Combined False Hyperkalemia and Hypocalcemia Due to Specimen Contamination During Routine Phlebotomy

NAGUIB, M TAREK; Evans, Nancy

doi:10.1097/00007611-200210000-00024

Cited by 10 publications

(11 citation statements)

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“…Any evidence of sample contamination by edta , for example, immediate resampling with a normal result, concurrent hypocalcaemia or severe hyperkalaemia with a normal heart rate, was recorded (Stockham and Scott 2002) and the cases were excluded. Cases with biochemical results that indicated other artefactual changes to the Na:K ratio, for example, lipaemia or hyperproteinaemia, and dogs receiving potassium supplementation at the time of sampling were not recorded before being excluded (Naguib and Evans 2002, Stockham and Scott 2002). …”

Section: Methodsmentioning

confidence: 99%

Low ratios of sodium to potassium in the serum of 238 dogs

et al. 2008

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Serum sodium:potassium (Na:K) ratios are often reported in biochemical studies of dogs, although their value has not been assessed. The aims of this study were to identify diseases associated with a low Na:K ratio in dogs and to compare their prevalence with the prevalence in dogs from the same referral hospital with normal Na:K ratios. A total of 238 dogs with a Na:K ratio less than 27 were identified from medical records. Sample contamination with edta was suspected in 74 cases (31 per cent) and these and two cases that had been supplemented with potassium were removed from the analysis. The remaining 162 cases and 147 control dogs were divided into five categories depending on the organ system affected. Among the cases there were significantly more in the endocrine category than among the control dogs. Hypoadrenocorticism was the most single common cause of a low Na:K ratio and affected 27 (16.7 per cent) of the cases. Other clinical problems associated with low Na:K ratios included different urogenital, cardiorespiratory and gastrointestinal diseases.

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Section: Methodsmentioning

confidence: 99%

Low ratios of sodium to potassium in the serum of 238 dogs

et al. 2008

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“…2 -4 Of these, spurious hyperkalaemia is the most problematic inevitably leading to patient inconvenience, but may also lead to mismanagement of the patient. 3,5 There is little data in the literature relating to the prevalence of sample contamination with EDTA. As part of a service evaluation, we measured EDTA in hyperkalaemic samples to identify EDTA contamination and further analysed all the samples for calcium, zinc, magnesium and alkaline phosphatase to study whether these could act as surrogate markers to reliably identify EDTA contamination.…”

Section: Introductionmentioning

confidence: 99%

Spurious hyperkalaemia due to EDTA contamination: common and not always easy to identify

2008

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Background: To study the detection and prevalence of spurious hyperkalaemia due to potassium ethylenediaminetetra-acetic acid (kEDTA) contamination. Methods: In a one-month prospective study, serum EDTA, zinc, calcium, magnesium concentrations and alkaline phosphatase activity were measured in samples with serum potassium 6.0 mmol/L. Results: Twenty-eight out of 117 hyperkalaemic samples were contaminated with EDTA. Only serum zinc values below the reference range had 100% sensitivity for indicating EDTA contamination, but even at an optimal specificity of 89% at least 12 potentially genuine hyperkalaemic samples would be rejected. Conclusion: Spurious hyperkalaemia due to kEDTA contamination is common. Gross kEDTA contamination is obvious by marked unexpected hyperkalaemia, hypocalcaemia, hypomagnesaemia and hypozincaemia. Spurious hyperkalaemia due to low concentrations of kEDTA contamination can only be confidently detected by measurement of serum EDTA.

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“…19 These forms of EDTA cross contamination are avoidable by complying with manufacturers' instructions and by observing the recommended order of drawing or filling when collecting blood into additive-containing tubes. 20,21 The purpose of this survey was to extract data on the selected pre-analytical errors of in vitro haemolysis and EDTA contamination, and thereby identify and quantify the rates and sources of such errors which are occurring throughout our Health Board area.…”

Section: Introductionmentioning

confidence: 99%

A survey of some pre-analytical errors identified from the Biochemistry Department of a Scottish hospital

Davidson

2014

Scott Med J

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Better training in blood collection, achieving the standard of professional phlebotomists, will improve validity of diagnostic information; reduce risks of dangerous misinterpretation of results, unwanted anaemia and needlestick injury and decrease laboratory supplies costs. This type of audit could be replicated in other Scottish Health Boards with some benefit and thereby better target future training needs.

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Combined False Hyperkalemia and Hypocalcemia Due to Specimen Contamination During Routine Phlebotomy

Cited by 10 publications

References 0 publications

Low ratios of sodium to potassium in the serum of 238 dogs

Low ratios of sodium to potassium in the serum of 238 dogs

Spurious hyperkalaemia due to EDTA contamination: common and not always easy to identify

A survey of some pre-analytical errors identified from the Biochemistry Department of a Scottish hospital

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