robbiemed on Nostr: Prolonged #tourniquet use during #venipuncture can lead to significant alterations in ...
Prolonged #tourniquet use during #venipuncture can lead to significant alterations in the concentrations of various analytes due to hemoconcentration and the movement of analytes from surrounding tissues into the bloodstream. The literature indicates that even short-term venous stasis can cause clinically significant changes in several analytes.
**Duration and Impact:**
- 1 minute: Statistically significant changes can be observed in albumin, calcium, and potassium.[1] The AHA recommends that a tourniquet should not be applied for more than 1 minute to avoid significant increases in triglyceride levels.[1][2]
- 3 minutes: significant increases in alanine aminotransferase, total cholesterol, glucose, and potassium. Hemoconcentration effects are more evident[1][3]
**So**
- It’s recommended to keep tourniquet application to less than 1 minute.[2]
- Waiting for 5 minutes with the needle in situ after removing the tourniquet can help reduce hemostasis-induced variability.[4] But this is never going to happen.
Basically, tourniquet application should not exceed 1 minute if you want to minimize the risk of significant alterations in analyte concentrations.
**Rationalization**
[1] Lippi G, Salvagno GL, Montagnana M, Brocco G, Guidi GC. Influence of Short-Term Venous Stasis on Clinical Chemistry Testing. Clinical Chemistry and Laboratory Medicine. 2005;43(8):869-75. doi:10.1515/CCLM.2005.146.
[2] Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2011;123(20):2292-333. doi:10.1161/CIR.0b013e3182160726.
[3] Cengiz M, Ulker P, Meiselman HJ, Baskurt OK. Influence of Tourniquet Application on Venous Blood Sampling for Serum Chemistry, Hematological Parameters, Leukocyte Activation and Erythrocyte Mechanical Properties. Clinical Chemistry and Laboratory Medicine. 2009;47(6):769-76. doi:10.1515/CCLM.2009.157.
[4] Devi S, Pasanna RM, Nadiger N, et al. Variability of Human Fasted Venous Plasma Metabolomic Profiles With Tourniquet Induced Hemostasis. Scientific Reports. 2021;11(1):24458. doi:10.1038/s41598-021-03665-2.
**Duration and Impact:**
- 1 minute: Statistically significant changes can be observed in albumin, calcium, and potassium.[1] The AHA recommends that a tourniquet should not be applied for more than 1 minute to avoid significant increases in triglyceride levels.[1][2]
- 3 minutes: significant increases in alanine aminotransferase, total cholesterol, glucose, and potassium. Hemoconcentration effects are more evident[1][3]
**So**
- It’s recommended to keep tourniquet application to less than 1 minute.[2]
- Waiting for 5 minutes with the needle in situ after removing the tourniquet can help reduce hemostasis-induced variability.[4] But this is never going to happen.
Basically, tourniquet application should not exceed 1 minute if you want to minimize the risk of significant alterations in analyte concentrations.
**Rationalization**
[1] Lippi G, Salvagno GL, Montagnana M, Brocco G, Guidi GC. Influence of Short-Term Venous Stasis on Clinical Chemistry Testing. Clinical Chemistry and Laboratory Medicine. 2005;43(8):869-75. doi:10.1515/CCLM.2005.146.
[2] Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2011;123(20):2292-333. doi:10.1161/CIR.0b013e3182160726.
[3] Cengiz M, Ulker P, Meiselman HJ, Baskurt OK. Influence of Tourniquet Application on Venous Blood Sampling for Serum Chemistry, Hematological Parameters, Leukocyte Activation and Erythrocyte Mechanical Properties. Clinical Chemistry and Laboratory Medicine. 2009;47(6):769-76. doi:10.1515/CCLM.2009.157.
[4] Devi S, Pasanna RM, Nadiger N, et al. Variability of Human Fasted Venous Plasma Metabolomic Profiles With Tourniquet Induced Hemostasis. Scientific Reports. 2021;11(1):24458. doi:10.1038/s41598-021-03665-2.