Journal articles: 'Lithium heparin'

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Bailey, Douglas L. "Using Lithium Heparin Plasma." Laboratory Medicine 29, no. 8 (August 1, 1998): 464–65. http://dx.doi.org/10.1093/labmed/29.8.464.

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Lippi, Giuseppe, Gian Luca Salvagno, Simona Lampus, Elisa Danese, Matteo Gelati, Chiara Bovo, Martina Montagnana, and Ana-Maria Simundic. "Impact of blood cell counts and volumes on glucose concentration in uncentrifuged serum and lithium-heparin blood tubes." Clinical Chemistry and Laboratory Medicine (CCLM) 56, no. 12 (November 27, 2018): 2125–31. http://dx.doi.org/10.1515/cclm-2018-0523.

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Abstract Background: Although it is known that glucose concentration exhibits a time-dependent decay in uncentrifuged serum and lithium-heparin blood tubes, no evidence exists on how this variation may depend on blood cell counts (CBC) and volumes. Methods: Venous blood was drawn from 30 non fasting healthy volunteers into three serum and three lithium-heparin tubes. One serum and lithium-heparin tubes were centrifuged within 15 min after collection and glucose was measured with a hexokinase assay. The second and third serum and lithium-heparin tubes were maintained at room temperature for 1 and 2 h after the first tubes were centrifuged. These other tubes were then centrifuged and glucose was measured. CBC was performed in the first lithium-heparin tube, before centrifugation. Results: The mean decrease of glucose was higher in lithium-heparin plasma than in serum (0.33 vs. 0.24 mmol/L/h; p<0.001). Glucose concentration decreased by 7% and 5% per hour in lithium-heparin plasma and serum, respectively. In univariate analysis, the absolute decrease of glucose concentration was associated with sex (higher in men than in women), red blood cell (RBC) count, hematocrit, white blood cell (WBC) count, neutrophils and monocytes in both lithium-heparin plasma and serum. In multivariate analysis, the decrease of glucose concentration remained independently associated with RBC, WBC, neutrophils and monocytes in both sample matrices. No significant association was found with platelet number and erythrocyte or platelet volume. Conclusions: Glucose concentration decrease in uncentrifuged lithium-heparin and serum tubes depends on the baseline number of RBC, WBC, neutrophils and monocytes within the tubes.

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Brizzee, Leila, Ashley Stone, and Melissa C. Palmer. "False lithium toxicity secondary to lithium heparin test tube: A case report and review." Mental Health Clinician 10, no. 3 (May 1, 2020): 90–94. http://dx.doi.org/10.9740/mhc.2020.05.090.

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Abstract This case demonstrates a false elevation of serum lithium concentrations that can occur when blood samples are collected using lithium heparin (green-top) tubes. The patient was a 58-year-old female on chronic lithium therapy for bipolar disorder who presented to the emergency department following an overdose of 5 unidentified medications. The patient was overly sedated and exhibited paradoxical laughter, slurred speech, and mild abdominal pain. The recommended maintenance lithium concentration is 0.6 to 1.0 mmol/L, and she had previously been stable within this therapeutic range. The initial lithium concentration drawn upon admission was 2.05 mmol/L. No intervening treatment was made with the exception of intravenous fluids due to a lack of correlation between clinical presentation and the lithium concentration. Six hours later, a repeat lithium concentration of <0.10 mmol/L was obtained. Upon investigation, it was discovered that the initial blood sample was obtained in a lithium heparin green-top tube instead of the recommended plastic tubes with either sodium heparin or dipotassium ethylenediamine tetraacetic acid as the anticoagulant. As this case demonstrates, lithium heparin tubes have the potential to cause falsely elevated lithium concentrations. It is important for health care professionals to be aware of the false elevations that can occur when blood samples are taken in this type of tube.

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Demonte, Davide, Mairi Pucci, Gian Luca Salvagno, and Giuseppe Lippi. "Can citrate plasma be used in exceptional circumstances for some clinical chemistry and immunochemistry tests?" Diagnosis 6, no. 4 (November 26, 2019): 369–75. http://dx.doi.org/10.1515/dx-2019-0027.

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Abstract Background The use of alternative sample matrices may be an advantageous perspective when the laboratory falls short of serum or lithium-heparin plasma for performing clinical chemistry and/or immunochemistry testing. This study was aimed at exploring whether some tests may be performed in citrate plasma as an alternative to lithium-heparin plasma. Methods Paired lithium-heparin and citrate plasma samples collected from 55 inpatients were analyzed on Roche Cobas 8000 for 28 different clinical chemistry and immunochemistry parameters. Data obtained in citrate plasma were adjusted for either the dilution factor or using an equation corresponding to the linear regression calculated by comparing unadjusted lithium-heparin and citrate plasma values. Results Except for magnesium (+17%) and sodium (+11%), unadjusted values of all remaining analytes were significantly lower in citrate than in lithium-heparin plasma, with bias ranging between −6.4% and −25.9%. The correlation between lithium-heparin and citrate plasma values was generally excellent (i.e. >0.90). The adjustment of citrate plasma values for the dilution factor (i.e. 1.1) was only effective in harmonizing the results of albumin and lipase, whilst the concentration of all other analytes remained significantly different between the two sample matrices. The adjustment of plasma citrate values using corrective formulas was instead effective in harmonizing all parameters, with no results remaining statistically different between the two sample matrices. Conclusions Citrate plasma may be used in exceptional circumstances for clinical chemistry and immunochemistry testing as a replacement for lithium-heparin plasma, provided that citrate plasma values are adjusted by using validated corrective equations.

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Kavsak, Peter A., Chantele Roy, Paul Malinowski, Lorna Clark, Shana Lamers, Karen Bamford, Stephen Hill, Andrew Worster, and Allan S. Jaffe. "Sample matrix and high-sensitivity cardiac troponin I assays." Clinical Chemistry and Laboratory Medicine (CCLM) 57, no. 5 (April 24, 2019): 745–51. http://dx.doi.org/10.1515/cclm-2018-1100.

