Probably a silly suggestion but is there any chance that the dilute
samples with high sodiums could have been inadvertently been put into
sodium citrate tubes before being transferred to heparin tubes?
Andrew Trull, PhD
Clinical Scientist Grade C
Head of Clinical Pharmacology
Department of Pathology
Papworth Hospital
Papworth Everard
Cambridge CB3 8RE
Tel.: 01480-830541 (x4301)
FAX: 01480-364777
On Wed, 23 Jan 2002, Hogan, Tim wrote:
> We recently received a blood sample taken from a six year old boy who
> attended our phlebotomy Dept. His clinical details were recurrent cough and
> abdominal pains with possible weight loss, he was not on a drip.
> The sample was taken into a disposable 5ml syringe and then transferred to a
> small plastic Lithium heparin tube for Chemistry and an EDTA for
> Haematology.
> The patients results which were very abnormal are listed below. The results
> were phoned to the GP and the patient was admitted to the paediatric ward a
> few hours later and another blood sample taken. The results for which were
> normal. This same situation occurred about a month ago but on an adult
> patient who was on plasma expanders and the samples taken into 7ml Beckton
> Dickenson SST tubes.
>
> The original sample appears diluted but with a high Sodium which is not
> detected (or not so detected) by Direct ISE. The high Sodium is repeatable
> on two different Olympus AU600 (indirect ISE) analysers. The Haematology
> sample also showed similar dilution effect. Has anyone any ideas what could
> be causing this effect?
> Original Original Direct ISE Repeat
> Analyser A Analyser B sample
> Na 173 171 148 140
> K 3.2 3.2 2.7 3.7
> Urea 3.6 6.1
> Glucose 2.9 4.8
> Creat 46 62
> Calcium 1.34 2.5
> Albumin 31 46
> TP 51 70
> ALT 12 12
> ALP 128 187
> Bilirubin 4 3
> Osmolality 275 289
> Hb 8.3 11
> WCC 7.2 13.1
> platelets 411 570
> HCT 25% 32%
> RBC 3.1 4.1
> MCV 80 78
>
>
> Tim Hogan
> Basildon
>
>
>
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