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Influence of parameters of blood count in dependence on the amount of blood collected into tubes
MOUDRÁ, Pavla
Haematology is the branch of science engaged in the study of blood and its components - especially blood cells - red blood cells, white blood cells and blood platelets. In the core haematology examination - the blood count - not only their amount is evaluated but also the morphology. When blood taking, the right ratio of blood and anticoagulant must be kept, otherwise changes in blood count may occur. Laboratorians are bound to reject examination of incorrectly taken samples. Since it is difficult to take blood from some patient groups (children, elderly, obese patients, etc.), there is often put a pressure on laboratories from the staff to process also the incorrectly taken samples. The aim of this study is to state the level of impact of the incorrect blood taking, within the meaning of the blood - anticoagulant ratio, on the particular parameters of the blood count. The sample consisted of one hundred patients who were invited by their physician for blood tests to the Synlab Czech., s.r.o. company, U Tří lvů 4, České Budějovice in the period from December 2011 to June 2012. There were healthy and sick patients aged 10-77 years in the sample. All one hundred patients were taken within the same examination two test tubes with anticoagulant K2EDTA made by Becton Dickinson - BD Vacutainer. According to instructions, 2 ml of blood were taken into the first tube. Into the second tube, from the fifty patients only 0.5 ml of blood were taken, from the another fifty patients 3.5 ml. These samples were measured in the laboratory of Synlab Czech, s.r.o. company, U Tří lvů 10, České Budějovice using the Advia 120 analyzer made by Bayern HealthCare LLC, serial number IR28850224, installed in 2011. All 13 parameters issued by Synlab Czech, s.r.o. company on the result sheet as a blood count were analysed. The results from correctly and incorrectly taken samples were compared using a paired t-test. Hypothesis assumed that deviations will occur at both sampling errors for all thirteen blood count parameters at the significance level of 95%. This hypothesis was not confirmed, there were no deviations of statistical significance in all of thirteen parameters in any incorrectly taken samples. In the case of test tube where more blood than required was taken, there were no deviations of statistical significance in any of thirteen parameters. In the case of test tube where less blood than required was taken, there were deviations of statistical significance in six of eight measured parameters. A statistically significant increase occurred in the number of red blood cells (by 0.85%), haemoglobin amount (by 0.97%), haematocrit values (by 2.19%) and MCV (by 1.41%). The decrease occurred in MCHC values (by 1.23%) and platelet count (4.96%). The differential white blood cell count was statistically significantly different only in the monocyte value (reduction of 6.35%). Within examination of samples from tube where more blood than required was taken, there were no statistically significant deviations. Therefore, we may assume that such incorrectly taken samples could be used for blood count examination. When taking less blood than required, statistically significant deviations occur in almost half of the blood count parameters. The platelet reduction of 4.96% is clinically the most important. Nevertheless, we can say that even this value is probably not significant enough to not use the incorrectly taken sample in acute cases. If the conclusions of this study are confirmed by other studies, it could be possible to make health care more effective in cases where deviation is considered to be neither statistically nor clinically significant.
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