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Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium

The ionized calcium level in blood is known to be falsely decreased when self-prepared liquid heparin anticoagulant is used, due to dilution and binding effects. The effect of liquid heparin on the determination of ionized magnesium is not as well understood. We compared the effect of liquid sodium...

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Autores principales: Shin, Cheung Soo, Chang, Chul Ho, Kim, Jeong-Ho
Formato: Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687627/
https://www.ncbi.nlm.nih.gov/pubmed/16642547
http://dx.doi.org/10.3349/ymj.2006.47.2.191
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author Shin, Cheung Soo
Chang, Chul Ho
Kim, Jeong-Ho
author_facet Shin, Cheung Soo
Chang, Chul Ho
Kim, Jeong-Ho
author_sort Shin, Cheung Soo
collection PubMed
description The ionized calcium level in blood is known to be falsely decreased when self-prepared liquid heparin anticoagulant is used, due to dilution and binding effects. The effect of liquid heparin on the determination of ionized magnesium is not as well understood. We compared the effect of liquid sodium heparin on the determination of ionized calcium and magnesium in 44 clinical samples using two types of user-prepared heparin syringes which differed in the amount of residual heparin from the BD Preset™ reference syringe. With the type 1 syringe, the liquid heparin was expelled once or twice such that some heparin could be left in the dead space at the syringe hub, while the liquid sodium heparin was thoroughly expelled from the type 2 syringe. The ionized magnesium levels obtained with the type 1 syringe were significantly lower than the reference value (by 0.068 mmol/L) (p < 0.0001), while the value obtained with the type 2 syringe differed less from the reference, by only 0.014 mmol/L (p < 0.0001). The heparin binding effect resulted in more negative bias in ionized magnesium (- 0.026 ± 0.032 mmol/L) than in ionized calcium (- 0.009 ± 0.042 mmol/L, p < 0.0001). In conclusion, we recommend using lyophilized, calcium-balanced, heparinized syringes for the determination of ionized magnesium and ionized calcium due to the increased negative bias in ionized magnesium determinations. When user-prepared syringes are used, the thorough evacuation of heparin solution should be strictly prescribed.
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spelling pubmed-26876272009-06-04 Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium Shin, Cheung Soo Chang, Chul Ho Kim, Jeong-Ho Yonsei Med J Original Article The ionized calcium level in blood is known to be falsely decreased when self-prepared liquid heparin anticoagulant is used, due to dilution and binding effects. The effect of liquid heparin on the determination of ionized magnesium is not as well understood. We compared the effect of liquid sodium heparin on the determination of ionized calcium and magnesium in 44 clinical samples using two types of user-prepared heparin syringes which differed in the amount of residual heparin from the BD Preset™ reference syringe. With the type 1 syringe, the liquid heparin was expelled once or twice such that some heparin could be left in the dead space at the syringe hub, while the liquid sodium heparin was thoroughly expelled from the type 2 syringe. The ionized magnesium levels obtained with the type 1 syringe were significantly lower than the reference value (by 0.068 mmol/L) (p < 0.0001), while the value obtained with the type 2 syringe differed less from the reference, by only 0.014 mmol/L (p < 0.0001). The heparin binding effect resulted in more negative bias in ionized magnesium (- 0.026 ± 0.032 mmol/L) than in ionized calcium (- 0.009 ± 0.042 mmol/L, p < 0.0001). In conclusion, we recommend using lyophilized, calcium-balanced, heparinized syringes for the determination of ionized magnesium and ionized calcium due to the increased negative bias in ionized magnesium determinations. When user-prepared syringes are used, the thorough evacuation of heparin solution should be strictly prescribed. Yonsei University College of Medicine 2006-04-30 2006-04-30 /pmc/articles/PMC2687627/ /pubmed/16642547 http://dx.doi.org/10.3349/ymj.2006.47.2.191 Text en Copyright © 2006 The Yonsei University College of Medicine http://creativecommons.org/licenses/by-nc/3.0 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 noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shin, Cheung Soo
Chang, Chul Ho
Kim, Jeong-Ho
Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium
title Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium
title_full Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium
title_fullStr Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium
title_full_unstemmed Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium
title_short Liquid Heparin Anticoagulant Produces More Negative Bias in the Determination of Ionized Magnesium than Ionized Calcium
title_sort liquid heparin anticoagulant produces more negative bias in the determination of ionized magnesium than ionized calcium
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687627/
https://www.ncbi.nlm.nih.gov/pubmed/16642547
http://dx.doi.org/10.3349/ymj.2006.47.2.191
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AT kimjeongho liquidheparinanticoagulantproducesmorenegativebiasinthedeterminationofionizedmagnesiumthanionizedcalcium