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. 2021 Jul 28:27:e00252.
doi: 10.1016/j.plabm.2021.e00252. eCollection 2021 Nov.

The "EPiQ"-Study (Evaluation of preanalytical quality): S-Monovette® in manual aspiration mode drastically reduces hemolytic samples in head-to-head study

Laura Millius  1 , Erwin Riedo  1 , Thierry Caron  1 , Juliette Belissent  1 , Benoît Fellay  1 , Vincent Ribordy  1 , Jean-Luc Magnin  1
Affiliations

The "EPiQ"-Study (Evaluation of preanalytical quality): S-Monovette® in manual aspiration mode drastically reduces hemolytic samples in head-to-head study

Laura Millius et al. Pract Lab Med. .

Abstract

Background: Hemolytic blood samples are the number one cause for specimen rejection at emergency departments. Triggered by unsuitable blood sampling material or incorrect handling and a related strong vacuum force, hemolytic samples often must be retaken. The objective of this study was to assess whether correct manual aspiration using S-Monovette® could reduce the number of hemolytic samples.

Methods: Between January and April 2019, a head-to-head study was conducted. Whereas in the first eight weeks, all specimens were collected using Vacutainer®, in the second eight weeks, blood was taken using S-Monovette® in aspiration mode. Specimens were categorized into five classes (0-30, 31-50, 51-75, 76-100, and 101+ mg/dl of cell-free hemoglobin) and for the statistical analyses, all samples exceeding 30 mg/dl were classified as hemolytic.

Results: Data were collected on 4794 blood specimens (Vacutainer®: 2634 samples, S-Monovette®: 2160 samples). While the percentage of non-hemolytic samples (HI of 0-30 mg/dl) was substantially higher for specimens drawn by S-Monovette® (95.7 %) than Vacutainer® (83.0 %), the opposite was true for all HI categories above 30 mg/dl. Importantly, the reduction of hemolytic samples took place immediately following the imposition of S-Monovette® and remained stable at a low level until the end of the study.

Conclusions: Based on our results, we conclude that switching to S-Monovette® in manual aspiration mode in the blood sampling process could be highly beneficial, not only from a financial point of view, but also with regards to reducing unnecessary tasks and stress for nursing staff and improving patient outcome overall.

Keywords: Clinical blood sampling; Hemolysis; Manual aspiration; S-Monovette®.

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Conflict of interest statement

The funding organization played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Figures

Fig. 1
Fig. 1
Simplified process flow of the causal link between the quality of preanalytics and patient outcome.
Fig. 2
Fig. 2
Proportion of hemolytic and non-hemolytic samples in relation to the total number of blood specimens. Across all four hemolytic categories, the proportion of samples was smaller for S-Monovette®. HI = hemolytic index (e.g., HI 1 = 1 mg/dl).
Fig. 3
Fig. 3
Proportion of hemolytic samples (HI > 30) in relation to the total number of blood specimens of a week. Compared to the first eight weeks, the percentage of hemolytic samples is drastically reduced in the second eight weeks. This effect can be observed across all four categories.
See this image and copyright information in PMC

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