Differences in Activated Partial Thromboplastin Time (APTT) measures depending on the device used in blood samples drawn (direct Vacutainer® versus Butterfly needle): A Randomized Comparative Study

  • Ana Belen Friginal Hospital Virgen de Altagracia.Manzanares. Ciudad Real.
  • Ángel Arias Hospital Mancha Centro.Ciudad Real.
  • Bolívar L. Díaz-Jordán Hospital Virgen de Altagracia. Manzanares, Ciudad Real.
  • Ana Rosa López-Quiñones Hospital Virgen de Altagracia. Manzanares.Ciudad Real.
  • M José Romero-Pino Hospital Virgen de Altagracia.Manzanares.Ciudad Real.
  • Alfredo J Lucendo Departamento de Digestivo.Hospital General de Tomelloso.Tomelloso.Ciudad Real.
Keywords: Activated partial thromboplastin time, Phlebotomy, Quality control, Blood Specimen Collection, Pre-analytical quality, Laboratory techniques and procedures

Abstract

 

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 Vacutainer® versus butterfly needle). 

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 vacuntainer® or butterfly needle first) were randomly established.

Results. 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 vacutainer® (34.01 ± 4.4 vs. 33.63 ± 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

Author Biographies

Ana Belen Friginal, Hospital Virgen de Altagracia.Manzanares. Ciudad Real.

Registered Nurse.División of Hematology. Hospital Virgen de Altagracia.

Ángel Arias, Hospital Mancha Centro.Ciudad Real.

BSc, MSc. Research Support Unit. Hospital Mancha Centro. Alcázar de San Juan, Ciudad Real. Spain

Bolívar L. Díaz-Jordán, Hospital Virgen de Altagracia. Manzanares, Ciudad Real.
MD. División of Hematology. Hospital Virgen de Altagracia.Manzanares.
Ana Rosa López-Quiñones, Hospital Virgen de Altagracia. Manzanares.Ciudad Real.

MD. División of Hematology. Hospital Virgen de Altagracia.Manzanares.

 

M José Romero-Pino, Hospital Virgen de Altagracia.Manzanares.Ciudad Real.

MD. División of Hematology. Hospital Virgen de Altagracia.Manzanares.

 

Alfredo J Lucendo, Departamento de Digestivo.Hospital General de Tomelloso.Tomelloso.Ciudad Real.

Department of Gastroenterology. Hospital General de Tomelloso. Tomelloso, Ciudad Real, Spain

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain

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Published
2019-11-24
How to Cite
Friginal, A. B., Arias Ángel, Díaz-JordánB. L., López-QuiñonesA. R., Romero-Pino, M. J., & Lucendo, A. J. (2019). Differences in Activated Partial Thromboplastin Time (APTT) measures depending on the device used in blood samples drawn (direct Vacutainer® versus Butterfly needle): A Randomized Comparative Study. International Journal of Nursing, 5(1). Retrieved from https://www.ijnonline.com/index.php/ijn/article/view/433
Section
Nursing Research