, Roche Cell-Free DNA Collection tubes and Biomatrica LBgard blood tubes in triplicate). Samples were either immediately processed or stored at room temperature for 24 or 72 hours before plasma preparation. DNA fragment size was evaluated by capillary electrophoresis. Reduced representation bisulphite sequencing was performed on the cell-free DNA isolated from these plasma samples. We evaluated the impact of blood tube and time delay on several quality control metrics. All preservation tubes performed similar on the quality metrics that were evaluated. Furthermore, a considerable increase in cfDNA concentration and the fraction of it derived from NK cells was observed after a 72-hour time delay in EDTA tubes. The methylation pattern of cfDNA is robust and reproducible in between the different preservation tubes. EDTA tubes processed as soon as possible, preferably within 24 hours, are the most cost effective. If immediate processing is not possible, preservation tubes are valid alternatives.

Determination of one year stability of lipid plasma profile and comparison of blood collection tubes using UHPSFC/MS and HILIC-UHPLC/MS

Effects of blood collection tubes, the time period, the sample origin, and the method used on the lipidomic profile are investigated by ultrahigh-performance supercritical fluid chromatography - mass spectrometry (UHPSFC/MS) and hydrophilic interaction liquid chromatography ultrahigh-performance liquid chromatography - mass spectrometry (HILIC-UHPLC/MS). Heparin plasma samples have been obtained from 99 healthy volunteers at three time points separated by six-month intervals together with one collection for EDTA plasma and serum. Furthermore, lipid concentrations in heparin plasma collected at two different sites are compared. 171 lipid species from eight lipid classes are quantified with UHPSFC/MS, and 122 lipid species from four lipid classes with HILIC-UHPLC/MS. The accuracy of both methods is monitored by the quantitation error using two internal standards (IS) per individual lipid classes. No significant differences in lipid profiles are observed for different time points and types of collection tubes (heparin plasma, EDTA plasma, and serum). Most pronounced lipid concentration differences are observed for the comparison of NIST SRM 1950 human plasma and mean lipid concentrations of the investigated cohort. Furthermore, differences in lipid concentrations are observed between employed methods (UHPSFC/MS vs. HILIC-UHPLC/MS), which can be compensated by the normalization using NIST SRM 1950 human plasma used as the quality control sample.

Effects of Blood Collection Tubes on Determination Vitamin-A by HPLC

Background: VACUETTE® Blood Collection Tubes are used for the collection of venous blood. VACUETTE® tubes are used to collect, transport, store and process blood for testing serum, plasma or whole blood in the clinical laboratory for professional use. Objective: Evaluate the effect of blood specimen collection methods of the VACUETTE Serum Sep Clot Activator tube (gel tube), in determination vitamin A by HPLC. Methods: Blood specimen was divided into three parts, Three tubes, for Part I, No Additive tubes were drawn, for Part 2 Serum SepClot Activator tube (gel tube), and for Part 3 EDTA-coated plastic tubes. The tubes were gently mixed using ten complete inversions immediately following blood collection and centrifuged after venipuncture for 15 min and the supernatants were stored at -70°C until analysis. Vitamin A Testing was performed on healthy blood donors; the testing was performed by HPLC. Results: Our study showed that, There was no difference in the results were obtained with the serum (No Additive tube) and plasma tube in concentration of retinol 67.7 ug/dl and 73.8 ug/dl, but the results was 9.2 ug/dl obtained with the VACUETTE® Serum Sep Clot Activator tubes (gel tube). Conclusions: Tubes are drawn in a specific order to avoid the possibility of erroneous test results caused by carryover of an additive. If Serum tube-with or without clot activator or gel, it should be drawn as the first tube. We recommended that only serum and EDTA -plasma samples be used for Vitamin A determination by HPLC and cannot be carried out with all gel tubes.

Effect of blood collection tubes on the incidence of artifactual hyperkalemia on patient samples from an outreach clinic

BackgroundAn offsite satellite clinic of the University of Chicago Medical Center (UCMC) requested an investigation by the Clinical Chemistry Laboratory (CCL) into several cases of possible falsely elevated potassium (K+) values in their patients. Bloods for K+ and chemistry profiles are routinely collected in mint-green, heparinized plasma separator tubes (PST), centrifuged, and transported by courier from satellite clinic to CCL within several hours. Samples from on-site phlebotomy areas are similarly collected but sent uncentrifuged to CCL via a pneumatic tube system within minutes of collection. MethodsOur investigations included extensive QC and QA review of UCMC onsite and offsite outpatient clinics, reference range studies using PST and serum separator tubes (SST), assessment of pre-analytic handling of specimens, including transportation simulation study, and comparison of K+ results for samples collected simultaneously using PST and SST tubes at an offsite clinic. ResultsOur transportation simulation demonstrated elevations in K+ concentrations following sample jostling and perturbations. We also observed RBC escape across the gel barrier further contributing to K+ elevations. ConclusionSerum is preferred sample type for an offsite clinic.

