Views:62 Author:Site Editor Publish Time: 2020-05-04 Origin:Site
Many people are very familiar with the simple action of making fist when blood test. However, even guidelines developed by the Clinical Laboratory Standardization Association (CLSI) and the World Health Organization (WHO) have questions about whether the making fist action during blood collection will affect the test results. Let us look at the related research.
A study by Gabriel Lima-Oliveira and others in Italy was published in the journal Clinical Biochemistry. This article has studied whether the simple action of collecting blood and punching fist will affect the test results of clinical biochemical indicators.
The study randomly selected 16 healthy subjects (4 males and 12 females, with an average age of 49 years). They were fasted for 12 hours and rested for 15 minutes quietly before blood collection to exclude interference from other external factors.
1. Collection of specimens and inspection
There are two methods for collecting specimens:
The first method (standard method): in the forearm, no tourniquet is used and the subject's hand is always open.
Second method: In the forearm, no tourniquet is used but the subject is required to punch 6 times in succession before holding blood and hold his fist until the end of the venous blood collection.
The first 8 subjects used the first method on their right hands and the second method on their left hands, and the opposite was true for the other 8 subjects. The blood collection is 5 mL, the first 2 mL is collected in the blood collection tube without any additives, and the last 3 mL is collected in the blood collection tube with lithium heparin and separation gel. Centrifuge for 10 minutes and check on the machine.
2. Inspection items
Blood test items include albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), pancreatic amylase, aspartate aminotransferase (AST), bilirubin, C-reactive protein (CRP) , Calcium ion, glutamyl transpeptidase (GGT), cholesterol, chloride, creatine kinase (CK), creatinine, glucose, lactate dehydrogenase (LDH), lipase, magnesium ion, phosphate, potassium ion, Sodium ions, total protein, triglycerides, urea nitrogen, uric acid, and more.
3. Inspection results
The blood test results showed that the making fist group had a 2.2% increase in calcium ion, a 1.0% increase in chloride, a 2.2% increase in creatine kinase, a 2.3% increase in magnesium ion, a 13.4% increase in potassium ion, a 0.7% increase in sodium ion, and a 28% increase in free cell hemoglobin. Reduced phosphate by 5.0%. There is a good correlation between plasma potassium and plasma creatine kinase (CK).
It is clear that potassium ions increase more. When multiple tubes of blood were continuously collected, serum potassium in the first tube was significantly higher than that in the third tube (25.6% in subjects, and the third tube was reduced by at least 0.2 mmol / L). The blood collection personnel were required to require no punches from the patients during blood collection. Compared with requiring punches, hyperkalemia was reduced from 16.0% to 4.9%, and cell free hemoglobin increased by 28%.
Many improper treatments before analysis can lead to hyperkalemia, especially blood samples that have not been centrifuged for too long, serum or lithium heparin blood samples contaminated with EDTA-K, blood samples that have been refrigerated for a long time, and so on. However, there is a connection between potassium ions and creatine kinase. The patient is required to punch and maintain the blood until the end of the blood test. This action will cause some indicators to change. There is a certain relationship between these indicators.
Making fist is a process of muscle contraction. The mechanisms related to muscle contraction include: cell penetration, adrenaline response, and the action of Na-K-ATPase. Based on these reactions, we can easily understand that the decrease in phosphate concentration is due to muscle contraction During the process of absorption, the increase in magnesium ion concentration is due to hemolysis and muscle contraction, while the changes in calcium ion and creatine kinase concentration are also due to muscle contraction.
What can you learn from the results of this blood test and inspection? Tell us your answer, welcome to communicate with us.