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Abstract Background Manufacturers of high-sensitivity cardiac troponin (hs-cTn) assays have restricted use of what sample types or matrices are acceptable to use for measurement. Our goal was to evaluate the comparability of the Siemens ADVIA Centaur hs-cTnI assay across different matrices and under different storage conditions. Methods Three different QC-plasma matrices were evaluated for imprecision <10 ng/L. Passing-Bablok regression and difference plots were determined for cTnI concentrations spanning the reference interval (limit of quantification to male 99th-percentile: 2.5 ng/L to <60 ng/L) between serum and lithium heparin plasma, lithium heparin and EDTA plasma and between the Siemens and Abbott hs-cTnI assays. Stability at room temperature (RT) and 2–8 °C was also assessed across the three matrices. Results Over 16-weeks the SDs were ≤1.0 ng/L for QCs ranging from 5.0 to 8.3 ng/L. Across the reference interval there was excellent agreement between lithium heparin plasma and serum for the Siemens hs-cTnI assay (slope=0.98/intercept=–0.1), however, cTnI concentrations were proportionally lower in EDTA as compared to lithium heparin plasma (slope=0.90, 95% CI: 0.88–0.92). In lithium heparin plasma the Siemens hs-cTnI concentrations were higher than the Abbott hs-cTnI concentrations (slope=1.26/intercept=–0.2). Stability of cTnI in lithium heparin plasma as compared in serum and EDTA plasma appeared more labile, with decreases ≥20% in concentrations evident as early as 1-day in storage at RT. Conclusions There is excellent agreement in concentrations between lithium heparin plasma and serum with the Siemens ADVIA Centaur hs-cTnI assay; however, cTnI concentrations in EDTA plasma are lower. Reference intervals and clinical studies in EDTA plasma for the Centaur hs-cTnI assay are required before clinical use.

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Bailey, I. R. "Effect on 16 Analytes of Overnight Storage of Specimens Collected into Heparinised Evacuated Tubes with Plasma Separator." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 27, no. 1 (January 1990): 56–58. http://dx.doi.org/10.1177/000456329002700111.

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Specimens taken into Becton Dickinson lithium heparin Vacutainers with plasma separator were compared with specimens taken into ordinary Becton Dickinson lithium heparin Vacutainers. After overnight storage, results for sodium, potassium, phosphate, albumin, lactate dehydrogenase, alkaline phosphatase, and urate concentrations showed statistical differences. Only the difference observed in urate concentration is likely to affect clinical interpretation.

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Wills, Brandon K., Mark B. Mycyk, Suzan Mazor, Michele Zell-Kanter, Larry Brace, and Timothy Erickson. "Factitious lithium toxicity secondary to lithium heparin-containing blood tubes." Journal of Medical Toxicology 2, no. 2 (June 2006): 61–63. http://dx.doi.org/10.1007/bf03161172.

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Collinson, P. O., S. Thomas, L. Siu, P. Vasudeva, P. J. Stubbs, and R. Canepa-Anson. "Rapid Troponin T Measurement in Whole Blood for Detection of Myocardial Damage." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 32, no. 5 (September 1995): 454–58. http://dx.doi.org/10.1177/000456329503200504.

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A dry chemistry system for rapid qualitative measurement of cardiac troponin T in whole blood, serum, EDTA and lithium heparin plasma was studied in 197 admissions to the coronary care unit and general wards of a typical district general hospital for whom troponin T was requested. This included patients with unexplained collapse, acute dysrythmia or elevated creatine kinase of unknown origin. EDTA whole blood and plasma proved the most satisfactory sample matrices. Lithium heparin whole blood was equally appropriate but lithium heparin plasma gave a false negative result. Serum was an unsatisfactory sample material. Comparison with the conventional wet chemistry quantitative enzyme-linked immunosorbent assay showed a positive bias for EDTA plasma, particularly in the range 0–1 μg/L and a significant negative bias for lithium heparin plasma. There was no difference between serum from plain or gel separator tubes. The whole blood method allows troponin T measurement to be performed rapidly and simply in the laboratory, either as an emergency test to alter patient management, or for those laboratories that wish to offer troponin T for selected cases but do not have the ability to measure troponin T quantitatively.

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Richman, Lisa S., Amy L. Dzierba, Kathleen A. Connolly, Paula M. Bryan, and Subani Chandra. "Artificial Lithium Toxicity." Journal of Pharmacy Practice 28, no. 5 (June 13, 2015): 479–81. http://dx.doi.org/10.1177/0897190015587698.

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Lithium toxicity results in a range of gastrointestinal and neurologic signs and symptoms and can ultimately be fatal. Serum lithium levels may be unreliable when evaluating patients for toxicity, since levels may not be elevated in patients on chronic lithium therapy. Serum lithium levels may also be artificially elevated if blood is collected in a tube containing lithium heparin. We present a case of a woman on chronic lithium therapy whose lithium level was artificially elevated due to blood collection in an incorrect tube.

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Kavsak, Peter A., Paul Malinowski, Chantele Roy, Lorna Clark, and Shana Lamers. "Assessing matrix, interferences and comparability between the Abbott Diagnostics and the Beckman Coulter high-sensitivity cardiac troponin I assays." Clinical Chemistry and Laboratory Medicine (CCLM) 56, no. 7 (June 27, 2018): 1176–81. http://dx.doi.org/10.1515/cclm-2017-1122.

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Abstract Background: Analytical evaluation of high-sensitivity cardiac troponin (hs-cTn) assays, with particular attention to imprecision, interferences and matrix effects, at normal cTn concentrations, is of utmost importance as many different clinical algorithms use concentration cutoffs <10 ng/L for decision-making. The objective for the present analytical study was to compare the new Beckman Coulter hs-cTnI assay (Access hsTnI) to Abbott’s hs-cTnI assay in different matrices and for different interferences, with a focus on concentrations <10 ng/L. Methods: The limit of blank (LoB) and the limit of detection (LoD) were determined in different matrices for the Beckman hs-cTnI assay. Passing-Bablok regression and difference plots were determined for 200 matched lithium heparin and EDTA plasma samples for the Beckman assay and 200 lithium heparin samples for the Abbott assay. Both EDTA and heparin plasma samples were also evaluated for stability under refrigerated conditions, for endogenous alkaline phosphatase interference and for hemolysis and icterus. Results: The Beckman hs-cTnI assay LoB was 0.5 ng/L with the following range of LoDs=0.8–1.2 ng/L, with EDTA plasma yielding lower concentrations as compared to lithium heparin plasma (mean difference=−14.9%; 95% CI=−16.9 to 12.9). Below 10 ng/L, lithium heparin cTnI results from the Beckman assay were on average 1.1 ng/L (95% CI=0.7 to 1.5) higher than the Abbott results, with no difference between the methods when using EDTA plasma (mean difference =−0.1 ng/L; 95% CI=−0.3 to 0.2). Low cTnI concentrations were less effected by interferences in EDTA plasma. Conclusions: The Access hsTnI method can reliably detect normal cTnI concentrations with both lithium heparin and EDTA plasma being suitable matrices.

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Landt, M., G. L. Hortin, C. H. Smith, A. McClellan, and M. G. Scott. "Interference in ionized calcium measurements by heparin salts." Clinical Chemistry 40, no. 4 (April 1, 1994): 565–70. http://dx.doi.org/10.1093/clinchem/40.4.565.

