Different manufacturers of syringes: A new source of variability in blood gas, acid-base balance and related laboratory test?

Objective: Evaluate whether four different brands/types of heparin coated syringes can represent a source of variability in blood gas analysis (BGA). Design and methods: Blood was collected from one hundred volunteers into different syringes: Syringe I (lithium heparin and calcium balanced); Syringe II: in-house prepared (sodium heparin); Syringe III: (spray-dried calcium-balanced lithium heparin); Syringe IV (lyophilized electrolyte-balanced lithium heparin). Results: Significant differences were as follows: a) Syringe I vs II: pO(2), sO(2), pCO(2)(t), cHCO(3)(-), ctCO(2), base excess (BE), total hemoglobin (tHb), sodium (Na+), potassium (K+), calcium (Ca2+), glucose (Glu), lactate (Lac), O-2 Hb and p 50; b) Syringe I vs III: pH, pO(2), cHCO(3)(-), ctCO(2), BE, Na+, Glu, Lac and p 50; c) Syringe I vs IV: pH, pO(2), sO(2), pCO(2)(t), BE, Na+, K+, Ca2+, Glu, Lac and O-2 Hb; d) Syringe II vs III: pH, pO(2), sO(2), pCO(2)(t), cHCO(3)(-), ctCO(2), ctO(2), tHb, Na+, K+, Ca2+, Lac, and p 50; e) Syringe II vs IV: pH, pO(2), sO(2), pCO(2)(t), cHCO(3)(-), ctCO(2), BE, tHb, Na+, K+, Ca2+, Lac, O-2 Hb and p 50; f) Syringe III vs IV: pH, pO(2), sO(2), cHCO(3)(-), ctCO(2), ctO(2), BE, Na+, K+, Ca2+, O-2 Hb and p 50. Conclusion: The different manufacturers of syringes can represent new source of variability on BGA. (C) 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.