Blood Collection Tubes

On October 14, 2010, in Tests, by Andrea

I’ve discussed various blood tests, what they are used for, how we read those tests, how we modify our vitamins based on those tests and much more.  But what exactly do we know about the tubes themselves?

This is just a touch of information about the tubes used in drawing procedures – including any additives used in each one.  This isn’t a cohesive guide by any stretch, but I think it’s interesting info to have regardless.

Info from Bakerman’s ABC’s of Interpretive Laboratory Data, Fourth Edition

  • Red Top, Additive: None — Serum or clotted whole blood; most routine chemistries, serology, blood bank
  • Red/Gray or Gold, Additive: Gel; Clot activator — Shorter clot time; gel for serum separation.  Most routine chemistries
  • Green, Additive: Lithium or Sodium Heparin — Faster turnaround than serum.  Plasma chemistry testing.
  • Green / Gray or Light Green, Additive: Gel; Lithium Heparin — Faster turnaround than serum; gel for plasma separation.  Plasma chemistry testing.
  • Yellow / Gray / Orange, Additive: Thrombin — Short clot time, STAT serum testing
  • Lavender, Additive: EDTA — Whole blood.  Hematology tests, genetic tests, immunosuppressants, HbA1c, RBC folate
  • Light Blue, Additive: Sodium Citrate — Plasma coagulation testing
  • Gray, Additive: NaF alone or with EDTA or Potassium — Fluoride inhibits glycolysis; oxalate or EDTA give plasma samples.  Glucose, lactate, and alcohol determination
  • Yellow, Additive: Acid Citrate Dextrose (ACD) — Blood bank studies, HLA phenotyping, DNA and paternity testing
  • Black, Additive: Sodium Citrate — Erythrocyte sedimentation rate by Westergren method

Specialty Tubes:

  • Dark Blue, Additive: Sodium Heparin or None — Trace element determination
  • Yellow, Additive: Sodium Polyanetholesulfonate (SPS) — Blood culture specimens
  • Light Blue, Additive: CTAD — CTAD = Citrate, Theophylline, Adenosine, Dipryidamole: platelet stabilizing additives prevent platelet activation; platelet activating studies and heparin monitoring
  • White, Additive: Gel and EDTA — Plasma testing, HIV and HCV viral load testing and genotyping
  • Green / Red or Blue / Black, Additive: Gel, Liquid Density Medium, and Sodium Heparin or Sodium Citrate — Mononuclear cell isolation

The anticoagulants, EDTA, citrate, and oxalate, act to prevent coagulation by removing calcium ions from the blood.  Heparin acts by inhibiting thrombin and thromboplastin.  Do not use anticoagulant containing sodium (Na) or potassium for electrolyte determinations; use lithium (Li) or ammonium salt.  Do not use anticoagulant containing ammonium for ammonia determination.

Methods used for assay have proliferated; appropriate tube for blood collection may vary by technique or laboratory preference, and should be checked prior to obtaining samples.

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