Pathology and Laboratory Medicine

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Large Academic Hospital Laboratory Investigates a Major Pre-Analytical Challenge in Africa and Developing Countries

Received: Dec. 20, 2018    Accepted: Jan. 20, 2019    Published: Feb. 07, 2019
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Abstract

Background: Delay in serum separation from red blood cells in samples collected from most primary healthcare facilities and transported to a laboratory for analysis is of great concern. Standard guidelines state that serum or plasma should be separated from cells within 2 hours of collection. The aim was to determine effects of delayed sample separation on measured biochemical analytes. The objective was to store blood samples in primary collection tubes at 20-25°C post venesection, then separate, and analyse samples of selected analytes. Methods: Multiple sample tubes of whole blood were collected from one of the authors volunteer, and subjected to time delays in centrifugation. The baseline serum was separated from red blood cells within 30 minutes of post venesection to allow adequate coagulation. Twenty analytes were studied using 2 analytical platforms. Percentage variation and standard error method were used to evaluate time-dependent variability in analytes. Total change limit was used to measure significant changes within-run variability for both platforms. Results: Most analytes were stable up to day 3 to 4 on both platforms. Serum CO2, CL, Ca, ALT and ALB were stable up to 8 days when they were measured on Cobas 8000®. BUN, TRIG, TB, CHOL, AST, ALT and ALB were stable up to 10 days on Dimension® CCS. K showed significant changes at 2h on both platforms at initial measurements. It was out-of-range at day 10 on Dimension® CCS. Serum creatinine levels showed substantial changes at day 2 on Dimension® analyzer and on Cobas 8000® at day 3. Conclusions: The study showed stability of wide range of serum analytes at 20-25°C for several days. The acceptable results can be achieved if samples are centrifuged the same day and analyzed later for most of biochemical analytes.

DOI 10.11648/j.plm.20190301.13
Published in Pathology and Laboratory Medicine ( Volume 3, Issue 1, June 2019 )
Page(s) 10-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Analyte, Delayed Measurement, Primary Healthcare, Analytical Platforms, Serum

References
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Cite This Article
  • APA Style

    Ernest Philani Buthelezi, Florence Marule, Bahule Nimrod Motlonye, Ntsoaki Mopane, Tshepo Rakhothule, et al. (2019). Large Academic Hospital Laboratory Investigates a Major Pre-Analytical Challenge in Africa and Developing Countries. Pathology and Laboratory Medicine, 3(1), 10-18. https://doi.org/10.11648/j.plm.20190301.13

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    ACS Style

    Ernest Philani Buthelezi; Florence Marule; Bahule Nimrod Motlonye; Ntsoaki Mopane; Tshepo Rakhothule, et al. Large Academic Hospital Laboratory Investigates a Major Pre-Analytical Challenge in Africa and Developing Countries. Pathol. Lab. Med. 2019, 3(1), 10-18. doi: 10.11648/j.plm.20190301.13

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    AMA Style

    Ernest Philani Buthelezi, Florence Marule, Bahule Nimrod Motlonye, Ntsoaki Mopane, Tshepo Rakhothule, et al. Large Academic Hospital Laboratory Investigates a Major Pre-Analytical Challenge in Africa and Developing Countries. Pathol Lab Med. 2019;3(1):10-18. doi: 10.11648/j.plm.20190301.13

