From the Guidelines
To prevent clumped platelets, a tube containing acid citrate dextrose solution A, such as a BD yellow top vacutainer tube, is used for blood collection, as it inhibits platelet aggregation and prevents platelet clumping. This type of tube is specifically designed to prevent platelet activation and aggregation, making it ideal for blood samples that require platelet studies or coagulation tests 1. The use of acid citrate dextrose solution A as an anticoagulant is a standard practice in blood collection, as it effectively prevents platelet clumping and ensures accurate results.
- Key considerations when using this type of tube include:
- Filling the tube to the recommended volume to ensure proper dilution of the sample with the anticoagulant
- Avoiding excessive agitation of the tube, as it can cause platelet activation
- Using a standardized venipuncture kit and procedure to minimize variability in blood collection
- Drawing blood into the tube using a 21-gauge needle, as used in the study 1 It's worth noting that while sodium citrate tubes are also commonly used for coagulation tests, the most recent and highest quality study 1 recommends the use of acid citrate dextrose solution A for preventing platelet clumping.
From the FDA Drug Label
INDICATIONS AND USAGE Anticoagulant Sodium Citrate 4% w/v Solution, USP is intended for use only with automated apheresis devices. The tube used to prevent clumped platelets is not specified in the provided drug label. Sodium citrate is an anticoagulant, but the label does not directly answer the question about the type of tube used to prevent clumped platelets 2.
From the Research
Types of Tubes to Prevent Clumped Platelets
- EDTA tubes are commonly used to prevent clot formation and maintain blood in a fluid state for hematological testing 3
- Sodium citrate tubes are widely used for hemostasis investigations, but may not be suitable for platelet function testing due to potential platelet aggregation 4
- Alternative anticoagulants such as hirudin have been suggested for platelet function testing, but more research is needed to confirm their superiority 4
- Amikacin can be added to blood to reduce the fall in platelet count and prevent pseudothrombocytopenia, a spurious phenomenon caused by anticoagulant-induced platelet aggregation 5
- MgSO4 tubes have been recommended for platelet counting in cases of EDTA-induced pseudothrombocytopenia, but agitation of these tubes can lead to a decrease in platelet counts due to platelet aggregate formation 6
Pre-Analytical Considerations
- Gentle agitation of EDTA tubes has minimal impact on platelet counts, but agitation of citrate or MgSO4 tubes can lead to significant decreases in platelet counts 6
- Sodium citrate and MgSO4 tubes should be handled carefully during transport to avoid shaking and potential platelet aggregate formation 6
- Sodium tetraphenylborate testing can be used to quickly and reliably distinguish EDTA-treated from citrated plasma samples, which is important for coagulation testing 7