Comparison between V-Tubes and BD Vacutainer Tubes for Use in Laboratory Tests

Eun Jeong Won; Myung-Geun Shin; Min-Joong Jang; Duck Cho; Seung-Jung Kee; Soo-Hyun Kim; Jong Hee Shin; Yonggwan Won; Dong-Wook Ryang; Soon-Pal Suh

doi:10.3343/lmo.2013.3.3.145

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Won, Shin, Jang, Cho, Kee, Kim, Shin, Won, Ryang, and Suh: Comparison between V-Tubes and BD Vacutainer Tubes for Use in Laboratory Tests

Original Article

Diagnostic Immunology

Laboratory Medicine Online 2013; 3(3): 145-154.

Published online: 3 July 2013

DOI: https://doi.org/10.3343/lmo.2013.3.3.145

Comparison between V-Tubes and BD Vacutainer Tubes for Use in Laboratory Tests

Eun Jeong Won, M.D.¹, Myung-Geun Shin, M.D.¹, Min-Joong Jang, M.D.¹, Duck Cho, M.D.¹, Seung-Jung Kee, M.D.¹, Soo-Hyun Kim, M.D.¹, Jong Hee Shin, M.D.¹, Yonggwan Won, M.D.², Dong-Wook Ryang, M.D.¹, Soon-Pal Suh, M.D.¹

¹Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea.

²School of Electronics and Computer Engineering, College of Engineering, Chonnam National University, Gwangju, Korea.

Corresponding author: Myung-Geun Shin, M.D. Department of Laboratory Medicine and Molecular Genetics, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, 160 Ilsim-ri, Hwasun-eup, Hwasun-gun 519-809, Korea. Tel: +82-61-379-7950; Fax: +82-61-379-7984; mgshin@chonnam.ac.kr

Received 27 November 2012 Revised 13 April 2013 Accepted 15 April 2013

(open-access):

This is anOpen 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

Vacuum tubes are widely used in clinical laboratories for routine tests. We compared a newly developed V-tube (AB Medical, Korea) and BD tubes (BD, USA) in common clinical assays, i.e., hematological, chemical, and immunological tests.

Methods

In total, 100 volunteers comprising 79 patients and 21 healthy volunteers were recruited and peripheral blood samples were collected with 2 brands of EDTA tubes and serum-separating tubes (SSTs). EDTA-tube samples were evaluated using 16 routine hematological tests. The SST samples were analyzed for 32 routine chemical parameters and 3 thyroid hormones. The results were statistically analyzed using the paired t-test and Bland-Altman plot. In addition, the stability of each analyte in 2 brands of vacutainers was evaluated. The results of the hematological tests at t=0 hr were compared with those at t=72±2 hr, and the results of the chemical parameters and thyroid hormones at t=0 hr were compared with those at t=72±2 hr and t=168±2 hr for each tube.

Results

Paired t-test analysis revealed that the test results of 16 routine hematological parameters, 32 routine chemical parameters, and 3 thyroid hormones showed clinically allowable differences between the 2 brands of vacuum tubes (t=0 hr). The results obtained when using V-tubes showed a statistically significant correlation with those obtained when using BD tubes. The stability of each analyte was similar in both vacuum tubes. Except for 10 parameters (white blood cell count, mean corpuscular volume, basophils [%], mean corpuscular hemoglobin concentration, monocytes [%], phospholipid, sodium, potassium, chloride, and free T4), all parameters showed significant but clinically allowable differences with regard to storage duration.

Conclusions

The newly developed V-tube vacutainers provide a suitable alternative to BD tubes in common clinical laboratories.

Keywords: V-tube, BD tube, Comparison

Figures and Tables

Fig. 1

Bland-Altman plot of the complete blood count in samples collected in V tubes and BD vacutainers. (A) white blood cell count, (B) red blood cell count, (C) hemoglobin, (D) hematocrit, (E) mean corpuscular volume, (F) mean corpuscular hemoglobin, (G) mean corpuscular hemoglobin concentration, (H) platelet, (I) red cell distribution width, (J) platelet distribution width, (K) neutrophil (%), (L) lymphocyte (%), (M) monocyte (%), (N) eosinophil (%), (P) basophil (%).

Fig. 2

Bland-Altman plots of the chemical parameter tests in samples collected in V tubes and BD vacutainers. (A) aspartate aminotransferase, (B) alanine aminotransferase, (C) alkaline phosphatase, (D) gamma glutamyl transpeptidase, (E) total protein, (F) albumin, (G) blood urea nitrogen, (H) creatinine, (I) total bilirubin, (J) direct bilirubin, (K) triglyceride, (L) total cholesterol, (M) high-density lipoprotein cholesterol, (N) low-density lipoprotein cholesterol, (P) glucose, (Q) uric acid, (R) calcium, (S) inorganic phosphorus, (T) creatine kinase, (U) amylase, (V) lactate dehydrogenase, W) magnesium, (X) iron, (Y) unsaturated iron-binding capacity, (Z) creatine kinase myocardial band isoenzyme, (AA) phospholipid, (AB) lipase, (AC) total iron-binding capacity, (AD) sodium, (AE) potassium, (AF) chloride.

