Variation in Parameters of Complete Blood Count Using Ethylene Diamine Tetra Acetic Acid (EDTA), Sodium Citrate and Lithium Heparin: A Cross-Sectional Study

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Sharaza Qadir Omer
Rawezh Q. Salih
Shvan Luqman Ezzat
Dahat A. Hussein
Ayman M. Mustafa
Aga Khdir Hamad
Hawnaz Salih Abdullah
Bayan Aziz Saeed
Shahid Salah Rashid
Sangar Jum’a
Mohammed Hassan Sofi


Complete blood count , EDTA , Sodium citrate , Lithium heparin, Parameters



The primary anticoagulants utilized in hematology are ethylene diamine tetra acetic acid (EDTA), lithium heparin, and citrate. Although various studies have investigated their impact on complete blood count (CBC) in various animals, limited data are available concerning humans. This study explores the differences in CBC parameters when using these anticoagulants.


This study was a cross-sectional study comprising 250 participants who underwent CBC tests with different anticoagulants. Blood samples were examined using the Medonic M51. Statistical analyses, including one-way ANOVA, intra-class correlation coefficient, and concordance correlation coefficient, were employed as applicable, with significance level set at p-values <0.05.


One hundred eight participants (43.2%) were male, and 142 (56.8%) were female, with a mean age of 40.88±17.06 years ranging from 7 to 91 years.  Comparing K2EDTA with lithium heparin, comparable values were found in 14 out of 23(60.87%) CBC parameters, while citrate showed similar results in 13(56.52%) parameters. Using K2EDTA as the standard, citrate showed perfect or substantial agreement in assessing 9 out of 23 CBC parameters (39.13%). Similarly, Lithium heparin showed perfect or substantial agreement in determining 9 out of 23(39.13%) parameters. Compared to K2EDTA, lithium heparin exhibited high precision and accuracy in estimating 13 out of 23(56.52%) CBC parameters. In contrast, citrate was accurate in 9 out of 23(39.13%) parameters.


Using citrate instead of K2EDTA for CBC estimation may yield inaccurate outcomes, whereas lithium heparin could serve as an alternative anticoagulant, requiring careful monitoring.

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