Influence of blood/anticoagulant ratio and storage temperature on platelet parameters using Cell Dyn Ruby® analyzer

Authors

DOI:

https://doi.org/10.11606/issn.2176-7262.rmrp.2022.192653

Keywords:

Blood count, Platelet count, Anticoagulant

Abstract

Introduction: The pre-analytical phase directly influences the laboratory result, such as the method of collection, transport, and storage of biological samples. Therefore, the stability of the biological sample is a crucial and determinant aspect of the quality of results in a clinical laboratory. Studies show that some platelet parameters may suffer alterations in the presence of altered blood/anticoagulant ratio, with increased storage time and/or variations in storage temperature, possibly leading to unrepresentative results. This study aimed to investigate the reliability of platelet parameters regarding the effect of the anticoagulant/blood ratio and storage temperature in samples stored for up to 24 hours after collection using the Cell Dyn Ruby® equipment.

Methodology: A total of 351 blood samples were evaluated under different analysis periods: 2, 5, 12, and 24 hours and storage methods: at room temperature (25 ⁰C) and 4 ⁰C, in addition to the analysis of anticoagulant/blood ratio. The Platelet parameters selected were: PLT (total platelet count), MPV (mean platelet volume), PDW (Platelet Distribution Width) and PCT (plateletcrit). The imprecision of the results was evaluated by the CVa (%) within the maximum allowed analytical variation, as well as by the mean difference of the results concerning the baseline sample (2 hours). Results: The total platelet count was the only parameter evaluated that showed reproducibility of results in all conditions analyzed. Regarding the other platelet parameters, it could be observed an imprecision of results emitted by Cell Dyn Ruby® after five hours of storage, both at room and refrigerated temperature. Conclusion: This study demonstrates that pre-analytical factors, such as storage temperature and storage time, can affect the variability of platelet parameters, which may produce erroneous results. Thus, the correct blood/anticoagulant ratio must be respected to avoid the late processing of the sample.

Downloads

Download data is not yet available.

Author Biographies

  • Maria Júlia Wolski, Universidade Estadual de Ponta Grossa – UEPG. Ponta Grossa, (PR), Brasil

    Graduanda em Farmácia

  • Mariane Faria Moss, Universidade Estadual de Ponta Grossa – UEPG. Ponta Grossa, (PR), Brasil

    Doutora em Medicina (Hematologia), Professora

  • Danielle Cristyane Kalva-Borato, Universidade Estadual de Ponta Grossa – UEPG. Ponta Grossa, (PR), Brasil

    Professora

References

Baccini V, Geneviève F, Jacqmin H, et al. Platelet counting: Ugly traps and good advice. proposals from the french-speaking cellular hematology group (gfhc). J Clin Med 2020; 9: 808.

Pogorzelska K, Krętowska A, Krawczuk-Rybak M, et al. Characteristics of platelet indices and their prognostic significance in selected medical condition – a systematic review. Adv Med Sci 2020; 65: 310–315.

Ikeda K, Ichihara K, Hashiguchi T, et al. Evaluation of the short-term stability of specimens for clinical laboratory testing. Biopreserv Biobank 2015; 13: 135–143.

Zini G. Stability of complete blood count parameters with storage: Toward defined specifications for different diagnostic applications. Int J Lab Hematol 2014; 36: 111–113.

Lippi G, Salvagno GL, Solero G Pietro, et al. Stability of blood cell counts, hematologic parameters and reticulocytes indexes on the Advia A120 hematologic analyzer. J Lab Clin Med 2005; 146: 333–340.

Mrazek C, Lippi G, Keppel MH, et al. Errors within the total laboratory testing process, from test selection to medical decision-making – A review of causes, consequences, surveillance and solutions. Biochemia Medica 2020; 30: 1–19.

Dalanhol M, Barros M, Mazuchelli J, et al. Efeitos quantitativos da estocagem de sangue periférico nas determinações do hemograma automatizado. Rev Bras Hematol Hemoter; 32. Epub ahead of print February 2010. DOI: 10.1590/s1516-84842010005000011.

Clinical and Laboratory Standards Institute. Procedures for the Handing and Processing of blood Specimens for Common Laboratory Tests. Appproved guideline. 4th ed. Wayner: CLSI 2010; 30: 1–68.