Fig. 3

Bland-Altman plot of the thyroid hormone tests in samples collected in V tubes and BD vacutainers. (A) triiodothyronine, (B) free thyroxine, (C) thyroid-stimulating hormone.

Table 1

Comparison of complete blood count and coagulation test results between those of V-tubes and BD tubes (N=100)

^*P-values were determined by using the paired t-test; ^†rho data were determined by Spearman's correlation with a P-value of <0.001; ^‡Allowable difference range extrapolated from Clinical Laboratory Improvement Act/College of American Pathologists (CLIA/CAP) participant surveys.

Abbreviations: WBC, white blood cell count; RBC, red blood cell count; Hgb, hemoglobin; Hct, hematocrit; MCV, mean corpuscular volume; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; RDW, red cell distribution width; PLT, platelet; PDW, platelet distribution width; MPV, MPV, mean platelet volume.

Table 2

Comparison of routine chemistry and thyroid function test results obtained from V-tubes and BD tubes (N=100)

^*P-values were determined by using the paired t-test; ^†rho data were determined by Spearman's correlation with a P-value <0.001; ^‡Allowable difference range extrapolated from Clinical Laboratory Improvement Act/College of American Pathologists (CLIA/CAP) participant surveys.

Abbreviations: CI, confidence interval; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; GGT, gamma glutamyl transpeptidase; BUN, blood urea nitrogen; T-BIL, total bilirubin; D-BIL, direct bilirubin; CHOL, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PI, inorganic phosphorus; CK, creatine kinase; LD, lactate dehydrogenase; UIBC, unsaturated iron-binding capacity; PL, phospholipid; CRP, C-reactive protein; TIBC, total iron-binding capacity; T3, triiodothyronine; FT4, free thyroxine; TSH, thyroid-stimulating hormone.

Table 3

Number of cases statistically different between V-tube and BD vacutainer in test results on Bland-Altman plot

Abbreviations: WBC, white blood cell count; RBC, red blood cell count; Hgb, hemoglobin; Hct, hematocrit; MCV, mean corpuscular volume; MCHC, mean corpuscular hemoglobin concentration; RDW, red cell distribution width; PLT, platelet; PDW, platelet distribution width; MPV, mean platelet volume; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; GGT, gamma glutamyl transpeptidase; BUN, blood urea nitrogen; T-BIL, total bilirubin; D-BIL, direct bilirubin; CHOL, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PI, inorganic phosphorus; CK, creatine kinase; LD, lactate dehydrogenase; UIBC, unsaturated iron-binding capacity; CK-MB, creatine kinase myocardial band isoenzyme; PL, phospholipid; CRP, C-reactive protein; TIBC, total iron-binding capacity; T3, triiodothyronine; FT4, free thyroxine; TSH, thyroid-stimulating hormone.

Table 4

Daily variations of complete blood count results between day 0 and day 3 obtained from V-tubes and BD tubes

^*P-values were determined by using the paired t-test.

Table 5

Daily variations of chemistry and thyroid function test results between day 0, day 3, and day 7 obtained from V-tubes

^*P-value for difference of the result between Day 0 (t=0 hr) and Day 3 (t=72±2 hr); ^†P-value for difference of the result between Day 3 (t=72±2 hr) and Day 7 (t=168±2 hr); ^‡P-value for difference of the result between Day 0 (t=0 hr) and Day 7 (t=168±2 hr).

Abbreviations: CI, confidence interval; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; GGT, gamma glutamyl transpeptidase; BUN, blood urea nitrogen; T-BIL, total bilirubin; D-BIL, direct bilirubin; TG, triglyceride; CHOL, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PI, inorganic phosphorus; CK, creatine kinase; LD, lactate dehydrogenase; UIBC, unsaturated iron-binding capacity; CK-MB, creatine kinase myocardial band isoenzyme; PL, phospholipid; CRP, C-reactive protein; TIBC, total iron-binding capacity; sodium; T3, triiodothyronine; FT4, free thyroxine; TSH, thyroid-stimulating hormone.

Table 6

Daily variations of chemistry and thyroid function test results between day 0, day 3, and day 7 obtained from BD tubes

^*P-value for difference of the result between day 0 (t=0 hr) and day 3 (t=72±2 hr); ^†P-value for difference of the result between day 3 (t=72±2 hr) and day 7 (t=168±2 hr); ^‡P-value for difference of the result between day 0 (t=0 hr) and day 7 (t=168±2 hr).

Abbreviations: CI, confidence interval; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; GGT, gamma glutamyl transpeptidase; BUN, blood urea nitrogen; T-BIL, total bilirubin; D-BIL, direct bilirubin; CHOL, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PI, inorganic phosphorus; CK, creatine kinase; LD, lactate dehydrogenase; UIBC, unsaturated iron-binding capacity; CK-MB, creatine kinase myocardial band isoenzyme; PL, phospholipid; CRP, C-reactive protein; TIBC, total iron-binding capacity; sodium; T3, triiodothyronine; FT4, free thyroxine; TSH, thyroid-stimulating hormone.

Notes

This article is available from http://www.labmedonline.org

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