Differences in Activated Partial Thromboplastin Time (APTT) measures depending on the device used in blood samples drawn (direct VacutainerÂ® versus Butterfly needle): A Randomized Comparative Study
Background. Most laboratory errors occur during the pre-analytical phase and are often related to the blood drawn equipment. No studies have evaluated yet the influence of the most common vein puncture devices on activated partial thromboplastin time (APTT). We aimed to compare APTT when venous blood samples are drawn with two different needle devices (direct VacutainerÂ® versus butterfly needle).Â
Methods. Consecutive adult healthy volunteers were prospectively enrolled and assigned to receive two antecubital peripheral blood punctures from both arms, using the two devices. The blood drawn sequence (i.e. right or left arm first) and the first device to be used (i.e. direct vacuntainerÂ® or butterfly needle first) were randomly established.
Results.Â Forty healthy volunteers (mean age 42.9 years; SD 7.5; range 27-58), comprising 25 (62.5%) women, were recruited. APTT obtained with the two blood drawn devices significantly and positive correlated (Spearman rho=0.943; p<0.001). However, mean APTT was significantly more prolonged in blood samples drawn with butterfly needles than in those obtained with direct vacutainerÂ® (34.01 Â± 4.4 vs. 33.63 Â± 3.8 seconds, respectively; p=0.013). No differences in APTT were found when samples obtained from right and left arms were compared.
Discussion. The type of blood drawn equipment significantly influences APTT, which is prolonged when a butterfly needle is used. An increased contact time between blood and butterfly tube plastic material would favor a premature consumption of plasma coagulation factors before mixing with anticoagulants in the collection tube. The appropriately chosen blood drawn device is thus essential to avoid pre-analytical errors.
KEY WORDS: Activated partial thromboplastin time, Phlebotomy; Quality control; Blood Specimen Collection; Pre-analytical quality; Laboratory techniques and procedures
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