Comparison of Two New Plastic Tubes (Sekisui INSEPACK and Green Cross Green Vac-Tube) with BD Vacutainer Tubes for 49 Analytes

Sue-Hyun Oh; Chang-Seok Ki

doi:10.3343/kjlm.2007.27.1.69

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Oh and Ki: Comparison of Two New Plastic Tubes (Sekisui INSEPACK and Green Cross Green Vac-Tube) with BD Vacutainer Tubes for 49 Analytes

Original Article

Korean J Leg Med 2007;27(1):69-75.

Published online: 10 February 2007

DOI: https://doi.org/10.3343/kjlm.2007.27.1.69

Comparison of Two New Plastic Tubes (Sekisui INSEPACK and Green Cross Green Vac-Tube) with BD Vacutainer Tubes for 49 Analytes

Sue-Hyun Oh, M.D., Chang-Seok Ki, M.D.

Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Received 23 August 2006 Revised 31 October 2006 Accepted 31 October 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Becton Dickinson (BD) Vacutainer tubes are the most widely used vacuum system for collection of blood in clinical laboratories. We compared the performance of two new tubes, Sekisui INSEPACK tube and Green Cross Green Vac-Tube, with the existing BD Vacutainer tubes for 49 common analytes.

Methods

A total of 20 apparently healthy volunteers were recruited for this study. For rountine chemistry and thyroid function tests, we compared the results of two new vacutainer tubes and BD Vacutainer tubes with those of BD glass tubes at t = 0 hr by student paired t test. Hematology and coagulation test results of the two new vacutainer tubes were compared with those of BD Vacutainer tubes at t =0 hr. To study the stability of each analyte, results at t = 24±2 hr, t = 72±2 hr, and t=168 ±2 hr were compared with those at t = 0 hr for each tube.

Results

Although paired t test analysis revealed statistically significant differences between two tested tubes and existing BD Vacutainer tube in several tests (total protein, total bilirubin, alkaline phosphatase, glucose, uric acid, calcium, inorganic phosphorus, direct bilirubin, triglyceride, HDL-cholesterol, LDL-cholesterol, lactate dehydrogenase, triiodothyronine, and thyroxine), these differences were not considered clinically significant. Stability of two new vacuum tubes for each analyte was similar to that of the BD Vacutainer tube.

Conclusions

Sekisui INSEPACK tube and Green Cross Green-Vac Tube showed a satisfactory analytical performance compared with existing BD Vacutainer tubes. We conclude that these two new plastic vacutainer tubes are acceptable for the commonly ordered laboratory tests.

Keywords: Vacutainer system, BD Vacutainer, Sekisui INEPACK, Green Cross Green Vac-Tube, Performance, Stability

References

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Table 1.

Evaluated vacutainer tubes and tested analytes

Additives	Brand	Cat. No.	Draw volume	Wall material	Analytes
Serum separating gel clot activator	BD Vacutainer	367989	5 mL	Plastic	total protein, albumin, globulin, A/G ratio, cholesterol, total bilirubin, AST, ALT, ALP, glucose, BUN, Cr, uric acid, calcium, inorganic phosphorus, direct bilirubin, GGT, Na, K, Cl, HCO₃, Fe, UIBC, Mg, hsCRP, TG, HDL-cholesterol, LDL-cholesterol, CK, LD, T3, T4, TSH, free T4
	Sekisui INSEPACK	ST740C	4 mL	Plastic
	Green Cross Green Vac-Tube	GV0225	5 mL	Plastic
EDTA-K2	BD Vacutainer	367844	4 mL	Plastic	WBC, RBC, hemoglobin, hematocrit, MCV, MCHC, RDW, neutrophil (%), lymphocyte (%), monocyte (%), eosinophil (%), basophil (%), ESR
	Sekisui INSEPACK	ST520EK	2 mL	Plastic
	Green Cross Green Vac-Tube	GV0312	2 mL	Plastic
3.2% sodium citrate	BD Vacutainer	366415	4.5 mL	Glass	PT, aPTT
	Sekisui INSEPACK	ST527SC	2.7 mL	Plastic
	Green Cross Green Vac-Tube	GV0512	2.7 mL	Plastic

Abbreviations: A/G, albumin/globulin; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; BUN, blood urea nitrogen; Cr, creatinine; GGT, gamma glutamyltranspeptidase; Na, sodium; K, potassium; Cl, chloride; HCO₃, bicarbonate; Fe, iron; UIBC, unsaturated iron-binding capacity; Mg, magnesium; hsCRP, high-sensitivity C-reactive protein; TG, triglyceride; HDL, high density lipoprotein; LDL, low density lipoprotein; CK, creatine kinase; LD, lactate dehydrogenase; T3, triiodothyronine; T4, thyroxine; TSH, thyroid stimulating hormone; WBC, white blood cell count; RBC, red blood cell count; MCV, mean corpuscular volume; MCHC, mean corpuscular hemoglobin concentration; RDW, red cell distribution width; ESR, erythrocyte sedimentation rate; PT, prothrombin time; aPTT, activated partial thromboplastin time.