Sousa ACN, Rodrigues Junior OM. Principais erros na fase pré-analítica de exames laboratoriais: uma revisão bibliográfica integrativa. Res Soc Dev 2021; 10: e261101523662.

Oliveira LR, Simionatto M, Cruz BR, et al. Stability of complete blood count in different storage conditions using the ABX PENTRA 60 analyzer. Int J Lab Hematol 2018; 40: 359–365.

Seniv L, Simionatto M, Cruz BR, et al. Analysis of temperature, time and blood/anticoagulant ratio in the complete blood count. Rev Bras Análises Clínicas; 49. Epub ahead of print 2017. DOI: 10.21877/2448-3877.201600545.

Buttarello M. Quality specification in haematology: The automated blood cell count. In: Clinica Chimica Acta. Clin Chim Acta, pp. 45–54.

Hopkins WG. Measures of reliability in sports medicine and science. Sports Medicine 2000; 30: 1–15.

Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochem Medica 2016; 26: 178.

Ricos C, Alvarez V, Cava F, Garcia-Lario JV, Hernandez A, Jimenez CV, Minchinela J, Perich C SM. Desirable biological variation database specifications. Westgard 2014; 1–2.

Briggs C, Harrison P, Machin SJ. Continuing developments with the automated platelet count. Int J Lab Hematol 2007; 29: 77–91.

Tanaka Y, Tanaka Y, Gondo K, et al. Performance Evaluation of Platelet Counting by Novel Fluorescent Dye Staining in the XN-Series Automated Hematology Analyzers. J Clin Lab Anal 2014; 28: 341–348.

Schmoeller D, Picarelli MM, Munhoz TP, et al. Mean platelet volume and immature platelet fraction in autoimmune disorders. Frontiers in Medicine 2017; 4: 6.

Daves M, Zagler EM, Cemin R, et al. Sample stability for complete blood cell count using the Sysmex XN haematological analyser. Blood Transfus 2015; 13: 576–582.

Gunawardena D, Jayaweera S, Madhubhashini G, et al. Reliability of Parameters of Complete Blood Count With Different Storage Conditions. J Clin Lab Anal 2017; 31: 1–6.

Hedberg P, Lehto T. Aging stability of complete blood count and white blood cell differential parameters analyzed by Abbott CELL-DYN Sapphire hematology analyzer. Int J Lab Hematol 2009; 31: 87–96.

Mehmood R, Muhammed RK, Hussain S, et al. Evaluation of di-potassium and tri-potassium EDTA evacuated tubes for routine haematological testing. J Clin Lab Anal; 32. Epub ahead of print 1 January 2018. DOI: 10.1002/jcla.22188.

Dastjerdi MS, Emami T, Najafian A, et al. Mean platelet volume measurement, EDTA or citrate? Hematology 2006; 11: 317–319.

Bowles KM, Cooke LJ, Richards EM, et al. Platelet size has diagnostic predictive value in patients with thrombocytopenia. Clin Lab Haematol 2005; 27: 370–373.

Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002; 117: 399–404.

Patterson K. Platelet parameters generated by automated blood counters. C Bull Haematol, 1997.

Diaz-Ricart M, Brunso L, Pino M, et al. Preanalytical treatment of EDTA-anticoagulated blood to ensure stabilization of the mean platelet volume and component measured with the ADVIA counters. Thromb Res; 126. Epub ahead of print 2010. DOI: 10.1016/j.thromres.2010.04.002.

Banfi G, Salvagno GL, Lippi G. The role of ethylenediamine tetraacetic acid (EDTA) as in vitro anticoagulant for diagnostic purposes. Clin Chem Lab Med 2007; 45: 565–576.

Published

2022-11-09

Issue

Section

Original Articles

How to Cite

1.
Wolski MJ, Moss MF, Kalva-Borato DC. Influence of blood/anticoagulant ratio and storage temperature on platelet parameters using Cell Dyn Ruby® analyzer. Medicina (Ribeirão Preto) [Internet]. 2022 Nov. 9 [cited 2024 May 17];55(3):e-192653. Available from: https://www.periodicos.usp.br/rmrp/article/view/192653