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Abstract We determined the suitability of various heparin salts used for anticoagulation of whole-blood specimens for measurement of ionized calcium (iCa), blood gases, and electrolytes. We were particularly interested in a new heparin product containing both zinc and lithium cations (CNLZ heparin), in which the binding sites with greatest affinity for divalent cations are bound with zinc and low-affinity sites with lithium. In initial experiments Li heparin decreased iCa concentrations 0.07 mmol/L at the lowest heparin concentration (3000 units/L) and progressively lowered them at higher concentrations. Zn heparin initially increased iCa concentrations 0.06 mmol/L but progressively lowered them as the heparin concentration was increased. Li heparin interfered even when present in amounts (9 units per 3-mL syringe) minimally effective in preventing coagulation. Use of CNLZ heparin (36 units per 3-mL syringe; Zn 63-78 g/kg of heparin) largely eliminated interference of heparin in iCa measurements. In studies that included the effects of concentration of heparin through partial filling of syringes, specimens anticoagulated with CNLZ heparin compared well with unheparinized controls in measurements of iCa, blood gases, and electrolytes. Blood gases and iCa results on CNLZ-heparinized specimens from intensive-care-unit patients also compared well with specimens anticoagulated with a preparation of heparin (EB heparin) in which calcium has been added to balance the calcium-binding capacity. However, the presence of calcium in EB heparin significantly increased measured total calcium concentrations, whereas the new CNLZ heparin did not interfere in total calcium determinations.

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Toffaletti, J., P. Ernst, P. Hunt, and B. Abrams. "Dry electrolyte-balanced heparinized syringes evaluated for determining ionized calcium and other electrolytes in whole blood." Clinical Chemistry 37, no. 10 (October 1, 1991): 1730–33. http://dx.doi.org/10.1093/clinchem/37.10.1730.

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Abstract By analyzing whole blood containing no anticoagulants (uncoagulated whole blood) immediately after collection, we evaluated the relative changes in the concentrations of ionized calcium and other electrolytes in whole blood collected in dry heparinized syringes and in serum prepared from blood collected in evacuated blood-collection tubes. Using these dry heparinized syringes, we collected and analyzed whole blood that contained either 33 or 13 int. units of lithium heparin or 40 int. units of electrolyte-balanced heparin per milliliter of blood. We evaluated the effects both of these heparins at different concentrations of ionized calcium and of the incomplete filling of the syringes. We conclude that: (a) when analyzed within 2-3 min after collection, uncoagulated whole blood provides ionized calcium results unaffected by anticoagulants or cellular metabolism; (b) the preparation of serum unpredictably changes ionized calcium; (c) the use of dry electrolyte-balanced heparin virtually eliminates the interference in ionized calcium concentrations between 0.9 and 1.6 mmol/L; and (d) incomplete filling of electrolyte-balanced heparinized syringes produces no effect in syringes two-thirds full (60 int. units/mL heparin concentration) and a small effect in syringes one-third full (120 int. units/mL heparin).

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Vertiprakhov, Vladimir, Alena Grozina, Vladimir Fisinin, Natalya Ovchinnikova, and Anatoly Bittirov. "Impact of various reagents during blood collection from poultry to analyze morpho-biochemical indicators." E3S Web of Conferences 262 (2021): 02009. http://dx.doi.org/10.1051/e3sconf/202126202009.

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The work provides experimental data on the impact of anticoagulants (K3 - EDTA, 3.8% sodium citrate and lithium heparin) and coagulation activator on morpho-biochemical indicators in the blood samples of broiler chickens of cross-selection of Agricultural Center “Smena” at the age of 35 days. The studies were carried out with the use of semi-automatic flow analyzer Sinnowa BS-3000P (SINNOWA Medical Science & Technology Co., Ltd, China) and veterinary automatic blood analyzer DF-50 by Dymind Biotech (PRC) with the use of original reagents. The results showed that the most optimal reagent for determination of morphological indicators of the poultry blood was EDTA. The average white blood count (WBC) is lower in blood samples with citrate and heparin in contrast to EDTA by 30.5% and 24.1%, respectively. The average red blood count (RBC) is lower in tubes with sodium citrate (by 37.9 %) and lithium heparin (by 13.8 %) in contrast to K3-EDTA. When the sodium citrate anticoagulant is used, the blood biochemistry results for all positions of the experiment, excluding calcium, are lower than in heparin, and its closest values are lower than in coagulation activator, excluding trypsin activity. That’s why, the most optimal reagents for biochemistry, including for blood enzyme tests, should be considered the tubes with heparin or coagulation activator.

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Dimeski, Goce, Julie Johnston, Paul P. Masci, Kong-Nan Zhao, and Nigel Brown. "Evaluation of the Greiner Bio-One serum separator BCA Fast Clot tube." Clinical Chemistry and Laboratory Medicine (CCLM) 55, no. 8 (July 26, 2017): 1135–41. http://dx.doi.org/10.1515/cclm-2016-0806.

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Abstract Background: Current commercial tubes have difficulties in producing “true” serum from all blood samples even within the recommended clotting times. Hence, Becton Dickinson (BD) and now Greiner have produced tubes containing thrombin as the procoagulant to reduce the clotting time and increase the possibility of producing serum from anticoagulated blood samples. Methods: The Greiner BCA Fast Clot (GBBCAFC) tube was evaluated in a hospital environment using 40 participants, (30 healthy and 10 undergoing renal dialysis) for 32 analytes against the Greiner lithium heparin tube and the BD Rapid Serum Tubes (BD RST) tube measured on Beckman DxC 800 and DxI 800 analyzers. Clotting strength was also examined using thromboelastography (TEG). Results: The analytes results showed there was a very close agreement between the BD RST tube and GBBCAFC tube in comparison with lithium heparin plasma. The result comparison data showed equivalent performance with lower levels of hemolysis. The prolonged storage study also showed very similar agreement between the BD RST and the GBBCAFC tubes. Likewise, the TEG data showed there was very little difference in clotting ability between the tubes, and neither was capable of producing true serum from blood spiked with 2 U heparin/mL of blood. Conclusions: The study showed the GBBCAFC tube with the combination of the two procoagulants blood clotting activator and thrombin produced comparable performance with the lithium heparin plasma and the BD RST serum samples.

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Zimmerman, Frederic S., Hani Karameh, Eli Ben-Chetrit, Todd Zalut, Marc Assous, and Phillip D. Levin. "Modification of Blood Test Draw Order to Reduce Blood Culture Contamination: A Randomized Clinical Trial." Clinical Infectious Diseases 71, no. 5 (October 1, 2019): 1215–20. http://dx.doi.org/10.1093/cid/ciz971.

