Shaking Red-Cap Blood Collection Tube without Additive Substances is Recommended to Accelerate The Blood Clotting Process Gilang Nugraha1.
Rohayati2 Department of Medical Laboratory Technology.
Faculty of Health.
Universitas Nahdlatul Ulama Surabaya.
Surabaya.
Indonesia Department of Medical Laboratory Technology.
Poltekkes Kemenkes Bandung.
Bandung.
Indonesia Correspondence:
Gilang Nugraha.
Jl.
Jemursari No.
Surabaya.
East Java.
Indonesia Zip Code : 60237 Email: gilang@unusa.
Received: February 26, 2019 Revised: March 21, 2019 Accepted: March 26, 2019 Abstract Many blood collection tube manufacturers do not recommend shaking the red tube.
Shaking the red tube to avoid the intensity of the changed of blood that interacts with the glass surface of the tube will trigger the contact path in the coagulation cascade.
Generally, the blood takes 30-60 minutes to clots at room temperature without shaking.
The aim of this study was to determine the effectiveness of shaking the red-cap blood collection tube in producing serum volume.
The method of this study was experimental As much as 5 mL of blood was taken and put into 3 tubes with a volume of 1mL each tube.
The first and the second tube were shaken 8 times.
The first tube was incubated for 10 minutes while the second tube was incubated for 25 Meanwhile, the third tube .
s a contro.
was not shaken but was incubated for 40 minutes.
The tube were centrifuged at 3000 g for 10 minutes.
The serum volume was measured using micropipette and collected into Eppendorf The results showed that there were a difference in the number of serums formed after tube shaking by time variation (P = 0.
, the results of the Post Hoc Test using Bonferroni test while showed that the second tube did not have a difference in serum volume with control (P = 0.
It can be concluded that the red-cap blood collection tube, which was shaken 8 times and incubated for 25 minutes long could accelerate the coagulation process.
Keywords Shaking.
Blood Collection Tube.
Blood Clotting Gilang Nugraha.
Rohayati INTRODUCTION Many MATERIALS AND METHODS manufacturers do not recommend shaking the red-cap The .
ot experimentally on August 2018.
As much as 5 mL blood samples were collected from 30 shaking blood collection tubes is to mix students of Medical Laboratory Technology additives with blood such as anticoagulants Study Program.
Faculty of Health.
Nahdlatul .
Red-cap collecting tubes are generally Ulama University of Surabaya.
The research was conducted in B Tower of laboratory of containing additive.
The immunoserology to obtain serum specimens and to incubate the specimen allowed to clot in this tube .
Nahdlatul Ulama University of Surabaya.
The blood samples were drawn about 5 mL using syringe, then put into 3 blood Shaking the red-cap blood collection collection tubes without additives 1 ml for tube increase the interaction of blood to the each tube .
ed li.
, tubes 1 .
irst tub.
and 2 glass surface of tube, then it can trigger the .
econd tub.
are used as test tubes and tube contact path which causes activation of factor 3 .
hird tub.
as a control.
The test tubes were XII (FXII.
and leads to the blood clotting immediately shaken 8 times, except the cascade .
Ae.
Activating the blood-clotting control tube.
Incubation was performed to give the chance for blood to clot.
The first accelerate the blood clotting process in the tube was incubated for 10 minutes, the red-cap blood collection tube, then the second tube was incubated for 25 minutes specimen can be performed immediately in and third tube was incubated for 40 minutes.
the pre-analytic stage.
Generally, the unshaken red-cap blood Incubated Thermo collection tube takes 30-60 minutes to clot Scientific SL 16 R R (Thermo Fisher the blood at room temperature in order to Scientific Inc.
Langenselbold.
German.
at obtain serum with a good quality .
3000 g for 10 minutes.
The serum volume Therefore, the aim of this study was to was measured using micropipette and determine the effectiveness of shaking the collected into Eppendorf tube.
red-cap blood collection tube in producing Ethical Approval serum volume.
This research was carried out experimentally on 30 volunteers.