Table 2.

Comparing the difference in chemistry test results obtained from glass and three plastic collection tubes at t=0 (mean±SD)

	BD glass	BD Vacutainer	Sekisui INSEPACK	Green Cross Green Vac	P^†	P^‡	P^§
T. protein (g/dL)	7.27±0.34	7.35±0.35	7.34±0.33	7.30±0.32	0.002	<0.001	0.043
Albumin (g/dL)	4.40±0.21	4.42±0.23	4.42±0.23	4.35±0.23	0.125	0.244	0.166
Globulin (g/dL)	2.89±0.34	2.93±0.37	2.92±0.33	2.94±0.37	0.196	0.297	0.083
A/G ratio	1.56±0.19	1.53±0.21	1.53±0.20	1.49±0.21	0.447	0.33	0.062
Chol (mg/dL)	177.9±37.28	179.36±36.40	179.04±36.01	177.77±35.15	0.407	0.525	0.943
T. bilirubin (mg/dL)	0.62±0.9	0.65±0.30	0.65±0.29	0.65±0.30	<0.001	<0.001	<0.001
AST (U/L)	19.43±6.41	19.38±6.92	19.93±6.76	19.59±6.18	0.563	0.049	0.191
ALT (U/L)	18.45±16.73	18.19±15.83	17.99±15.88	18.19±15.84	0.7	0.124	0.199
ALP (U/L)	57.30±16.26	57.85±16.36	57.72±16.58	57.72±16.37	<0.001	0.015	0.009
Glucose (mg/dL)	84.44±9.4	86.25±7.98	86.17±8.97	86.35±8.51	0.023	0.035	0.008
BUN (mg/dL)	11.97±2.31	11.94±2.31	12.10±2.36	11.98±2.26	0.645	0.015	0.843
Cr (mg/dL)	0.86±0.12	0.84±0.12	0.85±0.11	0.86±0.11	0.044	0.921	0.128
Uric acid (mg/dL)	4.73±1.31	4.77±1.33	4.79±1.34	4.78±1.33	0.044	0.026	0.047
Calcium (mg/dL)	8.84±0.32	8.99±0.28	8.99±0.26	8.93±0.26	<0.001	0.003	0.024
IP (mg/dL)	3.09±0.57	3.12±0.56	3.17±0.56	3.13±0.55	0.035	0.001	0.006
D. bilirubin (mg/dL)	0.30±0.15	0.36±0.16	0.36±0.17	0.36±0.16	<0.001	<0.001	<0.001
GGT (U/L)	23.22±19.7	23.53±19.26	23.26±19.64	23.33±19.62	0.094	0.754	0.735
Na (mmol/L)	141.6±1.532	141.51±1.34	141.45±1.30	141.50±1.37	0.495	0.258	0.371
K (mmol/L)	4.05±0.16	4.11±0.20	4.08±0.17	4.12±0.19	0.167	0.175	0.116
Cl (mmol/L)	102.50±1.31	102.53±1.49	102.42±1.46	102.46±1.54	0.765	0.265	0.634
HCO3 (mmol/L)	28.08±2.25	27.89±2.13	27.85±2.06	27.47±2.09	0.296	0.16	0.003
Fe (μg/dL)	109.28±50.27	109.67±50.37	109.45±50.43	109.86±49.89	0.191	0.482	0.018
UIBC (μg/dL)	214.04±56.54	213.25±0.57	216.40±58.14	215.89±57.10	0.603	0.08	0.048
Mg (mg/dL)	2.07±0.13	2.08±0.15	2.12±0.03	2.07±0.13	0.413	<0.001	0.964
hsCRP (mg/dL)	0.04±0.05	0.05±0.05	0.04±0.05	0.04±0.05	0.024	0.349	0.214
TG (mg/dL)	109.97±59.82	111.52±59.99	113.20±60.35	112.97±59.73	0.032	<0.001	0.001
HDL-C (mg/dL)	60.38±12.95	60.80±12.60	61.46±12.85	61.14±12.99	0.009	<0.001	<0.001
LDL-C (mg/dL)	106.36±30.98	108.36±31.84	107.97±31.71	106.50±31.76	0.001	<0.001	0.701
CK (IU/L)	117.08±112.04	117.97±112.63	116.87±110.13	117.14±112.67	0.027	0.729	0.841
LD (U/L)	297.70±52.60	316.15±50.23	313.55±50.87	302.45±51.40	<0.001	<0.001	0.001
T3 (ng/mL)	1.37±0.27	1.50±0.27	1.44±0.30	1.43±0.29	<0.001	0.001	0.003
T4 (μg/dL)	8.23±1.97	8.96±2.18	8.90±2.28	8.71±2.11	<0.001	<0.001	<0.001
TSH (μIU/mL)	1.95±1.22	1.92±1.27	1.96±1.23	1.97±1.28	0.493	0.277	0.518
Free T4 (ng/dL)	1.24±0.14	1.25±0.14	1.25±0.14	1.24±0.12	0.053	0.177	0.297