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Abstract Background Blood culture contamination leads to unnecessary interventions and costs. It may be caused by bacteria in deep skin structures unsusceptible to surface decontamination. This study was designed to test whether diversion of blood obtained at venipuncture into a lithium heparin tube prior to aspiration of blood culture reduces contamination. Methods The order of blood draws for biochemistry and blood cultures was randomized. Following standard disinfection and venipuncture, blood was either aspirated into a sterile lithium heparin tube before blood culture bottles (diversion group) or blood cultures first and then lithium heparin tube (control group). All study personnel were blinded with the exception of the phlebotomist. Results After exclusions, 970 blood culture/biochemistry sets were analyzed. Contamination occurred in 24 of 480 (5.0%) control vs 10 of 490 (2.0%) diversion group cultures (P = .01). True pathogens were identified in 26 of 480 (5.4%) control vs 18 of 490 (3.7%) diversion cultures (P = .22). Despite randomization, demographic differences were apparent between the 2 groups. A post hoc analysis of 637 cultures from 610 medical patients admitted from home neutralized demographic differences. Culture contamination remained more frequent in the control vs diversion group (17/312 [5%] vs 7/325 [2%]; P = .03). Fewer diversion group patients were admitted to hospital (control: 200/299 [66.9%] vs diversion: 182/311 [58.5%]; P = .03), and length of stay was shorter (control: 30 hours [interquartile range {IQR}, 6–122] vs diversion: 22 [IQR, 5–97]; P = .02). Conclusions Use of lithium heparin tubes for diversion prior to obtaining blood cultures led to a 60% decrease in contamination. This technique is easy and inexpensive and might decrease overall hospital length of stay. Clinical Trials Registration NCT03966534.

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Keppel, Martin H., Simon Auer, Giuseppe Lippi, Alexander von Meyer, Michael Cornes, Thomas K. Felder, Hannes Oberkofler, Cornelia Mrazek, Elisabeth Haschke-Becher, and Janne Cadamuro. "Heparin and citrate additive carryover during blood collection." Clinical Chemistry and Laboratory Medicine (CCLM) 57, no. 12 (November 26, 2019): 1888–96. http://dx.doi.org/10.1515/cclm-2019-0433.

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Abstract Background Published evidence on the risk of additive carryover during phlebotomy remains elusive. We aimed to assess potential carryover of citrated and heparinized blood and the relative volume needed to bias clinical chemistry and coagulation tests. Methods We simulated standardized phlebotomies to quantify the risk of carryover of citrate and heparin additives in distilled water, using sodium and lithium as surrogates. We also investigated the effects of contamination of heparinized blood samples with increasing volumes of citrated blood and pure citrate on measurements of sodium, potassium, chloride, magnesium, total and ionized calcium and phosphate. Likewise, we studied the effects of contamination of citrated blood samples with increasing volumes of heparinized blood on heparin (anti-Xa) activity, lithium, activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT). We interpreted these results based on measurement deviations beyond analytical, biological and clinical significance. Results Standardized phlebotomy simulations revealed no significant differences in concentration of surrogate markers. Clinically significant alterations were observed after contamination of heparinized blood samples with volumes of citrated blood beyond 5–50 μL for ionized calcium and beyond 100–1000 μL for sodium, chloride and total calcium. Investigations of pure citrate carryover revealed similar results at somewhat lower volumes. Heparinized blood carryover showed clinically significant interference of coagulation testing at volumes beyond 5–100 μL. Conclusions Our results suggest that during a standardized phlebotomy, heparin or citrate contamination is highly unlikely. However, smaller volumes are sufficient to severely alter test results when deviating from phlebotomy guidelines.

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Ercan, Şerif. "Comparison of test results obtained from lithium heparin gel tubes and serum gel tubes." Turkish Journal of Biochemistry 45, no. 5 (July 20, 2020): 575–86. http://dx.doi.org/10.1515/tjb-2019-0117.

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AbstractObjectivesThere is currently trend that plasma might be alternative to serum due to some of its advantages. This study aimed to compare test results from heparinized plasma and serum.MethodsBlood samples from total of 40 participants (20 healthy, 20 hemodialysis patients) were drawn into serum gel tubes with clot activator and lithium heparin gel tubes. Twenty-eight clinical chemistry analytes were measured in serum and plasma samples. To determine whether difference between test results is clinically significant, total error (TE) was calculated and compared total allowable error (TEa) limits.ResultsTE of below 5% was calculated for amylase, AST, calcium, total cholesterol, chloride, CK, glucose, HDL-cholesterol, iron, LDH, LDL-cholesterol, magnesium, sodium, total bilirubin, uric acid and urea. Albumin, ALT, creatinine, CRP, lipase, phosphorus, potassium, total protein, and triglyceride had TE of 5–7%. TE of 7–10% were determined for ALP, direct bilirubin, and GGT. TE values were within TEa limits for all analytes.ConclusionsIt was concluded that results of 28 analytes measured in lithium heparin gel tubes are comparable to those of serum gel tubes. It is thought that several advantages including reduced turnaround time might be provided by using plasma instead of serum for these tests.

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Cegla, Jaimini, Ben J. Jones, James Howard, Richard Kay, Colin S. Creaser, Stephen R. Bloom, and Tricia M. Tan. "The preanalytical stability of glucagon as measured by liquid chromatography tandem mass spectrometry and two commercially available immunoassays." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 54, no. 2 (November 2, 2016): 293–96. http://dx.doi.org/10.1177/0004563216675648.

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Background One of the main challenges in the measurement of glucagon is the premise that it is unstable in human plasma. Traditionally, protease inhibitors have been used to prevent its degradation; however, their use is controversial. Here, we investigated the optimal method of sample collection for glucagon, with measurement by liquid chromatography tandem mass spectrometry (LC-MS/MS) and two commercially available immunoassays. Methods Blood from healthy fasting volunteers (n = 10) was processed under a variety of preanalytical conditions including collection in EDTA vs. lithium heparin tubes and the addition of aprotinin and/or a dipeptidyl-peptidase IV (DPPIV) inhibitor. Additionally, the effect of freeze thaw was assessed. Plasma glucagon concentrations were measured by LC-MS/MS and two commercially available immunoassays (HTRF® sandwich immunoassay, Cisbio and Milliplex MAP Human Metabolic Hormone Panel, Merck Millipore). Results A systematic bias of Milliplex > LC-MS/MS > HTRF was noted and plasma glucagon concentrations were significantly different between methods (Milliplex vs. LC-MS/MS P < 0.01; Milliplex vs. HTRF P < 0.0001; LC-MS/MS vs. HTRF P < 0.001). The addition of aprotinin, DPPIV inhibitor or a combination of aprotinin and DPPIV inhibitor had no effect on plasma glucagon concentrations when compared to ‘non-stabilized’ samples or each other. Whether samples were taken in EDTA tubes or lithium heparin tubes made no difference to plasma glucagon concentrations. These findings were consistent for all three methods. Plasma glucagon concentrations were not significantly different after two freeze–thaw cycles (performed on samples in EDTA tubes containing aprotinin and DPPIV inhibitor). Conclusions This study demonstrates that glucagon is stable in both EDTA and lithium heparin tubes when stored at −80℃. Furthermore, the addition of aprotinin and DPPIV inhibitors is unnecessary.

