We use Li Hep plasma in A/E and AMU for routine chemist
Hi Asila
We use Li Hep plasma in A/E and AMU for routine chemistry to avoid the
20 minute clotting delay and regularly see 15 - 20g/L increase in plasma
total protein measurement.
As previously indicated - this is due to the increase in fibrinogen in
'acutely ill' patients and because the albumin measurement stays the
same, we report apparently high globulins which leads to a huge increase
in the number of requests for protein electrophoresis.
We rapidly introduced an auto-comment on these high globulin results
indicating that this increase is probably due to the increased
fibrinogen present in the plasma (Li Hep) sample.
The alternative would be to not report the globulins of course but the
more astute would still notice the increased total protein.
Subsequent serum samples confirm this difference when the patient is
transferred to one of the wards (where serum is the standard sample for
routine chemistry).
For the mean difference of 0.2mmol/L between serum and plasma K - we
make no comment.
Regards
Gail
Dr Gail Curtis
Principal Biochemist
Dept of Chemical Pathology
Ysbyty Glan Clwyd
01745 445293
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-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Asila
Al-Musheifri
Sent: 04 May 2009 11:14
To: [log in to unmask]
Subject: Total Protein
Hi,
Measurement of total protein can be done using either serum or plasma.
The
results are exchangable. In our laboratory we mainly use lithium heparin
tubes
(no gel) for routine measurements while total protein and albumin
specimens
are collected in serum. When we start to use plasma tube for measuring
TP
we have observed a significant difference (4-9 g/L) between serum and
plasma for the same patient. Does anyone observe such problem?
Regards,
Asila AL-Musheifri
Oman
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