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    Transport and temperature effects on measurement of serum and plasma potassium

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    URI
    https://rde.dspace-express.com/handle/11287/622191
    Author
    Seamark, D.
    Backhouse, S.
    Barber, P.
    Hichens, J.
    Salzmann, M.
    Powell, R.
    Date
    1999-07-01
    Journal
    Journal of the Royal Society of Medicine
    Type
    Journal Article
    Publisher
    Sage
    DOI
    10.1177/014107689909200703
    Rights
    Copyright © 1999, © SAGE Publications
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    Abstract
    Transport of blood samples from general practice to a central laboratory can result in spuriously high or low potassium concentrations. The importance of this phenomenon was studied in a general practice serving a population of 15,000 patients, 27 km from the pathology laboratory that routinely measured serum potassium. The design involved comparison of potassium levels between control serum (plain gel-separation serum tubes centrifuged in the surgery), routine serum (plain gel-separation tubes centrifuged in the laboratory) and routine plasma samples (lithium-heparin tubes centrifuged in the laboratory). Complete triple sets of data were obtained for 371 samples. Altman and Bland plots for the control serum vs routine serum samples showed a mean difference of +0.1 mmol/L with limits of agreement (+/- 2SD) +0.6 mmol/L, -0.4 mmol/L and for control serum vs routine plasma a mean difference of +0.2 mmol/L with limits of agreement +0.8 mmol/L, -0.4 mmol/L. There was a negative association between mean weekly routine plasma potassium levels with mean weekly temperatures achieved. Regression analysis indicated that both maximum temperature achieved and time to centrifugation significantly contributed to differences observed in the routine plasma samples, but not with the routine serum samples. For plasma samples exposed to high temperatures a clinically significant lowering of potassium concentrations can arise. These results confirm that spurious lowering of potassium concentrations occurs in plasma samples collected in a primary care setting. The preferred method is to centrifuge samples soon after venepuncture. Where this is not possible, collection into plain gel-separation tubes (serum) ensures less variation due to temperature and time to centrifugation than does collection into lithium-heparin tubes (plasma).
    Publisher URL
    https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/10615270/
    Note
    The article is available via Open Access. Click on the 'Additional link' above to access the full-text.
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