What is the proper procedure for dividing blood into aliquots for a 9-month-old child?

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Blood Aliquoting Procedure for a 9-Month-Old Child

Transfer blood from the collection tube to an intermediary conical tube after centrifugation, mix thoroughly by inverting 8-10 times, then aliquot 250 μL to 1 mL volumes into labeled cryovials with O-ring-sealed screw caps. 1

Critical Pre-Aliquoting Steps

Centrifugation and Initial Processing

  • Centrifuge blood collection tubes for 10 minutes at 1500 to 2000 × g at 4°C 1
  • For plasma collection (EDTA or heparin tubes): Immediately after blood draw, gently invert tubes 8-10 times, then centrifuge within 2 hours 1
  • For serum collection: Allow blood to clot upright at room temperature for 30-60 minutes before centrifugation 1

Transfer to Intermediary Tube

  • Use a disposable transfer pipette to carefully transfer the plasma or serum (top layer) to a 15 mL conical tube, avoiding disturbance of the buffy coat layer or red blood cells 1
  • This intermediary step is essential because direct aliquoting from blood collection tubes after centrifugation leads to heterogeneity among aliquots due to centrifugation forces 1
  • Leave the bottom ~10% of plasma/serum behind to prevent cross-layer contamination 1

Aliquoting Procedure

Mixing for Homogeneity

  • Before aliquoting, gently invert the conical intermediary tube 8-10 times to ensure homogeneous distribution 1
  • Alternatively, pipette up and down multiple times to achieve uniform mixing 1
  • This mixing step is critical to prevent heterogeneity among aliquots 1

Volume and Container Specifications

  • Aliquot 250 μL to 1 mL volumes into labeled microtubes or cryovials with O-ring-sealed screw caps 1
  • Use printed labels or barcodes rather than handwritten labels to avoid sample mix-up 1
  • Label tubes in advance of the blood collection visit 1

Storage

  • Store all aliquots upright in a specimen box in an -80°C or colder freezer 1
  • Aliquoting minimizes the impact of freeze/thaw cycles on sample quality 1

Pediatric-Specific Considerations

Blood Volume Context

  • Estimated blood volume in a 9-month-old infant is approximately 80-100 mL/kg 2
  • For a typical 9-month-old weighing 8-9 kg, total blood volume is approximately 640-900 mL
  • Blood culture volumes for this age/weight should be 1-1.5 mL per bottle 3
  • Each 10 mL of blood loss represents a clinically significant proportion of total blood volume in infants 4

Safety and Quality Control

  • Always use proper personal protective equipment (PPE) as all blood samples should be considered potentially infectious 1
  • Inspect samples for hemolysis using a reference chart (such as CDC Hemolysis Reference Palette), as hemolysis significantly deteriorates sample quality 1
  • Good pipetting skills are essential: gently draw liquid from the top and gradually move the pipette down with the liquid 1

Common Pitfalls to Avoid

  • Never aliquot directly from blood collection tubes after centrifugation without first transferring to an intermediary tube and mixing 1
  • Avoid disturbing the buffy coat (whitish middle layer) or red blood cell layer when pipetting 1
  • Do not include personal information on specimen labels to protect confidentiality 1
  • Avoid prolonged delays: blood should be centrifuged within 2 hours of collection and stored at 4°C if immediate processing is not possible 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Management of Neonatal Bleeding

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

The correct blood volume for paediatric blood cultures: a conundrum?

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2020

Guideline

Blood Loss Estimation

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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