Relevance of EDTA carryover during blood collection

Cadamuro, Janne; Felder, Thomas K.; Oberkofler, Hannes; Mrazek, Cornelia; Wiedemann, Helmut; Haschke-Becher, Elisabeth

doi:10.1515/cclm-2014-0944

Cited by 19 publications

(20 citation statements)

References 11 publications

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“…EDTA is used at approximately 1.5 mg/mL or 5 mM 34 and thus will undoubtedly confound assay results with Cu 2 L. EDTA is not known to readily extract copper(II) ions from other polydentate ligands, but as a hexadentate ligand itself, it is not surprising that it can displace eosin Y. 35 Regardless, this finding underscores the risk of exaggerating the selectivity of a chemosensor.…”

Section: Resultsmentioning

confidence: 99%

A Copper(II) Macrocycle Complex for Sensing Biologically Relevant Organic Anions in a Competitive Fluorescence Assay: Oxalate Sensor or Urate Sensor?

et al. 2020

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Fluorescence sensing of oxalate has garnered some attention in the past two decades as a result of this anion’s prominence and impact on society. Previous work on oxalate sensors and other divalent anion sensors has led to the conclusion that the sensors are selective for the anion under investigation. However, sensor selectivity is often determined by testing against a relatively small array of “guest” molecules or analytes and studies often exclude potentially interfering compounds. For example, studies on oxalate sensors have excluded compounds such as citrate and urate, which are anions in the biological matrices where oxalate is measured ( e.g ., urine, blood, and bacterial lysate). In the present study, we reassessed the selectivity of a dinuclear copper(II) macrocycle (Cu 2 L) in an eosin Y displacement assay using biologically relevant anions. Although previously reported as selective for oxalate, we found greater indicator displacement (fluorescence response) for urate and oxaloacetate and a significant response to citrate. These anions are larger than oxalate and do not appear to fit into the putative binding pocket of Cu 2 L. Consistent with previous reports, Cu 2 L did not release eosin Y in the presence of several other dicarboxylates, including adipate, glutarate, malate (except at 10 mM), fumarate, succinate, or malonate (except at 10 mM), and the monocarboxylate acetate. This was demonstrated by the failure of the anions to reverse eosin Y quenching by Cu 2 L. We also assessed, for the first time, other monocarboxylates, including butyrate, pyruvate, lactate, propionate, and formate. None of these anions were able to displace eosin Y, indicating no interaction with Cu 2 L that interfered with the eosin Y binding site. Single-crystal X-ray crystallography revealed that nonselective binding of the anions is likely partly caused by readily accessible copper(II) ions on the external surface of Cu 2 L. In addition, π–π stacking of urate with the aromatic groups of Cu 2 L cannot be ruled out as a contributor to binding. We conclude that Cu 2 L is not suitable for oxalate sensing in a biological matrix unless interfering compounds are selectively removed or masked.

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Section: Resultsmentioning

confidence: 99%

A Copper(II) Macrocycle Complex for Sensing Biologically Relevant Organic Anions in a Competitive Fluorescence Assay: Oxalate Sensor or Urate Sensor?

et al. 2020

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“…Underfilling of the tubes (tubes filled with less than 90% of draw volume) is strongly discouraged and should be avoided. Although some would argue that incorrect order of draw when using closed blood collection systems is not the source of contamination [77,78], there is firm evidence showing that contamination still occurs more commonly than might be expected and can be difficult to identify [79][80][81][82]. This is probably because venepuncture is not always performed under ideal conditions.…”

Section: Samplingmentioning

confidence: 99%

Joint EFLM-COLABIOCLI recommendation for venous blood sampling

Šimundić

Bölenius²,

Cadamuro³

et al. 2019

Annales De Biologie Clinique

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Introduction Scope of the guidance Disclaimer Methodology I. Pre-sampling General considerations on appropriate mode of communication with the patient Patient position Step 1. Patient identification (1C) Step 2. Verify patient is fasting and properly prepared (1B) Step 3. Obtain supplies required for venous blood collection (2C) Step 4. Labeling and/or identifying tubes (1C) II. Sampling Step 5. Put on gloves (1C) Step 6. Apply tourniquet (1A) Step 7. Select venepuncture site (1B) Step 8. Clean sampling site (1B) Step 9. Puncture the vein (1A) Step 10. Drawing blood into the first tube (1A) Step 11. Release the tourniquet (1A) Step 12. Gently invert the tubes once immediately after collection (1B) Step 13. Draw additional tubes following the recommended order of draw (1B) Step 14. Remove the needle from the vein and ensure the safety mechanism is activated (1A) Step 15. Dispose of the needle (1A) Step 16. Bandage the puncture site (1C) Step 17. Tell the patient to apply gentle pressure and do not bend the arm (1C) Step 18. Invert all tubes at least 4 more times (1B) Step 19. Remove gloves (1A) III. Post sampling Step 20. Advise the patient to rest for 5 min (1B) IV. Implementation of the guidelines Potential barriers and challenges Framework for a successful implementation of this recommendation Conclusions References

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“…Cadamuro et al . found that a simulated carryover of 1 µL of K 3 EDTA blood reduced calcium by 13% ( 21 ). According to Cadamuro et al , EDTA whole blood carryover is highly unlikely, and, even if it occurs, it would be needed a larger volume than 10 µL to alter test results.…”

Section: Discussionmentioning

confidence: 99%

Unexpected abnormal coagulation test results in a 2-year-old child

Radovanović

Mikulčić

Medica

2020

Biochem. med. (Online)

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Rejection of the sample with repeated blood withdrawal is always an unwanted consequence of sample nonconformity and preanalytical errors, especially in the most vulnerable population – children. Here is presented a case with unexpected abnormal coagulation test results in a 2-year-old child with no previously documented coagulation disorder. Child is planned for tympanostomy tubes removal under the anaesthesia driven procedure, and preoperative coagulation tests revealed prolonged prothrombin time, activated partial thromboplastin time and thrombin time, with fibrinogen and antithrombin within reference intervals. From the anamnestic and clinical data, congenital coagulation disorder was excluded, and with further investigation, sample mismatch, clot presence and accidental ingestion of oral anticoagulant, heparin contamination or vitamin K deficiency were excluded too. Due to suspected EDTA carryover during blood sampling another sample was taken the same day and all tests were performed again. The results for all tests were within reference intervals confirming EDTA effect on falsely prolongation of the coagulation times in the first sample. This case can serve as alert to avoid unnecessary loss in terms of blood withdrawal repetitions and discomfort of the patients and their relatives, tests repeating, prolonging medical procedures, and probably delaying diagnosis or proper medical treatment. It is the responsibility of the laboratory specialists to continuously educate laboratory staff and other phlebotomists on the correct blood collection as well as on its importance for the patient’s safety.

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Relevance of EDTA carryover during blood collection

Cited by 19 publications

References 11 publications

A Copper(II) Macrocycle Complex for Sensing Biologically Relevant Organic Anions in a Competitive Fluorescence Assay: Oxalate Sensor or Urate Sensor?

A Copper(II) Macrocycle Complex for Sensing Biologically Relevant Organic Anions in a Competitive Fluorescence Assay: Oxalate Sensor or Urate Sensor?

Joint EFLM-COLABIOCLI recommendation for venous blood sampling

Unexpected abnormal coagulation test results in a 2-year-old child

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