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  • Title: Preanalytical errors in ionized calcium measurements induced by the use of liquid heparin.
    Author: Sachs C, Rabouine P, Chaneac M, Kindermans C, Dechaux M, Falch-Christiansen T.
    Journal: Ann Clin Biochem; 1991 Mar; 28 ( Pt 2)():167-73. PubMed ID: 1859155.
    Abstract:
    The use of heparin in a liquid form to measure ionized calcium (Ca++) in plasma or whole blood can induce preanalytical errors by dilution and by changing the original Ca++ value by binding or by re-equilibration with calcium in the anticoagulant solution. To quantify these errors, Ca++ was measured on serum pools under different sampling conditions. Incomplete syringe filling and specimen volume/syringe nominal volume ratio effects were tested. Syringes were rinsed with saline to yield pure dilution effects, with sodium heparinate to study binding and with calcium-titrated heparinate to evaluate 'calcium-distortion'. Detailed tables provide percentage error values for all sampling conditions. Dilution errors could reach -5% and binding was always important (-14 to -50%). Distortion was minimal around 1.25 mmol/L but could reach -4% for high and +8% for low Ca++ values. Errors increased when syringes were not filled to their nominal volume, especially with small-sized specimens.
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