medigraphic.com
SPANISH

Acta Médica de Cuba

ISSN 1561-3186 (Electronic)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2021, Number 1

<< Back Next >>

Rev Acta Médica 2021; 22 (1)

Importance of the preanalytical phase for the clinical laboratory

Suardíaz EME, Aguirre GJ, Garciarena PQ, Alonso RCÁ
Full text How to cite this article

Language: Spanish
References: 48
Page:
PDF size: 173.23 Kb.


Key words:

preanalytical phase, blood specimen collection by venipuncture, clinical laboratory, lab results.

ABSTRACT

Introduction: The pre-analytical phase encompasses all the procedures before the start of laboratory testing. This phase of the testing process is responsible for the majority of the laboratory errors, since the related procedures involve many sorts of non-laboratory professionals working outside the laboratory setting, thus without direct supervision by the laboratory staff.
Objetive: The aim of this paper addressed to healthcare professionals is to highlight the importance of blood specimen management (from patient preparation to laboratory analyses), as a tool to prevent laboratory errors.
Methods: The review on this matter, including official documents of several international organizations of Clinical Lab, there is a consensus on those subjects that, although information and preparation of patients, the correct organization or management of both personnel and procedures that regard blood specimen collection by venipuncture are of fundamental importance, since the various steps for performing blood collection represent per se sources of laboratory variability.
Conclusions: Laboratory results from inappropriate blood specimens are inconsistent and do not allow proper treatment nor monitoring of the patient.


REFERENCES

  1. Izaguirre Ascargorta M; Fernández Landázuri S; Mugueta Uriaque C; Martínez Espartosa D; González Hernández Á. Evaluación y comparación de métodos. En: González Hernández A. Principios de bioquímica clínica y patología molecular. 3.ª edición, España: Elsevier 2019. Cap. 4; pp 33-39.

  2. Manso Guadarrama LL; Moré Chang CX; Pérez de Alejo Rodríguez L. Constancia en la labor educativa del método clínico vs la utilización del laboratorio clínico. EDUMECENTRO. 2015[acceso:7/8/2020];7(4):235-40. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2077- 28742015000400018&nrm=iso

  3. Hernández Betancourt Jenny de la C, Serrano Barrera OR. Consideraciones sobre la integración del laboratorio al método clínico. Medisur. 2016[acceso:7/8/2020];14(5):600-4. Disponible en: http://medisur.sld.cu/index.php/medisur/article/view/3199/2142

  4. Trimiño Galindo L, Padrón Ramos MJ, Guardarrama Linares L, García Cuervo D, Rubiera García JM. Método clínico vs laboratorio clínico. Rev Med Electrón. 2011[acceso:5/11/2020];33(6):795-806. Disponible en: http://www.revmatanzas.sld.cu/revista%20medica/ano%202011/ vol6%202011/tema14.htm

  5. Schultze AE, Irizarry AR. Recognizing and reducing analytical errors and sources of variation in clinical pathology data in safety assessment studies. Toxicol Pathol. 2017[acceso:7/8/2020];45(2):281-7. Disponible en: https://journals.sagepub.com/doi/full/10.1177/0192623316672945

  6. Lundberg GD. Acting on significant laboratory results. JAMA. 1981;245(17):1762– 3. DOI: https://doi.org/10.1001/jama.1981.03310420052033

  7. Plebani M, Lippi G. Closing the brain-to-brain loop in laboratory testing. Clin Chem Lab Med. 2011[acceso:5/10/2020];49(7):1131–3. Disponible en: https://www.researchgate.net/publication/51209976

  8. Carberry AR, Hanson K, Flannery A, Fischer M, Gehlbach J, Diamond C, et al. Diagnostic error in pediatric cancer. Clin Pediatr (Phila). 2018; [acceso:7/8/2020];57:11-8. Disponible en: https://journals.sagepub.com/doi/abs/10.1177/0009922816687325

