Specimen Quality

Physiological Variables Host Components ↑↓ ≠-

Concerns Host Components ↑↓ ≠-
Newborns RBC, WBC ↑ ↑Tourniquets Cholesterol ↑
Age Hemoconcentration
Kidney function ↓ Pumping Potassium ↑20%
Males ↑ ammonia
Gender RBC, Hgb, Hct catecholamines
Females ↓ CK
Blood Components ↑↓
iron ↑
Hemolysis magnesium phosphate
Glucose, potassium
other enzymes
creatinine,
RBC ↓
Walking insulin,
↑ EDTA RBC, Blood
lactic acid, ↓
Exercise total protein Blood Smear Hct
Potassium Staining Character
Exercise, pumping of hand
(Plasma)1
Partially filled tubes
Heparin Chemistry Analytes ≠
Vigorous ↑ Sodium Fluoride
Cholesterol None
exercise 6% Coagulation Tubes
Ammonia, Calcium powder Calcium results
↑protein Urea,

≠
Sweat Sodium Chloride
Uric Acid ↑ Specimen contamination
Glove Powder Bilirubin,
Glucose, Sweating Uric Acid,
Diet ↑carbohydrates No Alcohol, Phosphorus,
Insulin Hemolysis Potassium
↑water/other fluids Hgb ↓ Wrong or expired collection tube
None Clot
↑water/other fluids Electrolyte Balance
≠
30 minutes of standing Potassium ↑
↑
15 minutes stand RBC
basal
Supine → ↓
Body Plasma2
Standing 10%
Position Total and
high-density
Supine →
Standing
lipoprotein
(HDL)
-
cholesterol
Temperature Interstitial Fluid
Acute Heat (Plasma)3 ↑
Humidity
RBC
C-reactive protein, ↑
Altitude Uric Acid
↑Altitude
Oxygen
Urinary Creatinine, ↓
Plasma Renin
Concentrated Blood stream, RBCs enzymes,
Dehydration Smaller Plasma Volume
Hemoconcentration
Fe, Ca, Na,
Coagulation Factors
≠
AST and SGOT,
Drugs
ALP, LDH ↑
Oral Contraceptives ESR
Drug Therapy Chemotherapy Blood Cells
Drugs Clotting Factors ↓
Oral Contraceptives B12
Jaundice Bilirubin ↑
↓Hypoglycemia Insulin, Glucagon
Fever ↑
≠Normal diurnal Cortisol
Pregnancy ↑ Body Fluids RBC ↓
Intramuscular Recent CK, LDH
↑
injection Muscular Trauma CK
Cholesterol,
cortisol,
glucose,
↑ Cigarettes growth hormone,
triglyceride, ↑
WBC
Smoking IgE
↑ Chronic ↑
RBC, Hgb
Pulmonary Function

IgA, IgG, IgM ↓

↑ Cigarettes Immune Response
Blood components ≠
Crying, anxiety, fear, trauma WBC
Cortisol, ACTH, ↑
catecholamine
Stress
Serum iron ↓
Aldosterone,
TSH, GH ≠