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Kim, Sun Hee, Hae Ja Lim, Seong Ho Chang, Hun Cho, Myoung Hoon Kong, and Nan Sook Kim. "A Comparative Study of Liquid Na-Heparin Syringe and Dry Lithium-Heparin Kit for Arterial Blood Gas Analysis." Korean Journal of Anesthesiology 27, no. 8 (1994): 884. http://dx.doi.org/10.4097/kjae.1994.27.8.884.

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Power, Michael J., Bernadette O'Dwyer, Eugene Breen, and Patrick F. Fottrell. "Osteocalcin concentrations in plasma prepared with different anticoagulants." Clinical Chemistry 37, no. 2 (February 1, 1991): 281–84. http://dx.doi.org/10.1093/clinchem/37.2.281.

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Abstract We investigated the effects on plasma osteocalcin concentrations of different anticoagulants used to collect the blood samples. Plasma osteocalcin concentrations measured by enzyme immunoassay and radioimmunoassay are influenced by the nature of the anticoagulants used. The most significant difference between concentrations found in plasma and serum was seen with oxalate/fluoride anticoagulant, which reduced osteocalcin concentrations to 37.3% of serum values. This is probably related to increased hemolysis with this anticoagulant compared with osteocalcin concentrations in plasma prepared with other anticoagulants. Samples prepared with sodium citrate (0.105 mol/L) or lithium heparin gave values 92.4% and 83.6% of those obtained with matched serum samples. Osteocalcin concentrations were relatively stable in plasma and serum at -20 degrees C for two freeze/thaw cycles. In blood from 100 patients there was a good correlation between osteocalcin concentrations in serum and plasma (lithium heparin) (r2 = 0.831); the slope and intercept (+/- SE) were 0.924 +/- 0.04 and 4.92 +/- 1.25 micrograms/L, respectively. However, in 10 patients, serum osteocalcin concentrations were two- to threefold higher than those in matched plasma samples.

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Ching, Simon YL, Alex W. Prins, and John P. Beilby. "Stability of ascorbic acid in serum and plasma prior to analysis." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 39, no. 5 (September 1, 2002): 518–20. http://dx.doi.org/10.1258/000456302320314566.

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Introduction: The stability of ascorbic acid in serum and plasma prior to analysis was studied. Methods: Blood samples were collected from ten healthy subjects into Vacutainer tubes containing either dipotassium EDTA, lithium-heparin or no additive. Ascorbic acid was analysed following immediate separation and preservation of samples, following delayed separation for 2 h and after delayed deproteinization and preservation for 2, 5 and 8 h. Deproteinization and preservation were achieved using a solution containing perchloric acid, EDTA and dithiothreitol. Ascorbic acid was analysed by high-performance liquid chromatography. Results: Blood collected into EDTA and separated, deproteinized and preserved immediately gave the highest yield of ascorbic acid. Loss of analyte after delayed separation was least for EDTA tubes (median 7%, range 4-13%), followed by lithium-heparin (median 18%, range 10-32%) and serum (median 26%, range 14-50%). Immediate separation of samples but delayed deproteinization and preservation also resulted in substantial losses of ascorbic acid. Conclusion: Minimum loss of ascorbic acid is achieved if blood is collected into tubes containing dipotassium EDTA and separated within 2 h, followed by immediate deproteinization and preservation.

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Drogies, Tim, Till Ittermann, Jan Lüdemann, Doris Klinke, Thomas Kohlmann, Norbert Lubenow, Andreas Greinacher, Henry Völzke, and Matthias Nauck. "Potassium – reference intervals for lithium-heparin plasma and serum from a population-based cohort / Kalium – Referenzbereiche für Lithium-Heparin-Plasma und Serum aus einer bevölkerungsbezogenen Studie." LaboratoriumsMedizin 34, no. 1 (February 1, 2010): 39–44. http://dx.doi.org/10.1515/jlm.2010.002.

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AbstractBackground: Serum, as a standard material for the determination of numerous analytes, has disadvantages. The coagulation process leads to an artificial increase of the potassium concentration of approximately 0.3 mmol/L in serum samples compared to plasma. Consequently, plasma reflects the in vivo situation more accurately. The aim of the present analyses was to establish reference intervals (RIs) for potassium using data from a population-based study for serum (PS) and plasma (PP).Methods: Serum was used from 2897 subjects aged 20–79 years, participating in the 5-year follow-up of the Study of Health in Pomerania (SHIP 1), a population-based study in northeast Germany. In addition, 2483 samples (serum and plasma) from a population of blood donors (DONOR-SHIP) were used. Finally, calculated RIs were reevaluated in 202,350 potassium values from hospitalized patients. All measurements were performed on a Siemens Dimension RxL Max HM with ion-selective electrodes. Using the sample pairs from DONOR-SHIP, a regression formula for the transformation of PS to PP was calculated. This formula was applied to the serum data from SHIP 1 to calculate corresponding plasma values. RIs (2.5th and 97.5th percentile) were defined with quantile regression and bootstrap method in SHIP 1.Results: RIs for PS and PP were 3.7–5.1 mmol/L and 3.5–4.6 mmol/L, respectively. Clinically relevant age- or sex-specific tendencies were not detected. The difference between PS and PP is dependent on platelet count and potassium concentration.Conclusions: The study permitted the establishment of RIs for PS and PP on a population-based study. For serum, the influence of platelet count and absolute potassium concentration on the results should be taken into account.

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Dukic, Lora, and Ana-Maria Simundic. "Short-term and long-term storage stability of heparin plasma ammonia." Journal of Clinical Pathology 68, no. 4 (January 19, 2015): 288–91. http://dx.doi.org/10.1136/jclinpath-2014-202693.

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AimsAmmonia is an extremely unstable analyte and requires special attention during sampling, transport and storage. The aim of this study was to evaluate the stability of ammonia in lithium-heparin plasma during short-term (at +4°C) and long-term (at −20°C) storage.MethodsTwenty plasma samples were used for short-term stability assessment. Each sample was divided into five aliquots and stored in stoppered tubes at +4°C, for 1, 2, 3, 4 and 24 h from initial testing. Fifteen plasma samples were used for long-term stability assessment. Each sample was divided into eight aliquots and stored in stoppered tubes at −20°C for 3, 24, 48 h and 1, 2, 4, 8 and 12 weeks from initial testing. Ammonia concentration was determined on a Beckman Coulter AU2700 chemistry analyser using Randox ammonia enzymatic UV method. Bias was calculated from initial value for each time point and compared with quality specifications defined by Royal College of Pathologists of Australasia.ResultsThe average bias exceeded the total allowable error after storage of samples for 1 h at +4°C and 3 h at −20°C.ConclusionAmmonia is not stable during storage at +4°C and −20°C in lithium-heparinised plasma and should therefore be analysed immediately.

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McAllister, R. Eric. "Reversal of Heparin by Novel Synthetic Antagonist PMX-60056 Exhibits a Linear Dose-Response Relationship." Blood 116, no. 21 (November 19, 2010): 3329. http://dx.doi.org/10.1182/blood.v116.21.3329.3329.

