Use of sodium citrate anticoagulant for routine hematology analysis on the CELL-DYN® 4000: An opportunity to enhance efficiency in the clinical laboratory


Blood from 67 sophomore medical students was used to evaluate differences in complete blood count (CBC) normal ranges in specimens collected in either liquid tripotassium ethylene diamine tetraacetic acid (EDTA) or liquid trisodium citrate and analyzed by the Abbott CELL-DYN 4000 hematology system (Abbott Diagnostics, Abbott Park, IL). The data support the premise that citrate is a suitable anticoagulant for routine CBC analysis provided that a dilution correction factor for counts, hematocrit, and hemoglobin is applied automatically, either as a built-in algorithm in the software of the cell counter or of the laboratory information system. Once the corrections were made, the results showed excellent agreement between the two anticoagulants. In addition, peripheral blood smears prepared from citrated blood showed good morphology. Overall, the data demonstrate the suitability of performing a CBC with a citrated specimen, once it has been corrected for the dilution. This observation could facilitate the adaptation of one tube for two major analyses hematology and coagulation parameters), especially considering the advances in informatics and robotics technology. Immediate operational efficiencies could be realized throughout the testing process. Some would generate cost savings by eliminating the EDTA tube for routine CBC testing. Other savings could be generated in the pre-analytical phase, principally in the specimen collection process because fewer tubes and labels, and decreased sorting, routing, and phlebotomy time would be required. The authors suggest that larger and more thorough studies be performed to ascertain that these findings in citrated samples are valid across a broad spectrum of hematology conditions, and that they can be easily generated in the evolving and reconfigured laboratory operations.

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