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      Sample Management: Stability of Plasma and Serum on Different Storage Conditions

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          Abstract

          Background and objective

          The analytes stability on serum and plasma are critical for clinical laboratory, especially if there is a delay in their processing or if they need to be stored for future research. The objective of this research was to determine the stability of K 3EDTA-plasma and serum on different storage conditions.

          Materials and methods

          A total of thirty healthy adults were studied. The serum/plasma samples were centrifuged at 2000g for 10 minutes. Immediately after centrifugation, the serum/plasma analytes were assayed in primary tubes using a Cobas c501 analyzer (T0); the residual serum/plasma was stored at either 2-8°C or -20°C for 15 (T15) and 30 days (T30).

          Mean concentrations changes in respect of initial concentrations (T0) and the reference change values were calculated. For assessing statistical difference between samples, the Wilcoxon ranked-pairs test was applied.

          Results

          We evidenced instability for total bilirubin, uric acid, creatinine and glucose at T15 and T30 and stored at -20°C (p<0.05). However, potential clinical impact significance were observed only for total bilirrubin T30 at -20°C, and creatinine T30 at 2-8°C.

          Conclusions

          Our results had shown that storage samples at -20°C is a better way to preserve glucose, creatinine, and uric acid. Therefore, laboratories should freeze their samples as soon as possible to guarantee proper stability when there is need to repeat analysis, verify a result, or add a laboratory testing.

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          Most cited references32

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          The effect of storage time and freeze-thaw cycles on the stability of serum samples

          Introduction: Optimal storage of serum specimens in central laboratories for a long period for multicenter reference interval studies, or epidemiologic studies remains to be determined. We aimed to examine the analytical stability of chemistry analytes following numerous freeze-thaw and long term storage. Materials and methods: Serum samples were obtained from 15 patients. Following baseline measurement, sera of each subject were aliquoted and stored at −20 °C for two experiments. A group of sera were kept frozen for up to 1, 2 and 3 months and then analyzed for stability. The other experiment consisted of one to ten times of freeze and thaw cycles. Total of 17 chemistry analytes were assayed at each time point. The results were compared with those obtained from the initial analysis of fresh samples. Median or mean changes from baseline (T0) concentrations were evaluated both statistically and clinically according to the desirable bias. Results: Of the analytes studied, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), gamma-glutamyl transferase (GGT), direct bilirubin, glucose, creatinine, cholesterol, triglycerides, high density lipoprotein (HDL) were stable in all conditions. Blood urea nitrogen (BUN), uric acid, total protein, albumin, total bilirubin, calcium, lactate dehydrogenase (LD) were changed significantly (P < 0.005). Conclusions: As a result, common clinical chemistry analytes, with considering the variability of unstable analytes, showed adequote stability after 3 months of storage in sera at −20 °C, or up to ten times of freeze-thaw cycle. All the same, such analysis can only be performed for exceptional cases, and this should be taken into account while planning studies.
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            Stability study of 81 analytes in human whole blood, in serum and in plasma.

            We studied the pre-analytical stability of 81 analytes based on the variables of delay before processing, storage as whole blood or serum/plasma, the storage temperature and the type of tube the sample was stored in. The mean difference between assays for samples from 10 subjects was calculated with the samples being kept under different storage conditions and for different times between sampling time and analysis: up to 24h for biochemistry, coagulation and hematology, and up to 72 h for hormonology. This difference was compared to the acceptable limits derived from the analytical and the intra individual biological variation. Most of the analytes investigated remained stable up to 24h under all storage conditions prior to centrifugation. However, some analytes were significantly affected either by delay, tube type or temperature, such as potassium, inorganic phosphorus, magnesium, LD, glucose, lactate, mean corpuscular volume, mean corpuscular hemoglobin, activated partial thromboplastin time, insulin, C-peptide, PTH, osteocalcin, C-telopeptide and ACTH. This study may be useful to help define acceptable delay times and storage conditions when a short time between sample collection and processing is not possible. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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              Joint EFLM-COLABIOCLI Recommendation for venous blood sampling

              This document provides a joint recommendation for venous blood sampling of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). It offers guidance on the requirements for ensuring that blood collection is a safe and patient-centered procedure and provides practical guidance on how to successfully overcome potential barriers and obstacles to its widespread implementation. The target audience for this recommendation are healthcare staff members directly involved in blood collection. This recommendation applies to the use of a closed blood collection system and does not provide guidance for the blood collection with an open needle and syringe and catheter collections. Moreover, this document neither addresses patient consent, test ordering, sample handling and transport nor collection from children and unconscious patients. The recommended procedure is based on the best available evidence. Each step was graded using a system that scores the quality of the evidence and the strength of the recommendation. The process of grading was done at several face-to-face meetings involving the same mixture of stakeholders stated previously. The main parts of this recommendation are: 1) Pre-sampling procedures, 2) Sampling procedure, 3) Post-sampling procedures and 4) Implementation. A first draft of the recommendation was circulated to EFLM members for public consultation. WG-PRE-LATAM was also invited to comment the document. A revised version has been sent for voting on to all EFLM and COLABIOCLI members and has been officially endorsed by 33/40 EFLM and 21/21 COLABIOCLI members. We encourage professionals throughout Europe and Latin America to adopt and implement this recommendation to improve the quality of blood collection practices and increase patient and workers safety.
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                Author and article information

                Journal
                EJIFCC
                EJIFCC
                eJIFCC
                EJIFCC
                The Communications and Publications Division (CPD) of the IFCC
                1650-3414
                20 March 2020
                March 2020
                : 31
                : 1
                : 46-55
                Affiliations
                [1 ] Clinical Laboratory, Hospital General Docente Ambato , Ambato, Ecuador
                [2 ] Clinical Laboratory, Faculty of Health Sciences, Universidad Técnica de Ambato , Ambato, Ecuador
                [3 ] Ambato Hospital, Instituto Ecuatoriano de Seguridad Social , Ambato, Ecuador
                [4 ] Synlab Solutions in Diagnostics , Quito, Ecuador
                [5 ] Universidad Central del Ecuador , Quito, Ecuador
                Author notes
                Corresponding author: Klever Sáenz-Flor Synlab Soutions in Diagnostics Ecuador Clinical Patohology Postgrade/School of Medicine Central University of Ecuador Quito Ecuador E-mail: kleber.saenz@ 123456netlab.com.ec
                Article
                ejifcc-31-46
                7109503
                32256288
                f20db687-4560-4825-8465-4cc11d4c462d
                Copyright © 2020 International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). All rights reserved.

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

                History
                Page count
                Figures: 0, Tables: 2, Equations: 2, References: 36, Pages: 10
                Categories
                Research Article

                reproducibility of results,blood chemical analysis,specimen handling,temperature,total quality management

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