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Abstract Abstract 3329 PMX-60056 is a small-molecule first-in-class new chemical entity designed to bind to the pentasaccharide group in unfractionated heparin (UFH) and low-molecular-weight heparins (LMWH), and reverse their anticoagulation effects. It has been shown to reverse UFH and the LMWH tinzaparin to date, and without rebound anticoagulation. When no UFH or LMWH is present, PMX-60056 dosing has been limited by transient hypotension at doses over 0.4 mg/kg in volunteers, but its use for heparin reversal should eliminate this effect as PMX-60056 preferentially binds to heparin. A study with UFH at 70 U/kg and reversal with 0.3 mg/kg PMX-60056 showed full efficacy, and mild blood-pressure reductions in half the subjects that suggested excess PMX-60056. Therefore, we examined the dose-response, efficacy, and safety at higher doses of UFH as used in cardiac surgery. Hemodynamic effects were recorded with lithium-dilution cardiac output, and blood pressures were continuous intra-arterial measurements. PMX-60056 dose was titrated using activated clotting times (ACTs), and protamine requirements were also estimated by heparin-protamine titrations to determine heparin levels. 350 U/kg of heparin was reversed in 6 normal volunteers, after an initial 10-minute infusion of 0.7 mg/kg PMX-60056 and subsequent smaller doses as needed to normalize ACT. Hemodynamics were unaffected until total PMX-60056 dose exceeded 1 mg/kg – the initial dose of 0.7 mg/kg never produced a change. When a hemodynamic effect did occur (in 3 of the 6), it was initiated by a fall in systemic vascular resistance. Only 1 of these 6 subjects had a clinically significant hypotension, which lasted 15 minutes with pressor agents and limb elevation; this subject was subsequently found to have a past history suggestive of vaso-vagal instability. The other 5 subjects had no appreciable change in blood pressure. Per protocol the antagonist doses were in discrete amounts, so some overshoot was inevitable. Therefore, the total dose of PMX-60056 to the point immediately preceding full reversal of ACT was correlated with ACT, with initial protamine requirement according to heparin levels, and with estimated residual heparin (calculated from dose given and time elapsed). These data were highly correlated with a straight line from zero: R-squared was 0.90 with initial ACT, 0.96 with initial protamine requirement according to heparin levels, and 0.97 with estimated residual heparin (calculated). These data suggest that measurements routinely available during cardiac surgery are sufficient for predicting a single reversing dose of PMX-60056 that will safely and effectively neutralize UFH-induced anticoagulation. After reversal, the ability to re-anticoagulate is sometimes important. The same study also established that reversal of anticoagulation with PMX-60056 did not inhibit subsequent repeat anticoagulation with heparin a few minutes later, which was then also reversed with PMX-60056. This study was conducted according to cGCP at Duke University's Anesthesiology Research Unit. More results will be forthcoming as the analysis proceeds. Disclosures: McAllister: PolyMedix, Inc.: Employment.

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Stirling, Paul, Radwane Faroug, Suheil Amanat, Abdulkhaled Ahmed, Malcolm Armstrong, Pankaj Sharma, and Ahmed Qamruddin. "False-Negative Rate of Gram-Stain Microscopy for Diagnosis of Septic Arthritis: Suggestions for Improvement." International Journal of Microbiology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/830857.

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We quantify the false-negative diagnostic rate of septic arthritis using Gram-stain microscopy of synovial fluid and compare this to values reported in the peer-reviewed literature. We propose a method of improving the diagnostic value of Gram-stain microscopy using Lithium Heparin containers that prevent synovial fluid coagulation. Retrospective study of the Manchester Royal Infirmary microbiology database of patients undergoing synovial fluid Gram-stain and culture between December 2003 and March 2012 was undertaken. The initial cohort of 1896 synovial fluid analyses for suspected septic arthritis was reduced to 143 after exclusion criteria were applied. Analysis of our Gram-stain microscopy yielded 111 false-negative results from a cohort size of 143 positive synovial fluid cultures, giving a false-negative rate of 78%. We report a false-negative rate of Gram-stain microscopy for septic arthritis of 78%. Clinicians should therefore avoid the investigation until a statistically significant data set confirms its efficacy. The investigation's value could be improved by using Lithium Heparin containers to collect homogenous synovial fluid samples. Ongoing research aims to establish how much this could reduce the false-negative rate.

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Uettwiller-Geiger, Denise, Alan HB Wu, Fred S. Apple, Anthony W. Jevans, Per Venge, Marilyn D. Olson, Claude Darte, David L. Woodrum, Sean Roberts, and Stephen Chan. "Multicenter Evaluation of an Automated Assay for Troponin I." Clinical Chemistry 48, no. 6 (June 1, 2002): 869–76. http://dx.doi.org/10.1093/clinchem/48.6.869.

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Abstract Background: Cardiac troponin I (cTnI) is a powerful tool to aid in the diagnosis of myocardial infarction and cardiac muscle damage. We describe an assay that overcomes problems of early assays that were often affected by cTnI degradation, assay interference, poor sensitivity, and imprecision. Methods: The analytical performance of the Access® AccuTnITM assay (Beckman Coulter) was evaluated at five institutions. Controls, zero calibrator, and diluted patient samples were used to determine precision, detection limit, functional sensitivity, and linearity. The 97.5 and 99 percentiles of a reference population were determined. Common interferents and heterophilic patient samples were tested. Equimolarity was determined by assaying samples with various ratios of free and complexed cTnI. Matched samples drawn into serum, EDTA, lithium heparin, and sodium heparin sample tubes were compared. Results: Total imprecision (CVs) was 4.0–8.8% between 0.40 and 31 μg/L cTnI. The detection limit was <0.01 μg/L. The 97.5 percentile upper reference limit (URL) was 0.03 μg/L (CV = 20%), and the 99 percentile URL was 0.04 μg/L (CV = 14%). Total CVs of 10% and 20% were seen at and above 0.06 and 0.03 μg/L, respectively. The assay was linear to >60 μg/L and not affected by common assay interferents. An equimolar response was observed with free, complexed, phosphorylated, and dephosphorylated forms of cTnI. Results were 4% lower in serum and 14% lower in EDTA plasma than in lithium heparin plasma (P <0.01), independent of cTnI concentration. Conclusion: AccuTnI is a sensitive and precise assay for the measurement of cTnI.

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Vuillaume, Isabelle, Sylvie Penet, Thameur Rakza, Laurent Storme, Nadine Kacet, Pierre Lequien, and Jean Rousseaux. "High Concentrations of Lithium Heparin Decrease Measured Serum Sodium in Some Analyzers." Clinical Chemistry 45, no. 10 (October 1, 1999): 1880–81. http://dx.doi.org/10.1093/clinchem/45.10.1880.

