RESUMO
The choice of a venous access system to provide safe blood collection and reliable analytical results for that sample is of paramount importance in any accident and emergency department. The objective of this study was to identify the factors associated with haemolysis in venous blood samples, where the variables studied were: type of venipuncture (needle and catheter), type of catheter (3 catheters of 3 different materials) and diameter of the catheter. The sample was obtained from all patients who required a blood test in the accident and emergencies department of the Virgen del Camino Hospital over 34 days, collected in 3 different periods (September-November), involving a total of 1.933 procedures. Positive haemolysis determined by laboratory technicians was found in 2% (7/348) of samples obtained by needle compared to 14% (222/1585) obtained by catheter. We observe an 8% (39/475) of haemolysis in the samples taken by protective Teflon catheter, 18% (77/426) by Protectiv plus polyurethane and 15% (106/684) by BD-Nexiva Vialone. The haemolysis index fell with an increase in the size of the catheter, those of 18G showing 13% (115/867) and those of 20G showing 15% (107/708). The combination of catheter type and size maintains the smallest percentages of haemolysis in Teflon catheters and high diameters of 18G with 6% (19/301), less than half the haemolysis of the polyurethane catheters and a third of that for Vialone catheters respectively.
Assuntos
Hemólise , Flebotomia/efeitos adversos , Humanos , Flebotomia/instrumentação , Flebotomia/métodos , Estudos ProspectivosRESUMO
La elección de un sistema de acceso venoso que proporcione una extracción sanguínea segura y unos resultados analíticos fiables en dicha muestra es de suma importancia en cualquier servicio de urgencias. El objetivo del estudio fue identificar los factores asociados a la hemólisis en muestras de sangre venosa, siendo las variables estudiadas el tipo de venopunción (con aguja y con catéter), el tipo de catéter (3 catéteres de 3 materiales diferentes) y el diámetro del catéter. La muestra se obtuvo de todos los pacientes que precisaron analítica de sangre en el Servicio de Urgencias del Hospital Virgen del Camino durante 34 días, recogidos en 3 períodos distintos (septiembre-noviembre). Se completó un total de 1.933 procedimientos. Se registró hemólisis positiva, determinada por los técnicos de laboratorio, en un 2% (7/348) de muestras obtenidas con aguja frente al 14% (222/1585) del catéter. Se observó un 8% (39/475) de hemólisis en las muestras extraídas mediante catéter Protectiv® de teflón, 18% (77/426) mediante Protectiv plus® de poliuretano y 15% (106/684) mediante BD-Nexiva® de vialón. El índice de hemólisis disminuyó al aumentar el calibre del catéter; así presentaron un 13% (115/867) los de 18G y un 15% (107/708) los de 20G. La combinación tipo de catéter y calibre mantiene los menores porcentajes de hemólisis para catéteres de teflón y diámetros altos de 18G con un 6% (19/301), menos de la mitad de hemólisis que los respectivos de poliuretano y menos de la tercera parte que los de vialón (AU)
The choice of a venous access system to provide safe blood collection and reliable analytical results for that sample is of paramount importance in any accident and emergency department. The objective of this study was to identify the factors associated with haemolysis in venous blood samples, where the variables studied were: type of venipuncture (needle and catheter), type of catheter (3 catheters of 3 different materials) and diameter of the catheter. The sample was obtained from all patients who required a blood test in the accident and emergencies department of the Virgen del Camino Hospital over 34 days, collected in 3 different periods (September-November), involving a total of 1.933 procedures. Positive haemolysis determined by laboratory technicians was found in 2% (7/348) of samples obtained by needle compared to 14% (222/1585) obtained by catheter. We observe an 8% (39/475) of haemolysis in the samples taken by protective Teflon® catheter, 18% (77/426) by Protectiv plus® polyurethane and 15% (106/684) by BD-Nexiva® Vialone. The haemolysis index fell with an increase in the size of the catheter, those of 18G showing 13% (115/867) and those of 20G showing 15% (107/708). The combination of catheter type and size maintains the smallest percentages of haemolysis in Teflon catheters and high diameters of 18G with 6% (19/301), less than half the haemolysis of the polyurethane catheters and a third of that for Vialone catheters respectively (AU)
