Comparison of seven biochemistry analytes stability in serum separator and plasma tubes

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Comparison of stability of seven biochemistry analytes in serum separator and plasma tubes T he total testing process includes preanalytical, analytical, and postanalytical phases based on the brain-to-brain loop concept [1].The preanalytical phase is the primary source of laboratory mistakes in clinical laboratories [2].Numerous studies have indicated that this remains a matter of interest and concern to laboratory physicians.Errors in this phase lead to an increase in hospital costs of between 0.5% and 1.5% [3].The International Federation of Clinical Chemistry and Laboratory Medicine Working Group on Laboratory Errors and Patient Safety (IFCC WG-LEPS) created a list of quality indicators for reducing errors in the laboratory as well as 16 quality indicators related to important preanalytical steps required for the reliability of laboratory results, such as proper blood collection, the correct specimen type, and timely processing [2, 4].Clinical laboratories commonly use plasma and serum separating tubes (SSTs) to analyze chemistry analytes.It has been reported that the polymer gel used in these tubes is interfering with most analytes [5].Becton, Dickinson and Company (BD, Franklin Lakes, NJ, USA) developed the BD Barricor plasma tube, which has a mechanical barrier.According to the manufacturer, this tube requires a shorter centrifugation time and provides improved plasma quality and a longer stability period than the primary tube.Objectives: The aim of the present study was to compare the stability of 7 routine analytes using a BD Vacutainer Barricor plasma blood collection tube, a BD Vacutainer SST (Becton Dickinson and Company, Franklin Lakes, NJ, USA) and a Vacusera SST ((Disera A.S., Izmir, Turkey).Methods: Five mL blood samples from 60 volunteers were collected into the 3 tubes.Glucose, urea, creatinine, lactate dehydrogenase (LD), sodium (Na), chloride (Cl) and potassium (K) levels were analyzed at 0, 4, 8, and 12 hours on a Cobas 8000 analyzer ((F.Hoffmann-La Roche Ltd., Basel, Switzerland).Bias and bias% results were calculated and compared to clinically acceptable limits (CAL).Results: Intraclass correlation results revealed excellent agreement in the 7 chemistry analytes between the 3 tubes (0.863-1.000).The CAL for Cl, creatinine, glucose, K, LD, Na and urea are 3 mmol/L, 10%, 0.3 mg/dL, 10%, 0.5 mmol/L, 20%, 3 mmol/L and 2mg/dl, respectively.At the 12 th hour, there was a difference observed in glucose between Barricor-SST and Barricor-Vacusera SST were 10.06 mg/dL (11.38 %) and 11.14 mg/dL (-12.76%).Analytical coefficient (CV) of variation results for glucose, LD, creatinine, urea, Na, K, and Cl were 3.22%, 5.80%, 5.28%, 3.90%, 2.00%, 1.95%, and 1.37% respectively.Conclusion: Although the stability of all 7 analytes was within the CAL during a 12-hour period, clinically different results were obtained.In terms of stability evaluation, the use of plasma might be preferable in clinical laboratories.The routine chemistry analytes studied were within the clinically acceptable range in both plasma and serum specimens, but validation and estimation of reference intervals for plasma tubes are needed.