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Clin Chim Acta. 2012 Oct 9;413(19-20):1454-8. doi: 10.1016/j.cca.2012.06.001. Epub 2012 Jun 12.

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

Author information

  • 1Department of Pathology, Pritzker School of Medicine, The University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637, USA. nbabic@bsd.uchicago.edu

Abstract

BACKGROUND:

An 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.

METHODS:

Our 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.

RESULTS:

Our 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.

CONCLUSION:

Serum is preferred sample type for an offsite clinic.

Copyright © 2012 Elsevier B.V. All rights reserved.

PMID:
22698439
[PubMed - indexed for MEDLINE]
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