  9. Laposata M, Cohen MB. It’s our turn: implications for pathology from the institute of medicine’s report on diagnostic error. Arch Pathol Lab Med. 2016[acceso:20/11/2020];140(6):505-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26756648/

  10. Lippi G, Banfi G, Buttarello M, Ceriotti F, Daves M, Dolci A, et al. Recommendations for detection and management of unsuitable samples in clinical laboratories. Clin Chem Lab Med. 2007[acceso:20/11/2020];45(6):728–36. Disponible en: https://www.researchgate.net/publication/6256773

  11. Lippi G, Chance JJ, Church S, Dazzi P, Fontana R, Giavarina D, et al. Preanalytical quality improvement: from dream to reality. Clin Chem Lab Med. 2011[acceso:5/10/2020];49(7):1113–26. Disponible en: https://www.researchgate.net/publication/51074691

  12. Narayanan S, Guder WG. Preanalytical variables and their influence on the quality of laboratory results. eJIFCC 2017[acceso:7/8/2020];13(1):9-12. Disponible en: http://www.ifcc.org/ejifcc/ vol13no1/1301200107.htm

  13. Lippi G, Banfi G, Church S, Cornes M, De Carli G, Grankvist K, et al. Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM). Working group for Preanalytical Phase (WG-PRE). Clin Chem Lab Med 2015[acceso:7/8/2020];53(3):357–70. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25490032/

  14. Lippi G. Governance of preanalytical variability: travelling the right path to the bright side of the moon? Clin Chim Acta 2009[acceso:7/8/2020];404(1):32–6. Disponible en: https://pubmed.ncbi.nlm.nih. gov/19302993/

  15. Simundic AM. Preanalytical phase – an updated review of the current evidence. Biochem Med (Zagreb). 2014;24:6. DOI: http://dx.doi.org/10.11613/BM.2014.005

  16. Haverstick DM, Grosbach A. Specimen collection, Processing and Other Preanalytical Variables. In: Burtis CA, Bruns DE, eds. Tietz textbook of clinical chemistry and molecular diagnostics. USA, St. Louis: Elsevier, 2016. pp 72-88.

  17. Kiechle FL, Ed. So you’re going to collect a blood specimen: an introduction to phlebotomy. 14th ed. Northfield, Ill: College of American Pathologists, 2013. pp 12- 48.

  18. Robb J A; Bry L; Sluss PM; Wagar EA; Kennedy MF. College of American Pathologists Diagnostic Intelligence and Health Information Technology Biorepository Working Group. A Call to Standardize Preanalytic Data Elements for Biospecimens, Part II Arch Pathol Lab Med. 2015;139(9):1125-8. DOI: https://doi.org/10.5858/arpa.2014-0572-CP

  19. Kackov S, Simundic AM, Gatti Drnic A. Are patients well informed about the fasting requirements for laboratory blood testing? Biochem Med (Zagreb) 2013;23(3):326-31. DOI: https://doi.org/10.11613/BM.2013.040

  20. Lima Oliveira G, Volanski W, Lippi G, Picheth G, Guidi GC. Preanalytical phase management: a review of the procedures from patient preparation to laboratory analysis. Scand J Clin Lab Invest 2017;77(3):153-63. DOI: https://doi.org/10.1080/00365513.2017.1295317

  21. Cornes MP, Church S, van Dongen Lases E, Grankvist K, Guimarães JT, Ibarz M, et al. Working Group for Preanalytical Phase (WG-PRE) and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe. Ann Clin Biochem 2016;53(5):539-47. DOI: https://doi.org/10.1177/0004563216643969

  22. Lippi G, Banfi G, Church S, Cornes M, De Carli G, Grankvist K,et al. Preanalytical quality improvement. In pursuit of harmony, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE). Clin Chem Lab Med. 2015[acceso:23/11/2020];53:357-70. Disponible en: https://pubmed.ncbi.nlm.nih.gov /25490032/

