(P-BC-87) Validation of Coagulation Consistency in Sequential 2.7ml Citrate Tube Blood Draws

Background/Case Studies: Blood research often requires collection of multiple 3.2% sodium citrate tubes (SCT) during a single venipuncture. However, the variability in laboratory values across these tubes has not been fully quantified. Ensuring consistency in these results is critical to maintaining research quality, especially in the context of advancing trauma and surgical care. This study evaluated whether coagulation measurements remain consistent across multiple SCTs drawn from a single venipuncture.

Study

Design/Methods: SCT (3.2% sodium citrate) were collected from donors (n=23) at the US Army Institute of Surgical Research’s Blood Bank through routine venipuncture for various approved research protocols requesting a minimum of 13 tubes per donor. From these research collections, 3 additional tubes were collected and tubes 1, 8, and 16, were retained for evaluation of Prothrombin Time (PT), Partial Thromboplastin Time (PTT), fibrinogen concentration, Complete Blood Count (CBC), and thromboelastography (TEG). A repeated measures one-way ANOVA was used to compare changes over the serial collection, with significance set at p< .05.

Results/Findings: The ANOVA demonstrated an overall statistically significant difference (p=.0425) in platelet count as it declined from Tube 1 (209.0 x 10³/μL) to Tube 16 (201.1 x 10³/μL), although the pairwise comparison was not statistically significant between Tube 1 and Tube 16 (p=.0924). No significant differences were observed in fibrinogen concentration (p=.1243) or TEG MA (p=.5545). PT (p=.0665) and PTT (p=.4868) also remained consistent across all samples.

Conclusions: Coagulation and hematology measurements remained consistent across multiple SCTs collected from a single venipuncture. A minor, statistically insignificant downward trend in platelet count was observed, while fibrinogen and clot dynamics remained stable. Whether collecting more than 16 SCTs will cause a clinically relevant change in platelet count between tubes remains to be investigated. These results support the reliability of using multiple SCTs in trauma, surgical, and clinical research settings. Ensuring consistent results enhances data quality, supports robust clinical decision-making, and will inform future research protocol development.