The Role of Citrate Plasma in Clinical and Immunochemistry Tests

Summary

• Citrate plasma is suitable for use in clinical chemistry and immunochemistry tests due to its ability to prevent clotting and preserve analytes.
• It is commonly used when measuring coagulation parameters, such as PT and aPTT, as well as in tests for certain enzymes and proteins.
• Proper handling and processing of citrate plasma samples are essential to ensure accurate and reliable Test Results.

Introduction

In a medical laboratory setting, the choice of Anticoagulant used for blood collection plays a crucial role in the accuracy and reliability of Test Results. Citrate plasma is one such Anticoagulant that is commonly used in clinical chemistry and immunochemistry tests. In this article, we will explore the specific circumstances in which citrate plasma may be deemed suitable for use in a medical laboratory setting in the United States.

What is Citrate Plasma?

Citrate plasma is a type of Anticoagulant that works by binding to calcium ions in the blood, preventing clotting from occurring. It is commonly used for tests that require plasma rather than serum, as serum is obtained after blood has clotted and therefore does not contain clotting factors. Citrate plasma is typically collected in blue-top tubes, which are specifically designed for blood collection with citrate as the anticoagulant.

Specific Circumstances for Use in Clinical Chemistry Tests

There are several circumstances in which citrate plasma may be deemed suitable for use in clinical chemistry tests in a medical laboratory setting:

Coagulation Parameters

1. Prothrombin Time (PT): Citrate plasma is commonly used when measuring PT, which assesses the extrinsic pathway of the coagulation cascade. The citrate in the plasma prevents clotting from occurring, allowing for an accurate measurement of Clotting Time.
2. Activated Partial Thromboplastin Time (aPTT): Similarly, citrate plasma is used in aPTT testing, which evaluates the intrinsic pathway of the coagulation cascade. The Anticoagulant properties of citrate are essential for preventing premature clot formation during the test.

Enzyme and Protein Testing

1. Liver Enzymes: Citrate plasma may be used when measuring liver enzymes, such as ALT and AST, as the Anticoagulant properties of citrate help preserve these analytes for accurate testing.
2. Proteins: Certain proteins, such as fibrinogen and factors involved in the coagulation cascade, may also be measured in citrate plasma to ensure accurate and reliable Test Results.

Specific Circumstances for Use in Immunochemistry Tests

In addition to clinical chemistry tests, citrate plasma may also be deemed suitable for use in immunochemistry tests in a medical laboratory setting:

Autoimmune Testing

1. Autoantibodies: Citrate plasma can be used when testing for autoantibodies in conditions such as Autoimmune Diseases. The Anticoagulant properties of citrate help preserve the antibodies in the plasma for accurate detection.
2. Cytokines: Certain cytokines may also be measured in citrate plasma to assess immune function and inflammatory responses in patients.

Therapeutic Drug Monitoring

1. Anticoagulants: Patients on Anticoagulant therapy may undergo Therapeutic Drug Monitoring using citrate plasma to ensure that their medication levels are within the therapeutic range.
2. Immune Modulators: Citrate plasma may also be used to monitor drug levels of immune modulators used in the treatment of various conditions.

Proper Handling and Processing of Citrate Plasma Samples

It is important to note that proper handling and processing of citrate plasma samples are essential to ensure accurate and reliable Test Results. The following best practices should be followed when working with citrate plasma samples:

Sample Collection

1. Use blue-top tubes specifically designed for blood collection with citrate as the anticoagulant.
2. Ensure that an adequate volume of blood is collected to maintain the proper blood-to-Anticoagulant ratio.

Sample Processing

1. Immediately invert the tube gently several times after blood collection to mix the blood with the anticoagulant.
2. Centrifuge the sample promptly to separate the plasma from the cellular components.

Storage and Transport

1. Store citrate plasma samples at the recommended temperature and avoid repeated freeze-thaw cycles to prevent degradation of analytes.
2. If samples need to be transported, use proper packaging and follow guidelines for sample stability during transportation.

Conclusion

In conclusion, citrate plasma is deemed suitable for use in clinical chemistry and immunochemistry tests in a medical laboratory setting in the United States under specific circumstances. Its Anticoagulant properties make it ideal for tests that require plasma rather than serum, such as coagulation parameters and certain enzyme and protein tests. Proper handling and processing of citrate plasma samples are crucial to ensure accurate and reliable Test Results, making it a valuable tool in diagnostic testing.

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