{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T22:53:12Z","timestamp":1754261592338},"reference-count":10,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2019,10,15]]},"abstract":"<jats:p>Introduction: Phlebotomy is an error-prone process in which mistakes are difficult to reveal. This case report describes the effect on laboratory results originating from a blood sample collected in close proximity to an intravenous catheter. Materials and methods: A 69-year-old male patient was referred to the Emergency department where pneumonia was suspected. Phlebotomy was performed to collect blood samples to assess electrolytes, renal function, liver function, infection and haematological parameters. Results: The laboratory analysis showed reduced potassium and calcium concentrations. To prevent life-threatening cardiac failure the clinician decided to correct those electrolytes. Remarkably, the electrocardiogram showed no abnormalities corresponding to hypokalaemia and hypocalcaemia. This observation, in combination with an overall increase in laboratory parameters with the exception of sodium and chloride, led to the suspicion of a preanalytical error. Retrospectively, an intravenous catheter was inserted in close proximity of the puncture place but no continuous infusion was started prior to phlebotomy. However, the intravenous catheter was flushed with sodium chloride. Since potential other causes were excluded, the flushing of the intravenous catheter with sodium chloride prior to phlebotomy was the most probable cause for the deviating laboratory results and subsequently for the unnecessary potassium and calcium suppletion. Conclusion: This case underlines the importance of caution in the interpretation of laboratory results obtained from specimens that are collected in the proximity of an intravenous catheter, even in the absence of continuous infusion.<\/jats:p>","DOI":"10.11613\/bm.2019.031001","type":"journal-article","created":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T06:50:02Z","timestamp":1563346202000},"page":"614-618","source":"Crossref","is-referenced-by-count":4,"title":["Flushing of an intravenous catheter"],"prefix":"10.11613","volume":"29","author":[{"given":"Rutger C.C.","family":"Hengeveld","sequence":"first","affiliation":[{"name":"Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca E.","family":"Olofsen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edm\u00e9e C.","family":"van Dongen-Lases","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Leenhouts","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor F.H.A.","family":"Hakkenberg van Gaasbeek","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milan L.","family":"Ridderikhof","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maaike C.","family":"Gerards","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4885","published-online":{"date-parts":[[2019,10,15]]},"reference":[{"key":"key20190717024911_r1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.11613\/BM.2012.017","article-title":"Preanalytical phase--a continuous challenge for laboratory professionals.","volume":"22","author":"Simundic","year":"2012","journal-title":"Biochem Med (Zagreb)"},{"key":"key20190717024911_r2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1515\/dx-2018-0018","article-title":"Blood sample quality.","volume":"6","author":"Lippi","year":"2019","journal-title":"Diagnosis (Berl)"},{"key":"key20190717024911_r3","first-page":"911","article-title":"Reducing preanalytical laboratory sample errors through educational and technological interventions.","volume":"58","author":"Lillo","year":"2012","journal-title":"Clin Lab"},{"key":"key20190717024911_r4","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1080\/00365513.2017.1295317","article-title":"Pre-analytical phase management: a review of the procedures from patient preparation to laboratory analysis.","volume":"77","author":"Lima-Oliveira","year":"2017","journal-title":"Scand J Clin Lab Invest"},{"key":"key20190717024911_r5"},{"key":"key20190717024911_r6","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1515\/cclm-2018-0602","article-title":"Joint EFLM-COLABIOCLI Recommendation for venous blood sampling.","volume":"56","author":"Simundic","year":"2018","journal-title":"Clin Chem Lab Med"},{"key":"key20190717024911_r7","doi-asserted-by":"crossref","first-page":"342","DOI":"10.11613\/BM.2012.036","article-title":"Impact of the phlebotomy training based on CLSI\/NCCLS H03-a6 - procedures for the collection of diagnostic blood specimens by venipuncture.","volume":"22","author":"Lima-Oliveira","year":"2012","journal-title":"Biochem Med (Zagreb)"},{"key":"key20190717024911_r8"},{"key":"key20190717024911_r9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0736-4679(02)00766-7","article-title":"Spurious values of serum electrolytes due to admixture of intravenous infusion fluids.","volume":"24","author":"Allen","year":"2003","journal-title":"J Emerg Med"},{"key":"key20190717024911_r10","first-page":"220","article-title":"Richtlijn Veneuze bloedafname.","volume":"39","author":"Van Dongen-Lases","year":"2014","journal-title":"Ned Tijdschr Klin Chem Labgeneesk."}],"container-title":["Biochemia medica"],"original-title":[],"link":[{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/29\/3\/10.11613\/BM.2019.031001\/fullArticle","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T01:07:18Z","timestamp":1663981638000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/29\/3\/10.11613\/BM.2019.031001"}},"subtitle":["a cause for unreliable laboratory results"],"short-title":[],"issued":{"date-parts":[[2019,10,15]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,10,15]]},"published-print":{"date-parts":[[2019,10,15]]}},"URL":"https:\/\/doi.org\/10.11613\/bm.2019.031001","relation":{},"ISSN":["1846-7482","1330-0962"],"issn-type":[{"value":"1846-7482","type":"electronic"},{"value":"1330-0962","type":"print"}],"subject":[],"published":{"date-parts":[[2019,10,15]]}}}