Different manufacturers of syringes: A new source of variability in blood gas, acid-base balance and related laboratory test?

OBJECTIVE: Evaluate whether four different brands/types of heparin coated syringes can represent a source of variability in blood gas analysis (BGA).DESIGN AND METHODS: Blood was collected from one hundred volunteers into different syringes: Syringe I (lithium heparin and calcium balanced); Syringe II: in-house prepared (sodium heparin); Syringe III: (spray-dried calcium-balanced lithium heparin); Syringe IV (lyophilized electrolyte-balanced lithium heparin).RESULTS: Significant differences were as follows: a) Syringe I vs II: pO(2), sO(2), pCO(2)(t), cHCO(3)(-), ctCO(2), base excess (BE), total hemoglobin (tHb), sodium (Na(+)), potassium (K(+)), calcium (Ca(2+)), glucose (Glu), lactate (Lac), O(2) Hb and p 50; b) Syringe I vs III: pH, pO(2), cHCO(3)(-), ctCO(2), BE, Na(+), Glu, Lac and p 50; c) Syringe I vs IV: pH, pO(2), sO(2), pCO(2)(t), BE, Na(+), K(+), Ca(2+), Glu, Lac and O(2) Hb; d) Syringe II vs III: pH, pO(2), sO(2), pCO(2)(t), cHCO(3)(-), ctCO(2), ctO(2), tHb, Na(+), K(+), Ca(2+), Lac and p 50; e) Syringe II vs IV: pH, pO(2), sO(2), pCO(2)(t), cHCO(3)(-), ctCO(2), BE, tHb, Na(+), K(+), Ca(2+), Lac, O(2) Hb and p 50; f) Syringe III vs IV: pH, pO(2), sO(2), cHCO(3)(-), ctCO(2), ctO(2), BE, Na(+), K(+), Ca(2+), O(2) Hb and p 50.CONCLUSION: The different manufacturers of syringes can represent new source of variability on BGA.