A comparison of erythrocyte sedimentation rates of bloods anticoagulated with trisodium citrate and EDTA among TB presumptive patients at the University of Gondar comprehensive specialized hospital, northwest Ethiopia

Abstract

Objective: The purpose of this study was comparing the erythrocyte sedimentation rate (ESR) results of trisodium citrate (TSC) and ethylene diamine tetra-acetic acid (EDTA) anticoagulants. A comparative cross-sectional study was conducted at the University of Gondar specialized referral hospital, northwest, Ethiopia. A total of 70 TB presumptive participants were recruited. From each of the 70 participants of the study, 3 and 1.6 ml of blood was collected in EDTA tubes and 0.4 ml of trisodium Citrate anticoagulant containing test tubes, respectively. Results: The mean ± SD values of ESR were 57.9 ± 41.45 mm/hr in EDTA and 50.99 ± 43.5 mm/hr in TSC anticoagulated blood. The mean difference of ESR values between EDTA and TSC blood (6.91 ± 13.66 mm/hr) was statistically significant. The Mean ± SD of ESR values using EDTA and TSC in males were 59.57 ± 42.31 and 53.57 ± 44.61 mm/hr while for females it was 54.71±40.44 and 46.04 ± 41.82 mm/hr, respectively. The study indicated that there was a significant difference between ESR values with EDTA and tri-sodium citrate anticoagulants. Keywords: Erythrocyte sedimentation rate, EDTA, Tri-sodium citrate, Westergren Method, Comparison

Performance comparison of Westergren modified SRS 100/II and alternate iSED® method for erythrocyte sedimentation rate

“…In addition, EDTA anticoagulant used in iSED ® method additionally increases rouleaux formation. 21 This finding should be the subject of further studies which could reveal if the presence of inflammation and acute phase proteins in the sample is a significant factor that leads to higher ESR values obtained by this alternate method.…”

“…Since iSED® method measures ESR only during rouleaux formation process, it is expected that the presence of inflammation will cause higher ESR values obtained by this method. In addition, EDTA anticoagulant used in iSED® method additionally increases rouleaux formation 21 . This finding should be the subject of further studies which could reveal if the presence of inflammation and acute phase proteins in the sample is a significant factor that leads to higher ESR values obtained by this alternate method.…”

“…When inflammation is present, fibrinogen concentration in the blood induces the production of rouleaux formation leading to faster erythrocyte's settle. 21 Since iSED ® method measures ESR only during rouleaux formation process, it is expected that the presence of inflammation will cause higher ESR values obtained by this method. In addition, EDTA anticoagulant used in iSED ® method additionally increases rouleaux formation.…”

“…In addition, higher mean absolute bias was observed in group with elevated inflammation parameters and higher ESR values gained by the iSED® method. When inflammation is present, fibrinogen concentration in the blood induces the production of rouleaux formation leading to faster erythrocyte's settle 21 . Since iSED® method measures ESR only during rouleaux formation process, it is expected that the presence of inflammation will cause higher ESR values obtained by this method.…”

“…However, the small sample size in the high MCV and haematocrit groups ( N = 20 and N = 19, respectively) should definitely be taken into account as a study limitation and further studies on these groups should be conducted. We must emphasize that differences between methods can be also influenced by sample mixing and used anticoagulants since EDTA anticoagulant increases rouleaux formation more than citrate leading to increased ESR values while citrated blood is less viscous than EDTA resulting in lower ESR values 21,24 …”