Design, samples, and techniques Ethics Commission of Nahdlatul Ulama University of Surabaya.
East Java.
Indonesia, approved this research.
Informed consents Ina J Med Lab Sci Tech 2019.
: 33-37
Gilang Nugraha.
Rohayati were obtained from all patients before The characteristics of formed serum volume drawing blood specimens.
presented in Table 1.
Statistical analysis Significant test was used in this study.
ANOVA test was used to determine the effect of shaking and incubation time in formation of serum volume compared to the control.
Post Hoc analysis was used to determine the Table 1.
Characteristics of serum volume in various treatments MEAN
PARAMETER
(AAL)
1st Treatment 2nd Treatment Control same treatment with the control and determine the optimum treatment that can be P value <0.
05 was stated to be The effect of Shaking on Serum Volume The ANOVA test result revealed that the probability/sig results was 0.
Since the statistically significant.
probability the probability value/sig was <0.
05, it can be concluded that there was a RESULTS difference in the amount of formed serum Characteristics of Respondents As much as 30 respondents were enrolled in this study after obtaining individual approval and Institutional informed consent.
Respondents were active students in the Medical Laboratory Technology Study Program.
Faculty of Health.
Nahdlatul Ulama University of Surabaya.
The range of age was 20 to 23 years old with an average of 20.
years old.
The ratio of gender between men and women was 1:27.
Serum Volume The obtained blood samples were treated based on research methods.
The first after shaking the tube by time variation.
Post Hoc Test was used to these three homogeneous group variants (P = 0.
then using Bonferroni test to determine serum volume compared to the control.
Significant value of shaken blood tube incubated for 10 minutes was 0.
It means that there was a difference in serum volume with control.
Meanwhile, significant value of another shaken blood tube, which incubated for 25 minutes, was 0.
751, which means that there was no difference in serum volume compared with control.
treatment was given by shaking the tube 8 times and by incubating for 10 minutes.
The DISCUSSION Vacuum tube or commonly known as incubated for 25 minutes.
Furthermore, the vacutainer is vacuum containers used for control was not carried out by shaking.
blood collection .
There are two types of However it was incubated for 40 minutes.
Ina J Med Lab Sci Tech 2019.
: 33-37
second treatment was shaken 8 times and Gilang Nugraha.
Rohayati the red-cap vacuum tubes, which are made and serum volume was less than that in the from glass and plastic.
control treatment.
The differences in serum Red Plastic tube contains the blood volume formed could be due to incomplete clotting activator while red glass tube does not contain any additives.
Both tubes are used retraction process was not optimal when to obtain serum for clinical chemistry or serum was trapped by imperfect blood clot, immunoserology tests.
Most vacuum tube thus producing less serum volume .
manufacturers suggest to not shaking red The serum volume formed in the second glass tube due to excluded from additives treatment was not significantly different .
compared to the control (P=0.
This The surface of glass on collecting tube is means that the shaking of the red-cap tube negative charge, and then it easily triggers the incubated for 25 minutes had the same contact path in coagulation cascade during volume obtained from the commercial the blood clotting process.
Zymogen factor technique .
, while in this study the XII (FXII) is activated into FXIIa after control was incubated for 40 minutes, thereby contact with the glass tube surface and saving 15 minutes.
activated multistep cascades, while thrombin (FII.
is formed as an activator forming fibrin threads .
It means that the shaking of the red-cap recommended to increase contact of blood with the tube surface and to activate the blood Hence, blood-clotting process is formed faster.
CONCLUSIONS
The red-cap blood collection tube without additives is recommended with 8 times shaking and 25 minutes incubation.
The limitations of this study were measuring serum volume without considering debris that might be carried in serum.
Shaking test of two blood collection tubes incubated in 10 and 25 minutes produced significant different in serum volume (P=0.
The serum volume CONFLICT OF INTEREST There are no conflicts of interest.
formed in the first treatment was significantly different compared to the control (P = 0.
Ina J Med Lab Sci Tech 2019.
: 33-37
Gilang Nugraha.
Rohayati REFERENCES