The „EPiQ“-Study (Evaluation of preanalytical quality): S-Monovette® in manual aspiration mode drastically reduces hemolytic samples in head-to-head study

Abstract

Background Hemolytic blood samples are the number one cause for specimen rejection at emergency departments. Triggered by unsuitable blood sampling material or incorrect handling and a related strong vacuum force, hemolytic samples often must be retaken. The objective of this study was to assess whether correct manual aspiration using S-Monovette® could reduce the number of hemolytic samples. Methods Between January and April 2019, a head-to-head study was conducted. Whereas in the first eight weeks, all specimens were collected using Vacutainer®, in the second eight weeks, blood was taken using S-Monovette® in aspiration mode. Specimens were categorized into five classes (0–30, 31–50, 51–75, 76–100, and 101+ mg/dl of cell-free hemoglobin) and for the statistical analyses, all samples exceeding 30 mg/dl were classified as hemolytic. Results Data were collected on 4794 blood specimens (Vacutainer®: 2634 samples, S-Monovette®: 2160 samples). While the percentage of non-hemolytic samples (HI of 0–30 mg/dl) was substantially higher for specimens drawn by S-Monovette® (95.7 %) than Vacutainer® (83.0 %), the opposite was true for all HI categories above 30 mg/dl. Importantly, the reduction of hemolytic samples took place immediately following the imposition of S-Monovette® and remained stable at a low level until the end of the study. Conclusions Based on our results, we conclude that switching to S-Monovette® in manual aspiration mode in the blood sampling process could be highly beneficial, not only from a financial point of view, but also with regards to reducing unnecessary tasks and stress for nursing staff and improving patient outcome overall.

Reducing blood sample hemolysis in the emergency department using S-Monovette® in aspiration mode

“…Statistically significant reduction in serum K and LDH levels were also demonstrated ( Table 2 ). Similar findings have been demonstrated by other groups which have shown marked improvement in rates of hemolysis of blood drawn from IV catheters when the conventional vacuum blood collection system is replaced with the S-Monovette® blood collection system used in aspiration mode [ 13 , 17 , 21 ]. A study conducted to an ED in Italy showed a decrease of sample hemolysis rates from 29% to 2% after the introduction of the S-Monovette® blood collection system for blood drawn from intravenous catheters [ 13 ].…”

“…A study conducted to an ED in Italy showed a decrease of sample hemolysis rates from 29% to 2% after the introduction of the S-Monovette® blood collection system for blood drawn from intravenous catheters [ 13 ]. In a more recent “EPiQ” study done in an ED in Switzerland with 4794 subjects, introduction of the S-Monovette® system in place of the BD Vacutainer® SST II, resulted in the hemolysis rate of blood samples (HI > 30 mg/dL) to be reduced drastically (17.0%–4.3%) [ 17 ]. Both studies employed a cross-over design [ 17 ].…”

“…In a more recent “EPiQ” study done in an ED in Switzerland with 4794 subjects, introduction of the S-Monovette® system in place of the BD Vacutainer® SST II, resulted in the hemolysis rate of blood samples (HI > 30 mg/dL) to be reduced drastically (17.0%–4.3%) [ 17 ]. Both studies employed a cross-over design [ 17 ].…”

“…A few studies have demonstrated the effectiveness of SMA in reducing blood sample hemolysis [ 13 , 17 ]. Notwithstanding these studies, vacuum systems continue to be prevalent and specimen hemolysis continues to be a significant problem in clinical practice.…”

Comparison of blood gas parameters, ions, and glucose concentration in polish Holstein-Friesian Dairy cows at different milk production levels

“…The blood samples were collected in the morning, directly into 1 mL gasometric syringes (calcium-balanced lithium heparin, The Blood Gas Monovette® 1 ml Sarstedt, Nümbrecht, Germany) by manual aspiration. We decided to use this device to avoid hemolysis influencing the obtained results 25 . The air was removed by attaching a ventilation device and expelling the air from the syringe.…”