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Sudhakar, T., Sabitha Kandi, B. venugopal, K. Bhagwan Reddy, Md Rafi, Raj kumar, and K. V. Ramana. "Impedance of Results Using Lithium Heparin to Plain Tubes for Ionized Calcium." American Journal of Biomedical Research 2, no. 4 (November 10, 2014): 67–69. http://dx.doi.org/10.12691/ajbr-2-4-2.

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Sailer, Sebastian, Gertrudis Martí Aromir, José Manuel Rodríguez Miguélez, and Josep Figueras Aloy. "Factitious Hyperlithemia: Why Lithium Heparin Blood Tubes may get you in Trouble." Klinische Pädiatrie 231, no. 04 (April 1, 2019): 212–13. http://dx.doi.org/10.1055/a-0868-0074.

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Davison, Andrew S., Simon M. Darn, and Ravinder Sodi. "Can lithium–heparin plasma be used for protein electrophoresis and paraprotein identification?" Annals of Clinical Biochemistry 43, no. 1 (January 1, 2006): 31–34. http://dx.doi.org/10.1258/000456306775141821.

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Boink, A. B. T. J., B. M. Buckley, T. F. Christiansen, A. K. Covington, A. H. J. Maas, O. Müller-Plathe, Ch Sachs, and O. Siggaard-Andersen. "IFCC recommendation on sampling, transport and storage for the determination of the concentration of ionized calcium in whole blood, plasma and serum." Journal of Automatic Chemistry 13, no. 5 (1991): 235–39. http://dx.doi.org/10.1155/s1463924691000391.

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The substance concentration of ionized calcium (cCa2+) in blood, plasma or serum preanalytically may be affected by pH changes of the sample, calcium binding by heparin, and dilution by the anticoagulant solution.pH changes in whole blood can be minimized by anaerobic sampling to avoid loss ofCo2, by measuring as soon as possible, or by storing the sample in iced water to avoid lactic acid formation.cCa2+and pH should be determined simultaneously.Plasma or serum: If centrifuged in a closed tube, and measured immediately, the pH of the sample will be close to the original value. If a delay has occurred between centrifugation and the measurement, causing substantial loss ofCo2, equilibration of the sample with a gas mixture corresponding to pCO2= 5.3 kPa prior to the measurement is recommended. Conversion of the measured values tocCa2+(7.4) is only valid if the pH is in the range 7.2-7.6.Ca2+binding by heparin can be minimized by using either of the following:(1) A final concentration of sodium or lithium heparinate of 15 IU/ml blood or less(2) Calcium titrated heparin with a final concentration of less than 50 IU/ml blood.Dilution effect can be avoided by use of dry heparin in capillaries or syringes. When heparin solutions are used, errors due to dilution or calcium binding can be reduced by using syringes with a heparin solution containing free calcium ions corresponding to the mean concentration of ionized calcium in normal plasma.Conditions for blood collection, storage, and transport to avoid preanalytical errors are described in this paper.

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Slaughter, M. R., and J. S. Moen. "Aqueous lithium heparin is a superior anticoagulant to solid heparin for blood collection from the retro-orbital sinus of rats." Laboratory Animals 25, no. 3 (July 1991): 272–76. http://dx.doi.org/10.1258/002367791780808419.

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Namnyak, Simon, Sunny Hussain, Jane Davalle, Keith Roker, and Martin Strickland. "Contaminated lithium heparin bottles as a source of pseudobacteraemia due to Pseudomonas fluorescens." Journal of Hospital Infection 41, no. 1 (January 1999): 23–28. http://dx.doi.org/10.1016/s0195-6701(99)90033-6.

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Hallworth, M. J., N. J. West, and A. R. G. Allen. "Artefactual Elevation of Plasma Calcium Results Due to Contamination of Lithium Heparin Tubes." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 24, no. 5 (September 1987): 525–26. http://dx.doi.org/10.1177/000456328702400519.

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Jinks, Dorothea, Rebecca Brooks-White, and Valerie Bush. "Evaluation of Refrigerated Stability of 15 Analytes in Lithium Heparin Gel Primary Tubes." Laboratory Medicine 44, no. 1 (February 2013): e45-e51. http://dx.doi.org/10.1309/lmhfg0q5eykscldt.

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Dimeski, G., C. Solano, M. K. Petroff, and M. Hynd. "Centrifugation protocols: tests to determine optimal lithium heparin and citrate plasma sample quality." Annals of Clinical Biochemistry 48, no. 3 (March 11, 2011): 218–22. http://dx.doi.org/10.1258/acb.2010.010230.

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Hernandez, Julia A., J. Eric Stanford, Corliss V. Savoie, James H. Nichols, and Jennifer M. Colby. "Spuriously Elevated 25-Hydroxyvitamin D in Lithium Heparin Plasma Samples Transported by Courier." Journal of Applied Laboratory Medicine: An AACC Publication 2, no. 5 (September 29, 2017): 809–11. http://dx.doi.org/10.1373/jalm.2017.024604.

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38

Lima-Oliveira, Gabriel, Gian Luca Salvagno, Elisa Danese, Giorgio Brocco, Gian Cesare Guidi, and Giuseppe Lippi. "Contamination of lithium heparin blood by K2-ethylenediaminetetraacetic acid (EDTA): an experimental evaluation." Biochemia Medica 24, no. 3 (2014): 359–67. http://dx.doi.org/10.11613/bm.2014.038.

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MESSNER, H., W. KLEOPHAS, D. HEIN, F. A. GRIES, and J. KÖBBERLING. "Sodium lithium counter-transport is acutely influenced by heparin-induced extracorporal LDL precipitation." European Journal of Clinical Investigation 21, no. 2 (April 1991): 215–18. http://dx.doi.org/10.1111/j.1365-2362.1991.tb01812.x.

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Herzum, Ileana, Robert Bünder, Harald Renz, and Hans Günther Wahl. "Reliability of IFCC Method for Lactate Dehydrogenase Measurement in Lithium-Heparin Plasma Samples." Clinical Chemistry 49, no. 12 (December 1, 2003): 2094–96. http://dx.doi.org/10.1373/clinchem.2003.026336.

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Odsæter, Ingrid Hov, Bjørnar Grenne, Gunhild Garmo Hov, Lars Erik Laugsand, Rune Wiseth, and Gustav Mikkelsen. "Establishing the 99th percentile of a novel assay for high-sensitivity troponin I in a healthy blood donor population." Clinical Chemistry and Laboratory Medicine (CCLM) 58, no. 9 (August 27, 2020): 1557–63. http://dx.doi.org/10.1515/cclm-2019-1023.

