What type of tube is used for blood collection, such as plain bottle, C(Complete).EDTA (Ethylene Diamine Tetraacetic Acid), or D(Sodium).Sodium citrate?

From the Guidelines

For blood collection, especially when considering coagulation studies, the most appropriate tube to use is the sodium citrate tube, as it prevents clotting by binding calcium in a specific ratio, making it ideal for tests like PT/INR and PTT, as recommended by recent guidelines 1.

When selecting a blood collection tube, the specific test required is the key factor to consider. The options include:

• Plain tubes (red top) for serum tests like chemistry panels and serological studies
• EDTA tubes (purple top) for complete blood counts and molecular diagnostic tests
• Sodium citrate tubes (blue top) for coagulation studies
• Other specialized tubes like heparin tubes (green top) for plasma chemistry tests, sodium fluoride tubes (gray top) for glucose testing, and specialized tubes for trace elements or other specific analyses.

The correct selection of the blood collection tube is crucial to avoid inaccurate results, sample rejection, and potentially delayed or incorrect diagnosis and treatment. Recent studies emphasize the importance of using the right anticoagulant for the specific test, with sodium citrate being recommended for coagulation studies 1.

It's also important to follow a specific blood draw order to avoid cross-contamination of additives between tubes, as recommended by the Clinical and Laboratory Standards Institute 1. This order includes drawing blood into tubes in the following sequence: blood culture tube, sodium citrate tube, serum tube, heparin tube, EDTA tube, and finally sodium fluoride/potassium oxalate glycolytic inhibitor tube.

Using the wrong tube can lead to significant issues, including inaccurate test results and delayed diagnosis, which can negatively impact patient outcomes in terms of morbidity, mortality, and quality of life. Therefore, adhering to guidelines and recommendations for blood collection tube selection is paramount in clinical practice.

From the Research

Types of Tubes Used for Blood Collection

• Plain bottle: Not specifically mentioned in the provided studies as a recommended tube for blood collection in the context of the question.
• C(Complete).EDTA (Ethylene Diamine Tetraacetic Acid):
  • EDTA is a commonly used anticoagulant for hematological testing, as it allows for the best preservation of cellular components and morphology of blood cells 2.
  • Dipotassium EDTA is recommended as the anticoagulant of choice for blood cell counting and sizing, with a recommended amount of 1.5-2.2 mg per milliliter of blood 3.
• D(Sodium).Sodium citrate:
  • Sodium citrate is used as an anticoagulant for coagulation tests, with a recommended concentration of 3.13-3.2% and a ratio of 1:9 to whole blood 4.
  • It is commonly used in vacuum tubes for coagulation testing, such as prothrombin time (PT) and activated partial thromboplastin time (APTT) 5, 4.

Comparison of Tubes

• The choice of blood collection tube can have a significant effect on the detected metabolites and their overall abundances, with 496 hydrophilic and 242 hydrophobic compounds differing by collection tube 6.
• EDTA and sodium citrate tubes are used for different types of testing, with EDTA used for hematological testing and sodium citrate used for coagulation testing 5, 4, 2.