^* Data are given as mean±SD. Pvalues were determined by using the Student paired t test.

^† Comparison between BD Vacutainer and BD glass tube.

^‡ Comparison between Sekisui INSEPACK and BD glass tube.

^§ Comparison between Green Cross Green Vac-Tube and BD glass tube.

Abbreviations: chol, cholesterol; T. bilirubin, total bilirubin; IP, inorganic phosphorus; D. bilirubin, direct bilirubin; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein cholesterol; See Table 1 for the others.

Table 3.

Comparing the difference in routine hematology and coagulation test results obtained from BD Vacutainer and the two new plastic tubes at t=0 (mean±SD)

	BD Vacutainer	Sekisui INSEPACK	Green Cross Green Vac	P^†	P^‡
WBC (× 10³/μL)	5.39±1.06	5.39±1.03	5.42±1.06	0.899	0.324
RBC (× 100³/μL)	4.58±0.49	4.57±0.48	4.56±0.47	0.179	0.013
Hb (g/dL)	14.19±1.43	14.15±1.43	14.16±1.41	0.057	0.167
Hct (%)	43.01±3.98	43.09±3.96	43.04±3.74	0.364	0.732
MCV (fl)	94.05±4.27	94.51±4.26	94.67±4.28	<0.001	<0.001
MCHC (g/dL)	32.53±2.15	32.82±0.76	32.86±0.91	0.518	0.459
RDW (%)	12.77±0.73	12.77±0.73	12.78±0.73	0.841	0.694
Neutrophil (%)	52.85±8.46	52.69±8.48	52.99±8.52	0.573	0.632
Lymphocyte (%)	38.97±7.46	38.91±7.56	38.56±7.67	0.858	0.250
Monocyte (%)	5.45±1.35	5.52±1.20	5.71±1.35	0.792	0.391
Eosinophil (%)	2.34±1.89	2.43±1.86	2.33±1.69	0.166	0.839
Basophil (%)	0.40±0.21	0.46±0.23	0.43±0.30	0.051	0.412
ESR (mm/hr)	8.60±7.96	7.80±7.49	10.70±9.19	0.061	0.004
PT (sec)	13.64±0.61	13.48±0.55	13.52±0.61	0.001	0.018
aPTT (sec)	36.85±2.24	32.52±2.01	37.18±2.25	<0.001	0.002

^* Data are given as mean ±SD. P values were determined by using the Student paired t test.

^† Comparison between Sekisui INSEPACK and BD Vacutainer tube.

^‡ Comparison between Green Cross Green Vac-Tube and BD Vacutainer tube.

Abbreviations: Hb, hemoglobin; Hct, hematocrit; See Table 1 for the others.

Table 4.

Stability of chemistry and thyroid function tests with the three vacuum tubes on day 1, day 3, and day 7 (% change compared with day 0)

