![]() ![]() The contamination with EDTA can lead to spurious electrolyte results such as hyperkalemia, hypocalcemia, hypomagnesemia, hypozincemia, hypophosphatemia, and longer coagulation times. In general, the carryover of additives could virtually increase or decrease some laboratory values. Nowadays the order of blood draw established by the international guidelines is postulated to avoid cross-contamination between different additives contained in blood collection tubes, and it is as follows: blood culture bottle, non-additive tube, coagulation tube, clot activator, serum separator tube, sodium heparin, plasma separator tube, ethylenediaminetetraacetic acid (EDTA), blood tube, and oxalate/fluoride.Īdditive contamination, when it occurs, does not only result in erroneous blood values but also in a waste of healthcare resources and, particularly, if not swiftly recognized, may negatively affect patient care. ![]() ![]() But it was after the publication of the study by Calam and Cooper, in 1982, that the Clinical and Laboratory Standard Institute began to modify the recommendations slightly throughout the years, increasing the use of plastic instead of glass tubes and developing new additives. This particular finding has been the focus of numerous studies since 1977, when Sun and Knauf reported a case of spurious hyperkalemia and hypocalcemia due to suspected blood contamination. However, in the biomedical literature, there are different opinions about one special item of the recommendations: the order of draw of blood collection tubes. The World Health Organization and the Clinical and Laboratory Standard Institute have edited specific guidelines to ensure the good quality of the preanalytical phase. ![]()
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