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

Main Article Content

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

Keywords

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

Abstract

Introduction


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.


Methods


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.


Results


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.


Conclusion


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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References

1. Doeleman MJ, Esseveld A, Huisman A, de Roock S, Tiel Groenestege WM. Stability and comparison of complete blood count parameters between capillary and venous blood samples. International Journal of Laboratory Hematology. 2023;45(5):659-67. doi:10.1111/ijlh.14080
2. Etim NN, Williams ME, Akpabio U, Offiong EE. Haematological parameters and factors affecting their values. Agricultural science. 2014;2(1):37-47. doi:N/A
3. Akorsu EE, Adjabeng LB, Sulleymana MA, Kwadzokpui PK. Variations in the full blood count parameters among apparently healthy humans in the Ho municipality using ethylenediamine tetraacetic acid (EDTA), sodium citrate and lithium heparin anticoagulants: A laboratory-based cross-sectional analytical study. Heliyon. 2023;9(6). doi:10.1016/j.heliyon.2023.e17311
4. Walencik J, Witeska M. The effects of anticoagulants on hematological indices and blood cell morphology of common carp (Cyprinus carpio L.). Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology. 2007;146(3):331-5. doi:10.1016/j.cbpc.2007.04.004
5. Nemec A, Drobnič–Košorok M, Butinar J. The effect of high anticoagulant k3-edta concentration on complete blood count and white blood cell differential counts in healthy beagle dogs. Slovenian Veterinary Research. 2005;42(3/4):65-70. doi:N/A
6. Weiss DJ, Tvedten H. The complete blood count, bone marrow examination, and blood banking: general comments and selected techniques. InSmall animal clinical diagnosis by laboratory methods 2012(pp. 12-37). WB Saunders. doi:10.1016/B978-1-4377-0657-4.00002-8
7. Muhialdeen AS, Ahmed JO, Baba HO, Abdullah IY, Hassan HA, Najar KA, et al. Kscien’s List; A New Strategy to Discourage Predatory Journals and Publishers (Second Version). Barw Medical Journal.2023;1(1):24-26. doi:10.58742/bmj.v1i1.14
8. Lawrence I, Lin K. A concordance correlation coefficient to evaluate reproducibility. Biometrics. 1989:255-68. doi:10.2307/2532051
9. Faggio C, Arfuso F, Piccione G, Zumbo A, Fazio F. Effect of three different anticoagulants and storage time on haematological parameters of Mugil cephalus (Linneaus, 1758). Turkish Journal of Fisheries and Aquatic Sciences. 2014;14(3):615-21. doi:10.4194/1303-2712-v14_3_03
10. Zmigrodzka M, Winnicka A, Guzera M. Comparison of the influence of ADTA-K3 and sodium citrate on haematology analysis in healthy dogs. Polish journal of veterinary sciences. 2012;15(2). doi:10.2478/v10181-012-0059-6
11. Gunawardena D, Jayaweera S, Madhubhashini G, Lokumarakkala DD, Senanayake SJ. Reliability of parameters of complete blood count with different storage conditions. Journal of clinical laboratory analysis. 2017;31(2): e22042. doi:10.1002/jcla.22042
12. Stokol T, Erb HN. A comparison of platelet parameters in EDTA‐and citrate‐anticoagulated blood in dogs. Veterinary Clinical Pathology. 2007 Jun;36(2):148-54. doi:10.1111/j.1939-165X.2007.tb00201.x
13. Lin J, Luo Y, Yao S, Yan M, Li J, Ouyang W, Kuang M. Discovery and correction of spurious low platelet counts due to EDTA‐dependent pseudothrombocytopenia. Journal of clinical laboratory analysis. 2015;29(5):419-26. doi:10.1002/jcla.21818
14. Zhang L, Xu J, Gao L, Pan S. Spurious thrombocytopenia in automated platelet count. Laboratory medicine. 2018;49(2):130-3. doi:10.1093/labmed/lmx081
15. Dima F, Salvagno GL, Danese E, Veneri D, Lippi G. An unusual case of sodium citrate-dependent artifactual platelet count. Interventional Medicine and Applied Science. 2020;11(3):193-6. doi:10.1556/1646.11.2019.24
16. McShine RL, Das PC, Smit Sibinga CT, Brozović B. Effect of EDTA on platelet count and other platelet parameters in blood and blood components collected with CPDA-1. Vox sanguinis. 1991;61(2):84-9. doi:10.1159/000461330
17. Sharif MT, Mahabadi MA, Moshfeghi S, Sharifi H, Hoseini SM, Alavi SM. Artifactual changes in hematological variables in equine blood samples stored at different temperatures and various anticoagulants. Comparative Clinical Pathology. 2012; 21:449-52. doi:10.1007/s00580-010-1116-0
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