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  • @article{10.11648/j.plm.20190301.13,
      author = {Ernest Philani Buthelezi and Florence Marule and Bahule Nimrod Motlonye and Ntsoaki Mopane and Tshepo Rakhothule and Donald Moshen Tanyanyiwa},
      title = {Large Academic Hospital Laboratory Investigates a Major Pre-Analytical Challenge in Africa and Developing Countries},
      journal = {Pathology and Laboratory Medicine},
      volume = {3},
      number = {1},
      pages = {10-18},
      doi = {10.11648/j.plm.20190301.13},
      url = {https://doi.org/10.11648/j.plm.20190301.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.plm.20190301.13},
      abstract = {Background: Delay in serum separation from red blood cells in samples collected from most primary healthcare facilities and transported to a laboratory for analysis is of great concern. Standard guidelines state that serum or plasma should be separated from cells within 2 hours of collection. The aim was to determine effects of delayed sample separation on measured biochemical analytes. The objective was to store blood samples in primary collection tubes at 20-25°C post venesection, then separate, and analyse samples of selected analytes. Methods: Multiple sample tubes of whole blood were collected from one of the authors volunteer, and subjected to time delays in centrifugation. The baseline serum was separated from red blood cells within 30 minutes of post venesection to allow adequate coagulation. Twenty analytes were studied using 2 analytical platforms. Percentage variation and standard error method were used to evaluate time-dependent variability in analytes. Total change limit was used to measure significant changes within-run variability for both platforms. Results: Most analytes were stable up to day 3 to 4 on both platforms. Serum CO2, CL, Ca, ALT and ALB were stable up to 8 days when they were measured on Cobas 8000®. BUN, TRIG, TB, CHOL, AST, ALT and ALB were stable up to 10 days on Dimension® CCS. K showed significant changes at 2h on both platforms at initial measurements. It was out-of-range at day 10 on Dimension® CCS. Serum creatinine levels showed substantial changes at day 2 on Dimension® analyzer and on Cobas 8000® at day 3. Conclusions: The study showed stability of wide range of serum analytes at 20-25°C for several days. The acceptable results can be achieved if samples are centrifuged the same day and analyzed later for most of biochemical analytes.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Large Academic Hospital Laboratory Investigates a Major Pre-Analytical Challenge in Africa and Developing Countries
    AU  - Ernest Philani Buthelezi
    AU  - Florence Marule
    AU  - Bahule Nimrod Motlonye
    AU  - Ntsoaki Mopane
    AU  - Tshepo Rakhothule
    AU  - Donald Moshen Tanyanyiwa
    Y1  - 2019/02/07
    PY  - 2019
    N1  - https://doi.org/10.11648/j.plm.20190301.13
    DO  - 10.11648/j.plm.20190301.13
    T2  - Pathology and Laboratory Medicine
    JF  - Pathology and Laboratory Medicine
    JO  - Pathology and Laboratory Medicine
    SP  - 10
    EP  - 18
    PB  - Science Publishing Group
    SN  - 2640-4478
    UR  - https://doi.org/10.11648/j.plm.20190301.13
    AB  - Background: Delay in serum separation from red blood cells in samples collected from most primary healthcare facilities and transported to a laboratory for analysis is of great concern. Standard guidelines state that serum or plasma should be separated from cells within 2 hours of collection. The aim was to determine effects of delayed sample separation on measured biochemical analytes. The objective was to store blood samples in primary collection tubes at 20-25°C post venesection, then separate, and analyse samples of selected analytes. Methods: Multiple sample tubes of whole blood were collected from one of the authors volunteer, and subjected to time delays in centrifugation. The baseline serum was separated from red blood cells within 30 minutes of post venesection to allow adequate coagulation. Twenty analytes were studied using 2 analytical platforms. Percentage variation and standard error method were used to evaluate time-dependent variability in analytes. Total change limit was used to measure significant changes within-run variability for both platforms. Results: Most analytes were stable up to day 3 to 4 on both platforms. Serum CO2, CL, Ca, ALT and ALB were stable up to 8 days when they were measured on Cobas 8000®. BUN, TRIG, TB, CHOL, AST, ALT and ALB were stable up to 10 days on Dimension® CCS. K showed significant changes at 2h on both platforms at initial measurements. It was out-of-range at day 10 on Dimension® CCS. Serum creatinine levels showed substantial changes at day 2 on Dimension® analyzer and on Cobas 8000® at day 3. Conclusions: The study showed stability of wide range of serum analytes at 20-25°C for several days. The acceptable results can be achieved if samples are centrifuged the same day and analyzed later for most of biochemical analytes.
    VL  - 3
    IS  - 1
    ER  - 

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Author Information
  • Department of Health, Johannesburg, South Africa

  • Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa

  • National Health Laboratory Service, Johannesburg, South Africa

  • National Health Laboratory Service, Kalafong Hospital, Pretoria, South Africa

  • Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa

  • Department of Chemical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa

  • Section