Influence of short-term venous stasis on clinical chemistry testing
Abstract
Control and standardization of preanalytical variability is a critical factor for achieving accuracy and precision in laboratory testing. Although venous stasis from tourniquet placement during venepuncture should be minimized, as it has been claimed to account for spurious and significant variations for several analytes in plasma, there is controversy surrounding its real impact on laboratory testing. The aim of the present study was the investigation of the influence of short-term venous stasis on routine biochemical testing, by measuring the plasma concentration of 12 common analytes, including proteins, protein-bound substances, enzymes and electrolytes, in plasma specimens collected either without venous stasis or following the application of standardized external pressure of 60 mm Hg using a sphygmomanometer for 1 and 3 min. Although the overall correlation between measures was acceptable, the pattern of change was mostly dependent on the length of stasis, size and protein-binding characteristics of the analytes, achieving clinical significance for albumin, calcium and potassium after 1-min stasis, and alanine aminotransferase, albumin, calcium, chloride, total cholesterol, glucose and potassium after 3-min stasis. Statistically significant differences could be observed in seven (alanine aminotransferase, albumin, calcium, total cholesterol, creatine kinase, iron and potassium) and ten (alanine aminotransferase, albumin, calcium, chloride, total cholesterol, creatine ki…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Tourniquets cause a temporary occlusion of veins and temporary venous stasis.
“Tourniquets cause a temporary occlusion of veins and temporary venous stasis.”
From Joint EFLM-COLABIOCLI Recommendation for venous blood sampling (2018) · cites this paper as [85]
Most changes from tourniquet application are negligible within 1 min but can become clinically significant afterwards.
“Most of these changes are negligible within 1 min of the application of the tourniquet, but can become clinically significant afterwards [84], [85], [86].”
From Joint EFLM-COLABIOCLI Recommendation for venous blood sampling (2018) · cites this paper as [85]
If applied for longer than 1 min, a tourniquet induces a substantial variation of blood composition due to extravasation of water and small molecules such as ions from the vessel into the subendothelial space.
“If applied for a long period of time (longer than 1 min) a tourniquet induces a substantial variation of blood composition, due to extravasation of water and small molecules such as ions from the vessel into the subendothelial space.”
From Joint EFLM-COLABIOCLI Recommendation for venous blood sampling (2018) · cites this paper as [85]
During tourniquet application, large molecules such as lipoprotein particles, proteins and protein-bound substances, cells and coagulation factors remain within the vessel, so their concentration progressively increases.
“During that process, large molecules such as lipoprotein particles, proteins and protein-bound substances, cells and coagulation factors remain within the vessel, so that their concentration progressively increases.”
From Joint EFLM-COLABIOCLI Recommendation for venous blood sampling (2018) · cites this paper as [85]
Cites
Bonini, P., Plebani, M., Ceriotti, F., & Rubboli, F. (2002) · Clinical Chemistry · doi:10.1093/clinchem/48.5.691 · Cited by 850 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Influence of hemolysis on routine clinical chemistry testing
Lippi, G., Luca Salvagno, G., Montagnana, M., Brocco, G., & Cesare Guidi, G. (2006) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2006.054 · Cited by 344 · see citing works
Self-citationJoint EFLM-COLABIOCLI Recommendation for venous blood sampling
Simundic, A.-M., Bölenius, K., Cadamuro, J., Church, S., Cornes, M. P., van Dongen-Lases, E. C., Eker, P., Erdeljanovic, T., Grankvist, K., Guimaraes, J. T., et al. (2018) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2018-0602 · Cited by 240 · see citing works
Self-citationLima-Oliveira, G., Volanski, W., Lippi, G., Picheth, G., & Guidi, G. C. (2017) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365513.2017.1295317 · Cited by 117 · see citing works
Self-citationPhlebotomy, a bridge between laboratory and patient
Ialongo, C., & Bernardini, S. (2016) · Biochemia Medica · doi:10.11613/bm.2016.002 · Cited by 97 · see citing works
LIMA‐OLIVEIRA, G., LIPPI, G., SALVAGNO, G. L., MONTAGNANA, M., SCARTEZINI, M., GUIDI, G. C., & PICHETH, G. (2011) · International Journal of Laboratory Hematology · doi:10.1111/j.1751-553x.2011.01305.x · Cited by 46 · see citing works
Self-citationElimination of the venous stasis error for routine coagulation testing by transillumination
Lima-Oliveira, G., Salvagno, G. L., Lippi, G., Montagnana, M., Scartezini, M., Picheth, G., & Guidi, G. C. (2011) · Clinica Chimica Acta · doi:10.1016/j.cca.2011.04.008 · Cited by 38 · see citing works
Self-citationBölenius, K., Lindkvist, M., Brulin, C., Grankvist, K., Nilsson, K., & Söderberg, J. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-463 · Cited by 30 · see citing works
Evaluation of different mixing procedures for K2 EDTA primary samples on hematological testing
Lippi, G., Salvagno, G. L., Montagnana, M., Banfi, G., & Guidi, G. C. (2007) · Laboratory Medicine · doi:10.1309/95r8a56bdn10auuh · Cited by 24 · see citing works
Self-citation
- Authors
- Lippi, G., Salvagno, G. L., Montagnana, M., Brocco, G., & Guidi, G. C.
- Affiliations
- University of Verona (IT)
- Venue
- Clinical Chemistry and Laboratory Medicine (CCLM)
- Publisher
- Walter de Gruyter GmbH
- Published
- 2005-01-01
- Volume
- 43
- Issue
- 8
- Pages
- 869-75
- ISSN
- 1434-6621 (ISSN-L)
- 1437-4331
- OpenAlex
- W1974330656
- Cited by
- 81
- References
- 1
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 1 · 2021: 3 · 2019: 4 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 2 · 2013: 9 · 2012: 7
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Scientific Measurement and Uncertainty Evaluation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Keywords
- venous stasis, tourniquet, pre-analytical variability, venipuncture, potassium, calcium, albumin, alanine aminotransferase, electrolytes, venous pressure, laboratory quality control
- MeSH terms
- Adult, Blood Chemical Analysis, Female, Hemostasis, Humans, Male, Time Factors, Tourniquets, Phlebotomy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