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AbstractBackgroundThe recommended cut-off of cardiac troponin (cTn) for the diagnosis of acute myocardial infarction (AMI) is the 99th percentile in a healthy reference population. We aimed to determine the 99th percentile of the novel ADVIA Centaur® High Sensitivity Troponin I assay (Siemens Healthcare Diagnostics) in fresh lithium heparin plasma samples from healthy blood donors.MethodsA total of 1000 apparently healthy blood donors were included. High-sensitivity (hs) cTnI, hs-cTnT, creatinine and N-terminal pro b-type natriuretic peptide (NT-proBNP) were measured in fresh lithium heparin plasma samples, and glycated hemoglobin (HbA1c) was measured in ethylenediaminetetraacetic acid (EDTA)-blood. The 99th percentile was estimated for the whole population, as well as for males and females separately.ResultsFor the total population the 99th percentile of ADVIA Centaur® High Sensitivity Troponin I was 96 (65–149) ng/L. The estimated value differed significantly from results published by others and was highly dependent on which values were considered statistical outliers.ConclusionsThe estimated 99th percentile for hs-cTnI in the population studied differed significantly from previously published results. There is a need for further specifications regarding how subjects used for estimating the 99th percentile of cTns in healthy populations should be recruited and how outlier values should be identified, as this can highly influence the diagnostic cut-off applied for AMI.

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Khoza, Siyabonga, Sarah Ford, Ernest Buthelezi, and Donald Tanyanyiwa. "Comparative study of chemical pathology sample collection tubes at the largest hospital in South Africa." Journal of Medical Biochemistry 40, no. 4 (2021): 358–66. http://dx.doi.org/10.5937/jomb0-27216.

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Background: BarricorTM Lithium heparin plasma tubes are new blood tubes that have been introduced to overcome the effects of gel in serum separator tubes (SST) and the shortcomings of standard Lithium heparin plasma. We aimed to evaluate BarricorTM tubes as an alternative to serum separator tubes and compare the stability between the tubes. Methods: Forty-four paired samples were collected using both BarricorTM and SST. We compared five analytes at baseline (<6 h) and after every 24 h using the PassingBablok and Bland-Altman plots. Aspartate aminotransferase (AST), potassium (K), phosphate (PO4) , lactate dehydrogenase (LDH), and creatinine were analysed in both tubes. We calculated the percentage difference for each analyte between the baseline and time intervals to assess analyte stability. The percentage difference was compared to the desirable specification for bias and reference change value (RCV). Results: All analytes were comparable at baseline. Statistical differences (p<0.001) became evident after 24 h. PO4, K, and creatinine had a mean difference that exceeded the desirable specification for bias (-9.59%, - 9.35%, and -4.59%, respectively). Potassium was stable up to 24 h in both tubes. LDH showed better stability in SST (144 h vs 96 h). PO4 concentrations were more stable in both tubes with the SST (96 h vs 72 h). Creatinine and AST had the longest stability in both tubes compared to other analytes (144 h). Conclusions: Data demonstrated variability and similarities in analyte concentrations and stability, respectively, in both tubes.

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Toffaletti, J., and T. Thompson. "Effects of blended lithium-zinc heparin on ionized calcium and general clinical chemistry tests." Clinical Chemistry 41, no. 2 (February 1, 1995): 328–29. http://dx.doi.org/10.1093/clinchem/41.2.328.

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Ferré, Natàlia, Jordi Camps, Judit Marsillach, Bharti Mackness, Mike Mackness, Blai Coll, Mònica Tous, and Jorge Joven. "Comparison of Paraoxonase 1 Measurements in Serum and in Lithium-Heparin-Anticoagulated Plasma Samples." Clinical Chemistry 51, no. 5 (May 1, 2005): 922–23. http://dx.doi.org/10.1373/clinchem.2005.048231.

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Friebe, Astrid, and Hans-Dieter Volk. "Stability of Tumor Necrosis Factor α, Interleukin 6, and Interleukin 8 in Blood Samples of Patients With Systemic Immune Activation." Archives of Pathology & Laboratory Medicine 132, no. 11 (November 1, 2008): 1802–6. http://dx.doi.org/10.5858/132.11.1802.

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Abstract Context.—Tumor necrosis factor α, interleukin 6, and interleukin 8 serum/plasma levels are frequently used for the monitoring of patients with systemic immune activation/ sepsis. This requires comparability of test results over time. However, cytokines are usually not considered to be very stable after blood collection, which might artificially interfere with test results. Objective.—To obtain better knowledge about stability of these cytokines in blood samples for interpretation of test results. Design.—Blood of patients with systemic immune activation was collected in EDTA, lithium heparin, ammonium heparin, and serum tubes. Aliquots were analyzed after storage at room temperature for 2 to 8 hours. Additionally, storage conditions for separated serum/plasma for 24 hours and the reproducibility of repeated cytokine measurements by an automated DPC Immulite analyzer were tested. Results.—Tumor necrosis factor α level was stable in EDTA plasma for 8 hours, while slightly increasing in heparin plasma and serum. Interleukin 6 concentrations were stable for 8 hours in all blood types, whereas interleukin 8 concentrations were stable only in EDTA plasma and were strongly increasing in heparin plasma and serum. Cytokine concentrations in separated serum/plasma were stable during 24 hours if stored at 4°C or frozen at −20 or −70°C. Reproducibility of repeated cytokine measurements revealed no significant differences for all blood types. Conclusions.—Cytokine levels were most critically influenced by the period between blood collection and plasma separation, but its impact was strongly dependent on cytokine and anticoagulant. However, under appropriate conditions cytokine levels were surprisingly stable for up to 8 hours.

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Lippi, G., P. Avanzini, M. Cosmai, R. Aloe, and D. Ernst. "Incomplete filling of lithium heparin tubes affects the activity of creatine kinase and γ-glutamyltransferase." British Journal of Biomedical Science 69, no. 2 (January 2012): 67–70. http://dx.doi.org/10.1080/09674845.2012.12002439.

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Durham, B. H., J. Robinson, and W. D. Fraser. "Differences in the Stability of Intact Osteocalcin in Serum, Lithium Heparin Plasma and EDTA Plasma." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 32, no. 4 (July 1995): 422–23. http://dx.doi.org/10.1177/000456329503200413.

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Zendjabil, M., I. Rikai, and G. Benhamed. "Lithium heparin tubes should not be used for the determination of gamma-glutamyl transferase activity." Clinica Chimica Acta 493 (June 2019): S687. http://dx.doi.org/10.1016/j.cca.2019.03.1523.

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Haverstick, Doris M., Louis B. Brill, Mitchell G. Scott, and David E. Bruns. "Preanalytical variables in measurement of free (ionized) calcium in lithium heparin-containing blood collection tubes." Clinica Chimica Acta 403, no. 1-2 (May 2009): 102–4. http://dx.doi.org/10.1016/j.cca.2009.01.026.

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Arslan, Zainab, Naveen K. Athiraman, and Simon J. Clark. "Lithium toxicity in a neonate owing to false elevation of blood lithium levels caused by contamination in a lithium heparin container: case report and review of the literature." Paediatrics and International Child Health 36, no. 3 (May 16, 2016): 240–42. http://dx.doi.org/10.1179/2046905515y.0000000050.

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Journal articles on the topic 'Lithium heparin'

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