Effect of luer-lock access device on hemolysis during blood collection via intravenous catheters in the emergency department

Abstract Objectives Emergency departments are the units where hemolysis is most frequently observed, and blood collection from intravenous catheters increases the hemolysis rate. This study aimed to compare the effects of two different blood collection methods from an intravenous catheter (an adapter and a syringe) on serum indices, complete blood count, and routine clinical chemistry tests in an emergency department. Methods The study encompassed 104 patients from the yellow and green zones of the Emergency Department at Canakkale Onsekiz Mart University Hospital. Blood samples were obtained from an intravenous catheter with a standard syringe and an adapter into serum separator tubes and dipotassium ethylenediaminetetraacetic acid (K 2 EDTA) tubes. Serum index, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), potassium, high-sensitivity (hs) Troponin T, and complete blood count were evaluated. Passing-Bablok regression analysis was performed, and the mean percentage difference was calculated and compared to target values via a Bland-Altman plot. Results A statistically higher hemolysis rate was observed when blood was collected with a syringe, compared to collecting blood with an adapter (p<0.001). When the results were categorized according to the parameter-specific hemolysis index, AST, CK, potassium, LDH, and hs Troponin T results were more affected by hemolysis when blood was collected with a syringe (p<0.001). The mean percentage difference for AST and LDH exceeded the minimum target values based on biological variation. Conclusions Using a catheter-compatible adapter in emergency departments may reduce the rate of hemolysis and provide reliable results for tests frequently affected by hemolysis.