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Cited by 66Clinical Laboratory Practices and Quality ControlPotassium and Related DisordersAnalytical chemistry methods development

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

EDTA sample contamination is common and often undetected, putting patients at unnecessary risk of harm

Open access
Sharratt, C. L., Gilbert, C. J., Cornes, M. C., Ford, C., Gama, R.·2009·International Journal of Clinical Practice
DOI 10.1111/j.1742-1241.2008.01981.x
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Abstract

BACKGROUND: Potassium ethylenediaminetetraacetic acid (EDTA) is a sample tube anticoagulant used for many laboratory analyses. Gross potassium EDTA contamination of blood samples is easily recognised by marked hyperkalaemia and hypocalcaemia. However, subtle contamination is a relatively common, often unrecognised erroneous cause of spurious hyperkalaemia. Potassium EDTA contamination may also cause hypomagnesaemia and hypozincaemia. There are, however, no data on the prevalence of EDTA contamination as a cause of hypocalcaemia, hypomagnesaemia and hypozincaemia. METHODS: Following a recent service evaluation, we measure EDTA in serum samples from patients with unexplained hyperkalaemia (serum potassium > 6.0 mmol/l). In addition, over a 1-month period EDTA concentrations were measured in hypocalcaemic (serum adjusted calcium < 2.0 mmol/l), hypomagnesaemic (serum magnesium < 0.7 mmol/l) and hypozincaemic (serum zinc < 11 micromol/l) serum samples. RESULTS: Ethylenediaminetetraacetic acid contamination was detected in 31 samples, nine of which were detected by our routine screening programme. The remaining 22 samples represented 14.3% (19/133) of hypocalcaemic samples, 4.8% (5/104) of hypomagnesaemic samples and 1.4% (2/139) of hypozincaemic samples. A total of 25/31 (80.6%) of patients were re-bled, of which 23/25 (92%) results normalised. CONCLUSIONS: Factitious hyperkalaemia, hypocalcaemia and hypomagnesaemia caused by potassium EDTA contamination in our studies are relatively common, and if unrecognised may adversely affect patient care and waste scarce healthcare resources. Correct order of draw of blood samples, improved education and routine laboratory screening of EDTA are necessary to prevent and identify EDTA contamination.

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Crossref · 10.1111/j.1742-1241.2008.01981.x

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  • Contamination still occurs more commonly than might be expected and can be difficult to identify.

    “there is firm evidence showing that contamination still occurs more commonly than might be expected and can be difficult to identify [79], [80], [81], [82].”

    From Joint EFLM-COLABIOCLI Recommendation for venous blood sampling (2018) · cites this paper as [81]

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Metadata

Authors
Sharratt, C. L., Gilbert, C. J., Cornes, M. C., Ford, C., & Gama, R.
Affiliations
  • New Cross Hospital (GB)
  • University of Wolverhampton (GB)
Corresponding author
Sharratt, C. L.
ORCID
Venue
International Journal of Clinical Practice
Publisher
Hindawi Limited
Published
2009-08
Volume
63
Issue
8
Pages
1259-1262
ISSN
  • 1368-5031 (ISSN-L)
  • 1742-1241
DOI
10.1111/j.1742-1241.2008.01981.x
OpenAlex
W2068554951
Semantic Scholar
87bb853ac9d53601f5ee21c411f642dc5e950e50
Cited by
66
References
6
Citations by year
2026: 4 · 2025: 2 · 2024: 4 · 2023: 4 · 2021: 4 · 2020: 5 · 2019: 8 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 7 · 2013: 1 · 2012: 3
FWCI
3.09
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 2222 d)
Locations
  • International Journal of Clinical Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Nephrology › Potassium and Related Disorders
  • Physical Sciences › Chemistry › Analytical Chemistry › Analytical chemistry methods development
Keywords
hypocalcemia, hypomagnesemia, hypozincemia, rebleeding, patient safety
MeSH terms
Anticoagulants, Blood Specimen Collection, Diagnostic Errors, Edetic Acid, Equipment Contamination, Humans, Risk Factors

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