Differential effect of blood collection tubes on total free fatty acids (FFA) and total triiodothyronine (TT3) concentration: A model for studying interference from tube constituents

Background Besides total triiodothyronine (TT 3), total free fatty acids (FFA) concentrations were higher with serum separator tube (SST™) than Vacuette™ tubes. Methods The effects of surfactant, rubber stopper, and separator gel from various tubes were investigated on FFA, β-hydroxybutyrate (β-HB), and TT 3 with 8 different tube types in blood specimens of apparently healthy volunteers. Results Compared to Vacuette tubes, serum FFA and TT 3 concentrations were significantly higher in SST than glass tubes. Reformulated SST eliminated the increase in TT 3 but not FFA. No significant difference was observed for β-HB concentration among tube types. Surfactant and rubber stoppers from the different tube types significantly increased TT 3 but not FFA and β-HB concentrations. Agitation of whole blood but not serum or plasma specimens with separator gel from SST, reformulated SST and plasma preparation tube (PPT™) tubes compared to Vacuette tubes gave higher FFA but not β-HB levels. Conclusions Unidentified component(s) from the separator gel in SST, reformulated SST and PPT tubes cause falsely high FFA concentration. In contrast to TT 3, falsely high FFA results require exposure of whole blood and not serum to tube constituent(s). The approach employed here may serve as a model for assessing interference(s) from tube constituent(s).

Effects of Blood Collection Tubes, including Pediatric Devices, on 16 Common Immunoassays

The effects of different blood collection tubes on hormones and tumor markers, clinical chemistry, and therapeutic drug monitoring have been studied (1)(2)(3)(4), and only serum triiodothyronine (T3) was found to be significantly affected by the types of blood collection tubes(4). One of the interferents for immunoassays has been identified as an organosilicone surfactant(5). Daae et al.(6)(7) investigated the difference of hematology values in capillary and venous blood samples collected in Microtainers and Vacutainers, respectively. Clinical differences were observed for some analytes (6)(7). We compared the results obtained by 4 immunoassays for specimens from 20 adult volunteers collected in red-top Microtainers and Vacutainers during the same venous draw and observed clinically significant differences(8). The objective of present study was to investigate effects of various types of Vacutainer and Microtainer tubes on 16 widely used immunoassays performed on the Immulite 2000 (Diagnostic Product Corporation) or Advantage (Nichols Institute Diagnostics). Blood collection tubes were from BD Diagnostics. The Vacutainers were red-top (plain …

Effect of Blood Collection Tubes on Total Triiodothyronine and Other Laboratory Assays

Effect of Blood Collection Tubes on Total Triiodothyronine and Other Laboratory Assays

Effect of Blood Collection Tubes on Total Triiodothyronine and Other Laboratory Assays

Increased total triiodothyronine (TT(3)) assay results in apparently euthyroid patients triggered an investigation of the effect of blood collection tubes on serum TT(3) and other laboratory assays. We examined potential assay interference for three types of tubes: plastic Greiner Bio-One Vacuette; glass Becton Dickinson (BD) Vacutainer; and plastic BD Vacutainer SST tubes. Serum samples from apparently healthy volunteers (age range, 30-60 years; 15 males and 34 females) were collected in different tube types and analyzed in 17 immunoassays (n = 49), 30 clinical chemistry tests (n = 20), and 33 immunology assays (n = 15). Tube effects were also examined by adding pooled serum to different tube types. TT(3) values, when measured by the IMMULITE 2000 but not the AxSYM analyzer, were significantly higher (P <0.0001) for SST (2.81 nmol/L) than either glass (2.15 nmol/L) or Vacuette (2.24 nmol/L) tubes. The effect was large enough to substantially shift the distribution of patient values, increasing the percentage of values above the reference interval from 11.3% to 35.8%. The degree of interference from SST tubes on TT(3) differed among various tube lots and could be attributed to a tube additive shared by other plastic tubes. Results from several other tests statistically differed among tube types, but differences were not considered to be clinically significant. Assay interferences from blood collection tubes represent challenges to clinical laboratories because they are not detected by the usual quality-control or proficiency testing programs. Laboratories can, however, address this problem by monitoring distribution of patients' results.

Potential Interferences from Blood Collection Tubes in Mass Spectrometric Analyses of Serum Polypeptides

Currently, there are high degrees of both enthusiasm and controversy regarding the potential diagnostic application of matrix-assisted laser desorption/ionization time-of-flight (MALDI TOF) mass spectrometry (1)(2)(3)(4)(5)(6)(7). This technique permits the simultaneous analysis of a large number of polypeptide components in biological fluids. Greatest sensitivity and resolution are achieved by MALDI TOF mass spectrometry in the mass range from ∼500 to 20 000 Da; this has led to the recognition that there is a highly complex mixture of peptide components in serum that circulate bound to larger proteins (8)(9). The complex patterns of peptide components are very information rich and may contain multiple biomarkers of diagnostic value (1)(2)(3)(4)(5)(6)(7)(8)(9). The present study examined whether different types of blood collection tubes add molecules to specimens that may appear as interfering or confounding peaks during MALDI TOF mass spectrometry. Commercially available blood collection tubes contain multiple components that may shed polymers in the molecular size range of interest. Silicones are commonly used as lubricants for stoppers or coatings for the internal surface of tubes. Polymeric surfactants such as polyvinylpyrrolidones or polyethylene glycols may be added to influence surface wetting. Tubes may contain either clot inhibitors or activators. Serum separator tubes contain polymeric gels with several constituents to adjust viscosity, density, and other physical properties. Rubber stoppers and the plastics comprising tube walls may shed polymeric components or plasticizers. Previous studies have reported effects of blood collection tubes on a variety of laboratory tests (10)(11)(12)(13)(14). These effects can arise from adsorption of serum or plasma components to the tube or separator gel, from the release of materials …