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Schouwers S.,Laboratory for Clinical Chemistry and Toxicology | Brandt I.,Laboratory for Clinical Chemistry and Toxicology | Willemse J.,Laboratory for Clinical Chemistry and Toxicology | Van Regenmortel N.,ZNA Stuivenberg | And 4 more authors.
Clinica Chimica Acta

Background: A separator or barrier gel is a common component of serum and plasma collection tubes. Despite their advantages, the use of these tubes is not universally accepted, especially for therapeutic drug monitoring (TDM). The aim of this study was to evaluate whether the polyacrylester separator gel in Sarstedt S-Monovette\® tubes influences the concentration of 10 selected parameters (amikacin, vancomycin, valproic acid, acetaminophen, cortisol, free thyroxine, thyroid-stimulating hormone, transferrin, prealbumin and carcinoembryonic antigen) in a clinically significant way. Methods: Results from patient samples collected in plastic Sarstedt S-Monovette® tubes with separator gel were compared with those from plain serum sample tubes. Analytes were measured in both tubes on 4 consecutive days to study the influence of prolonged contact with the separator gel. Between analyses tubes were stored at 4°C. Stability was also evaluated over 72. h for each collection tube. When statistical differences were detected, the clinical significance was evaluated based on the total allowable error (TEa). Results: On day 1 no statistically significant differences were observed between samples collected in Sarstedt S-Monovette® tubes with and without separator gel. Statistical differences were present from day 2 on, but were not clinically significant. All evaluated parameters were clinically stable over 72. h at 4°C based on TEa, except for transferrin en fT4. Conclusion: The separator gel in Sarstedt S-Monovette® tubes did not show statistically significant differences on the day of phlebotomy. Later on statistically significant differences appeared but except for the stability of fT4 and transferrin they all remained clinically insignificant. © 2011 Elsevier B.V. Source

Heytens L.,Sint Augustinus Hospital | Neels H.,University of Antwerp | Neels H.,Laboratory for Clinical Chemistry and Toxicology | Van Regenmortel N.,ZNA Stuivenberg | And 5 more authors.
Annals of Clinical Biochemistry

We report a case of an ethanol and massive gamma-butyrolactone (GBL) intoxication, the precursor of the recreational drug gamma-hydroxybutyric acid (GHB), resulting in life-threatening metabolic acidosis (pH 6.5) with a highly increased anion- and osmolal gap. Rapid analysis using gas chromatography revealed a GHB plasma concentration of 4400 mg/L, far above the upper limit concentration of 1000 mg/L found in adult fatalities attributed to GBL. Full recovery was established following supportive treatment including haemodialysis. This is the first report of a combined ethanol/GBL intoxication as a cause of high serum anion- and osmolal-gap metabolic acidosis. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav Source

Schouwers S.,Laboratory for Clinical Chemistry and Toxicology | Cuypers E.,Laboratory for Clinical Chemistry and Toxicology | Vervaet S.,Laboratory for Clinical Chemistry and Toxicology | Uyttenbroeck W.,Laboratory for Clinical Chemistry and Toxicology | Neels H.,Laboratory for Clinical Chemistry and Toxicology
Clinical Biochemistry

Background: We illustrate the impact of sample evaporation on analytical results in laboratory practice and highlight preventive measures. Methods: Plasma (n=10) was analysed for glucose, Na+, HCO3- and calcium on six different sample configurations at 5 time points within 2h. Results: With time glucose, Na+ and calcium values increased and HCO3- values decreased in a clinically significant way. Conclusions: Analytical error due to evaporation may be significant, but can be reduced with optimal sample handling. A pierceable cover does not prevent loss of HCO3-. © 2010 The Canadian Society of Clinical Chemists. Source

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