  23. Benozzi SF, Unger G, Pennacchiotti GL. Fase preanalítica en un laboratorio clínico de Argentina. ¿Cómo se instruye a los pacientes para sus análisis de sangre? Revista Electrónica de Ciencias de Laboratorio Clínico para Latinoamérica, España y Portugal. Diagnóstico in vitro. 2017[acceso:20/11/2020];5(6):39-46. Disponible en: https://www.researchgate.net/publication/317358931

  24. Lippi G, Salvagno GL, Lima-Oliveira G, Brocco G, Danese E, Guidi GC. Postural change during venous blood collection is a major source of bias in clinical chemistry testing. Clin Chim Acta. 2015;440:164-8. DOI: http://dx.doi. org/10.1016/j.cca.2014.11.024

  25. Lippi G, Salvagno GL, Lima Oliveira G, Danese E, Favaloro EJ, Guidi GC. Influence of posture on routine hemostasis testing. Blood Coagul Fibrinolysis 2015;26(6):716-9. DOI: http://dx.doi.org/10.1097/MBC.0000000000000326

  26. World Health Organization (WHO) guidelines on drawing blood: best practices in phlebotomy: WHO Press. 2010[acceso:23/11/2020]:125. Disponible en: htpps://apps.who.int/iris/handle/10665/44294

  27. Nikolac N, Simundic AM, Kackov S, Serdar T, Dorotic A, Fumic K, et al. The quality and scope of information provided by medical laboratories to patients before laboratory testing: Survey of the Working Group for Patient Preparation of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Clin Chim Acta. 2015;450:104-9. DOI: https://doi.org/10.1016/j.cca.2015.08.001

  28. Nikolac N, Simundic AM, Ichimura M, Sasaki S, Mori M, Ogino T. Tapping but not massage enhances vasodilation and improves venous palpation of cutaneous veins. Acta Med Okayama. 2015;69(2):79-85. DOI: https://doi.org/10.18926/AMO/53336

  29. Lima Oliveira G, Lippi G, Salvagno GL, Montagnana M, Manguera CL, Sumita NM, et al. New ways to deal with known preanalytical issues:use of transilluminator instead of tourniquet for easing vein access and eliminating stasis on clinical biochemistry. Biochem Med (Zagreb). 2011;21(2):152-9. DOI: http://dx.doi.org/10.11613/BM.2011.024

  30. Nikolac N, Supak Smolcic V, Simundic AM, Celap I, Croatian Society of Medical B, Laboratory M. Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling. Biochem Med (Zagreb). 2013;23(3):242-54. DOI: http://dx.doi.org/10.11613/BM.2013.031

  31. Simundic AM, Church S, Cornes MP, Grankvist K, Lippi G, Nybo M, et al. Compliance of blood sampling procedures with the CLSI H3-A6 guidelines: An observational study by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Working group for the preanalytical phase (WG-PRE). Clin Chem Lab Med. 2015;53:1321-31. DOI: http://dx.doi.org/10.1515/cclm-2014- 1053

  32. Alcaraz Quiles J, Rico Santana N, Bedini Chesa JL. Estabilidad de 27 magnitudes bioquímicas en muestras de suero conservadas en refrigeración. Rev Lab Clin. 2014;7(1):9-16. DOI: http://dx.doi.org/10.1016/j.labcli.2014.02.003

  33. Ialongo C, Bernardini S. Phlebotomy, a bridge between laboratory and patient. Biochem Med (Zagreb). 2016;26(1):17–33. DOI: https://doi.org/10.11613/BM.2016.002

  34. Ialongo C, Bernardini S. Preanalytical investigations of phlebotomy: methodological aspects, pitfalls and recommendations. Biochem Med (Zagreb). 2017;27(1):177-91. DOI: https://doi.org/10.11613/BM.2017.020

