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A study to determine the minimum volume of blood necessary to be discarded from a central venous catheter before a valid sample is obtained in children with cancer

Lookup NU author(s): Mike Cole, Annie Parry, Dr Michael Reid, Professor Alan Boddy, Professor Gareth Veal

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Abstract

Background. The objective of this study was to determine the minimum volume of blood that should be discarded from a range of different types of central venous catheter (CVC), such that the subsequent blood sample was not diluted or contaminated by the residual intra-luminal fluid. Procedure. Seventy children aged 1-19 years with central venous access inserted as part of their standard clinical treatment were recruited to this prospective study. Statistical comparison of the extent of variation in biochemical and haematological parameters observed between two blood samples taken following routine 5 ml discard blood volumes, as compared to the extent of variation between samples drawn following a 5 ml discard volume and <5 ml volumes, was carried out. Results. Data indicate that the measurement error in a clinical sample obtained following a 3 ml discard volume is no different to the measurement error obtained when using a standard 5 ml discard volume. Comparable results were obtained from patients with various different types of CVC or portacath access. Conclusions. The withdrawal of a 3 ml discard volume is sufficient to ensure that the subsequent blood sample is not diluted or contaminated by residual intra-luminal fluid. This may have a significant clinical impact in paediatric oncology, where patients frequently require blood transfusions due to the haematological toxicities associated with chemotherapy. It is hoped that these results will impact on hospital policies concerning specified discard volumes taken from CVCs prior to the withdrawal of blood samples for research purposes and routine clinical analysis. © 2006 Wiley-Liss, Inc.

Publication metadata

Author(s): Cole M, Price L, Parry AP, Picton S, Waters F, Marshall S, Goran C, Parnham A, Wastell H, Reid M, Pearson ADJ, Boddy AV, Veal GJ

Publication type: Article

Publication status: Published

Journal: Pediatric Blood and Cancer

Year: 2007

Volume: 48

Issue: 7

Pages: 687-695

Print publication date: 15/06/2007

Date deposited: 04/08/2010

ISSN (print): 1545-5009

ISSN (electronic): 1545-5017

Publisher: Wiley-Blackwell

URL: http://dx.doi.org/10.1002/pbc.20873

DOI: 10.1002/pbc.20873

PubMed id: 16676305

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