	BD Vacutainer			Sekisui INSEPACK			Green Cross Green Vac-Tube
	Day 1	Day 3	Day 7	Day 1	Day 3	Day 7	Day 1	Day 3	Day 7
T. protein	1.95	1.30	2.24	1.01	−0.46	2.48	0.85	−0.31	2.42
Albumin	1.77	3.11	3.73	2.62	2.02	3.86	3.77	1.45	3.10
Globulin	2.24	−1.92	−0.31	−1.55	−3.90	0.35	−3.38	−2.75	1.70
A/G ratio	−0.79	4.70	4.88	4.86	7.37	5.40	8.34	5.21	3.47
Chol	−0.53	1.99	3.00	−0.32	0.98	2.49	−0.75	0.12	1.68
T. bilirubin	0.36	−2.14	−1.84	0.28	−2.81	−5.51	−1.78	−6.29	−13.17
AST	6.24	12.47	13.03	3.60	5.31	12.22	7.12	4.54	14.73
ALT	−15.5	−2.01	1.41	−10.6	1.30	6.28	−10.2	−4.91	0.01
ALP	1.11	1.68	3.09	0.96	0.87	2.20	0.33	0.36	3.88
Glucose	0.35	0.43	0.66	0.41	0.47	0.31	−1.77	−1.42	−1.97
BUN	2.62	−0.01	2.50	1.06	−2.04	1.50	1.43	−2.67	1.67
Cr	−0.02	−2.20	−1.61	−0.47	−1.80	−1.90	−0.02	−2.39	−1.89
Uric acid	1.21	0.79	2.19	0.31	−0.14	0.51	−0.14	−0.71	−0.45
Calcium	6.10	1.69	2.41	5.53	1.42	0.69	1.27	1.09	0.58
IP	1.77	2.85	6.39	2.43	2.96	5.40	1.69	2.10	−0.31
D. bilirubin	0.77	−4.72	−5.32	0.79	−4.75	−10.44	−3.15	−12.0	−39.9
GGT	−4.29	−1.36	6.66	−1.73	1.19	1.47	−3.00	−0.36	−6.62
Na	0.18	1.25	1.95	0.02	1.09	1.97	−0.06	0.66	1.51
K	0.45	3.41	12.13	0.16	1.59	5.49	0.09	1.38	8.22
Cl	−0.04	0.81	0.90	−0.16	0.66	0.81	0.05	0.14	0.12
HCO₃	−11.1	−22.8	−22.3	−11.4	−22.2	−23.7	−9.8	−20.0	−26.4
Fe	1.39	1.70	−1.47	2.14	2.53	3.07	1.41	1.60	−0.26
UIBC	5.63	4.32	5.33	6.26	4.07	4.76	4.95	4.56	6.05
Mg	−0.22	−1.55	2.02	−1.85	−1.52	0.35	−0.56	−0.01	1.49
TG	3.04	−0.71	8.55	3.37	2.89	5.64	1.54	1.23	5.69
HDL-C	−1.67	−2.26	−7.33	−3.33	−4.09	−7.83	−2.21	−3.72	−6.77
LDL-C	−1.09	2.73	1.20	0.12	0.05	−3.78	0.47	−0.90	0.86
CK	1.09	−0.18	0.64	−0.72	−1.60	−1.10	−1.25	−1.78	−4.75
LD	0.90	−3.13	−8.93	−0.86	−2.53	−8.09	0.26	2.43	2.96
T3	−5.53	−13.11	−1.42	0.24	−11.32	4.64	2.91	−8.38	5.07
T4	−4.22	−2.80	−2.13	−2.86	−2.90	−1.98	−1.21	−0.75	−0.50
TSH	0.98	3.96	15.3	0.87	−0.46	14.79	0.72	−0.77	14.29
Free T4	2.18	0.36	−2.86	1.93	2.45	1.29	1.23	1.63	1.62

Abbreviations: See Table 1, 2.

Table 5.

Stability of hematology and coagulation tests with three vacuum tubes on day 1 and day 3 (% change compared with day 0)

	BD Vacutainer		Sekisui INSEPACK		Green Cross Green Vac-Tube
	Day 1	Day 3	Day 1	Day 3	Day 1	Day 3
WBC	−0.37	−7.79	−0.93	28.57	−2.21	−8.67
RBC	−0.66	0.00	−0.88	−0.22	0.22	0.22
Hb	−0.99	−0.70	−0.35	−0.85	−0.42	−4.45
Hct	0.98	3.00	0.46	2.60	0.98	2.86
MCV	1.84	3.30	0.75	2.84	0.76	2.79
MCHC	−1.91	−2.40	−0.76	−3.41	−1.37	−3.74
RDW	0.00	−0.63	0.00	−0.39	0.55	0.31
Neutrophil	0.49	−5.85	2.03	−3.44	1.02	−8.06
Lymphocyte	−3.00	2.23	−3.88	0.49	−2.10	6.20
Monocyte	67.71	35.41	11.96	26.45	4.03	26.62
Eosinophil	−5.13	2.56	−7.41	0.41	1.29	4.72
Basophil	22.50	55.00	−10.87	32.61	2.33	58.14
ESR	14.53	−17.44	12.82	−13.46	−2.80	−30.84
PT	0.15	4.62	3.71	10.01	5.47	13.09
aPTT	7.57	15.96	17.07	24.78	10.65	21.57

Abbreviations: See Table 1, 3.

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