  35. Lippi G, Baird GS, Banfi G, Bölenius K, Cadamuro J, Church S, et al. Improving quality in the preanalytical phase through innovation, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE). Clin Chem Lab Med. 2017;55(4):489–500. DOI: https://doi.org/10.1515/cclm-2017-0107

  36. Ferraro S, Braga F, Panteghini M. Laboratory medicine in the new healthcare environment. Clin Chem Lab Med. 2016;54(4):523-33. DOI: https://doi.org/10.1515/cclm-2015-0803

  37. Orth M, Averina M, Chatzipanagiotou S, Faure G, Haushofer A, Kusec V, et al. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy (‘4P medicine’). J Clin Pathol. 2019;72:191-7. DOI: https://doi.org/10.1136/jclinpath- 2017-204734

  38. American Association for Clinical Chemistry (AACC). Lab Tests Online. [acceso:7/8/2020]. Disponible en: https://labtestsonline.org/. https://www.aacc.org/advocacy-and-outreach/lab-tests-online

  39. Pérez JAC, Argente R. Gestión de laboratorios. In: José Luis TM, Mercedes Mengíbar T. eds. Gestión hospitalaria. McGraw-Hill. 2020[acceso:7/8/2020];30. Disponible en: https://accessmedicina.mhmedical.com/ content.aspx? bookid= 1492§ionid=98858383

  40. Killeen AA, Anthony A. Laboratorio clínico en la atención médica moderna. Capítulo 480e In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J, et al. Eds. Principios de Medicina Interna, McGraw-Hill; 2020[acceso:7/8/2020]:480e. Disponible en: https://accessmedicina.mhmedical.com/content.aspx?bookid=1717§ionid=114 944602

  41. Carmona EE. Los exámenes de Laboratorio Clínico en el siglo XXI: ¿a favor o en contra del método clínico? Gaceta Médica Espirituana. 2017[acceso:7/8/2020];12(3):2010. Disponible en: http://revgmespirituana.sld.cu/index.php/gme/article/view/1546

  42. Moreno Rodríguez MA. ¿Análisis Complementarios vs. Método Clínico? Revista Habanera de Ciencias Médicas. 2014;13(5):650-6. Disponible en: http://www.medigraphic.com /pdfs/revhabciemed/hcm-2014/hcm145a.pdf

  43. Harvey Y. Abnormal full blood count in the asymptomatic patient. Common sense pathology. Clin Biochem. 2019[acceso:23/11/2020];1(12):16. Disponible en: https://www.researchgate.net/publication/ 345859531

  44. Plebani M. Towards a new paradigm in laboratory medicine: the five rights. Clin Chem Lab Med. 2016;4:1881-91. DOI: https://doi.org/10.1515/cclm-2016-0848

  45. Masood, A and Karim, MI. The Clinical Approach on Receipt of an Unexpected Laboratory Test Result. International Journal of General Medicine. 2020;13:969-76. DOI: http://doi.org/10.2147/IJGM.S269299

  46. Mrazek C; Lippi M; Keppel MH; Felder TK; Oberkofler H; Haschke Becher E; Cadamuro J. Errors within the total laboratory testing process, from test selection to medical decision-making. A review of causes, consequences, surveillance and solutions. 2020;30(2):020502. DOI: https://doi.org/10.11613/BM.2020.020502

  47. Sonmez C, Yıldız U, Akkaya N, Taneli F. Cureus. Preanalytical Phase Errors: Experience of a Central Laboratory. 2020;12(3):e7335. DOI: https://doi.org/10.7759/cureus.7335

  48. Cornes M, van Dongen Lases E, Grankvist K, Ibarz M, Kristensen G, Lippi G, et al. Working Group for Preanalytical Phase (WG-PRE). Order of blood draw: Opinion Paper by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM). Clin Chem Lab Med. 2017;55(1):27-31. DOI: https://doi.org/10.1515/cclm- 2016-0426




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Acta Médica. 2021;22