Affiliation:
1. University of Florida Health, Jacksonville
2. Department of Pharmacotherapy and Translational Research
3. Department of Pathology and Laboratory Medicine
4. Division of Infectious Disease, University of Florida College of Medicine, Jacksonville
Abstract
Abstract
Objectives
Patient compliance with laboratory testing is one of the most underrecognized challenges in developing a treatment plan for acute and chronically ill patients. The ability to offer alternatives to standard venipuncture blood draws would greatly increase a laboratory’s ability to provide testing to patients and health care providers.
Methods
We performed a prospective observational study on paired venous and fingerstick capillary blood samples from admitted patients undergoing vancomycin therapy. Paired specimens were analyzed for vancomycin and a basic metabolic panel (BMP: calcium, carbon dioxide, chloride, potassium, sodium, creatinine, glucose, serum urea nitrogen) on the core laboratory’s automated chemistry and immunochemistry platforms.
Results
A total of 59 paired fingerstick and venous blood specimens from 56 unique inpatients were analyzed. Paired samples were comparable for all the analytes tested with the exception of bicarbonate and potassium, which were significantly different among the capillary sample group. Patients required multiple fingers be lanced in 15% of cases to obtain sufficient blood to carry out the testing. Capillary sample rejection rates due to insufficient volumes were as high as 30% in the initial 30 patients enrolled in the study.
Conclusions
Vancomycin and the BMP, with the exception of potassium and bicarbonate, were determined to be analytically comparable. However, significant preanalytical issues should preclude laboratories and providers from more widespread adoption of fingerstick-derived capillary blood as an alternative sampling method except in the most extenuating of circumstances.
Publisher
Oxford University Press (OUP)
Reference13 articles.
1. Infections caused by Gram-positive bacteria: a review of the global challenge;Woodford;J Infect.,2009
2. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists, American Journal of Health-System Pharmacy;Rybak;Am J Health-Syst Pharm.
3. Vancomycin nephrotoxicity: myths and facts;Gupta;Neth J Med.,2011
4. Evidence-based guidelines to eliminate repetitive laboratory testing;Eaton;JAMA Intern Med.,2017
5. Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels;Thavendiranathan;J Gen Intern Med.,2005
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
1. Research and scholarly methods: Writing abstracts;JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY;2023-06-08