{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:16:33Z","timestamp":1791317793810,"version":"4.3.1"},"reference-count":14,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the effect of prolonged time before analysis and mechanical manipulation on pre-analytical stability of biomarkers and the validity of blood gas analysis results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected blood samples from 240 ICU patients from May 18, 2022 to March 31, 2023. Samples were analyzed immediately per standard operating procedure, then the syringes were kept at room temperature for 60 min, subjected to standardized mechanical forces (repeated drops) and analyzed again. Thirteen typical blood gas analytes were measured. Bland\u2013Altman plots were prepared to assess differences between initial and delayed analyses. Differences were compared against official accuracy limits specified in German quality assurance guidelines (Rili-BAEK).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For hemoglobin, creatinine, glucose, and electrolytes (calcium, sodium, chloride, bicarbonate), agreement between immediate and post-delay analyses remained within the official acceptable ranges. For pH and potassium, deviations exceeded the Rili-BAEK accuracy limits but remained clinically acceptable. Only oxygen partial pressure and lactate levels changed so markedly that they would no longer be reliable for clinical interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Even after a 60-min delay and excessive mechanical stress, selected blood gas analytes such as hemoglobin, glucose, and electrolytes can be considered valid. Potassium and carbon dioxide partial pressure were altered but might be suitable for approximation purposes. Findings for oxygen partial pressure and lactate were generally invalid. In the future, these findings can aid in reducing unnecessary blood sampling. These findings may guide clinicians in deciding whether repeat sampling is necessary, potentially reducing unnecessary blood draws, while reinforcing that critical parameter (pO\u2082, pCO\u2082, pH) still require prompt analysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0334710","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T18:43:09Z","timestamp":1764873789000},"page":"e0334710","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stability of arterial blood gas samples after delayed analysis and mechanical stress"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8212-6718","authenticated-orcid":true,"given":"Max","family":"Gutermuth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Ihmsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Krischke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Moritz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Prottengeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"issue":"2","key":"pone.0334710.ref001","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s12630-023-02643-8","article-title":"Effect of using smaller blood volume tubes and closed blood collection devices on total blood loss in patients undergoing major cardiac and vascular surgery","volume":"71","author":"V Neef","year":"2024","journal-title":"Can J Anaesth"},{"key":"pone.0334710.ref002","author":"P Meybohm","year":"2017"},{"issue":"4","key":"pone.0334710.ref003","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1183\/09031936.97.10040910","article-title":"Effects of four different methods of sampling arterial blood and storage time on gas tensions and shunt calculation in the 100% oxygen test","volume":"10","author":"FW Smeenk","year":"1997","journal-title":"Eur Respir J"},{"issue":"1","key":"pone.0334710.ref004","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13049-017-0371-3","article-title":"Can we rely on out-of-hospital blood samples? A prospective interventional study on the pre-analytical stability of blood samples under prehospital emergency medicine conditions","volume":"25","author":"J Prottengeier","year":"2017","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"pone.0334710.ref005","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s11812-017-0085-5","article-title":"Arterielle Blutgasanalyse","volume":"12","author":"H Schinko","year":"2017","journal-title":"Wien Klin Wochenschr Educ"},{"issue":"8476","key":"pone.0334710.ref006","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"JM Bland","year":"1986","journal-title":"Lancet"},{"key":"pone.0334710.ref007","article-title":"Guideline of the German Medical Association for the quality assurance of laboratory medical examinations - Rili-B\u00c4K","volume":"111","author":"German Medical Association","year":"2014","journal-title":"Dtsch Arztebl"},{"key":"pone.0334710.ref008","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.cca.2016.03.010","article-title":"Preanalytics: The (in-)stability of volatile POCT parameters and the homogeneity of blood in syringes at the market","volume":"457","author":"MA Gruber","year":"2016","journal-title":"Clin Chim Acta"},{"issue":"7","key":"pone.0334710.ref009","first-page":"732","article-title":"Effects of syringe material, sample storage time, and temperature on blood gases and oxygen saturation in arterialized human blood samples","volume":"51","author":"TP Knowles","year":"2006","journal-title":"Respir Care"},{"issue":"2","key":"pone.0334710.ref010","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2170\/jjphysiol.34.205","article-title":"The Bohr effect and the Haldane effect in human hemoglobin","volume":"34","author":"I Tyuma","year":"1984","journal-title":"Jpn J Physiol"},{"issue":"17","key":"pone.0334710.ref011","doi-asserted-by":"crossref","first-page":"9518","DOI":"10.1021\/acs.analchem.5c01345","article-title":"Crystal facet engineering modulated electron transfer mechanisms: a self-powered photoelectrochemical sensing platform for noninvasive detection of uric acid","volume":"97","author":"S Tian","year":"2025","journal-title":"Anal Chem"},{"issue":"39","key":"pone.0334710.ref012","doi-asserted-by":"crossref","first-page":"13582","DOI":"10.1021\/acs.analchem.2c03263","article-title":"Tunable competitive absorption-induced signal-on photoelectrochemical immunoassay for cardiac troponin I based on Z-scheme metal-organic framework heterojunctions","volume":"94","author":"Y Gao","year":"2022","journal-title":"Anal Chem"},{"issue":"36","key":"pone.0334710.ref013","article-title":"Mechanism exploration of the photoelectrochemical immunoassay for the integration of radical generation with self-quenching","volume":"96","author":"H Wang","year":"2024","journal-title":"Anal Chem"},{"issue":"21","key":"pone.0334710.ref014","doi-asserted-by":"crossref","first-page":"8740","DOI":"10.1021\/acs.analchem.4c01059","article-title":"Pt\/Zn-TCPP nanozyme-based flexible immunoassay for dual-mode pressure-temperature monitoring of low-abundance proteins","volume":"96","author":"D Wu","year":"2024","journal-title":"Anal Chem"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0334710","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T18:43:12Z","timestamp":1764873792000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0334710"}},"subtitle":[],"editor":[{"given":"Baeckkyoung","family":"Sung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,12,4]]},"references-count":14,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0334710","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,4]]}}}