Blood sample quality using Greiner Bio-One HOLDEX® Single-Use Holder and VACUETTE® SAFELINK holder with male luer lock: a comparative study

Gian Luca Salvagno, Mairi Pucci, Giuseppe Lippi


Background: Hemolysis is the most frequent and potentially one of the most harmful causes of poor sample quality. Many strategies have been attempted for minimizing the risk of generating spurious hemolysis during blood collection, such as using the HOLDEX® single-use holder, which features a chamber that decelerates blood flow pressure before entering evacuated blood tubes. We have hence designed a study to establish whether the new VACUETTE® SAFELINK, which shares different structure but similar strategy affecting blood flow pressure, may ensure a comparable sample quality as using HOLDEX® single-use holder.
Methods: A total number of 24 clinical chemistry, hematologic and hemostasis parameters were measured in paired blood samples collected from 30 healthy volunteers using either HOLDEX® single-use holder or VACUETTE® SAFELINK. Test results were compared with paired Student’s t-test, Pearson’s correlation and Bland-Altman plots.
Results: All test results were non-significantly different in blood samples collected with HOLDEX® single-use holder or VACUETTE® SAFELINK except potassium, whose values were marginally higher in plasma collected with VACUETTE® SAFELINK. All Pearson’s correlation coefficients were excellent except potassium, chloride and H-index. In this latter case, the correlation did not reach statistical significance. The percent bias of different parameters in samples collected with HOLDEX® single-use holder or VACUETTE® SAFELINK was minimal, comprised between −4.5% and +1.6%. In all cases the percent bias was comprised within the quality specifications tests. The rate of plasma samples with H-index >3 was eventually lower when blood was collected using SAFELINK than with HOLDEX® single use holder (odds ratio, 0.52; 95% confidence interval, 0.17–1.60).
Conclusions: The results of this comparative study suggest that sample quality is thoughtfully comparable using HOLDEX® single-use holder and VACUETTE® SAFELINK, thus translating into the concept that VACUETTE® SAFELINK may also be an effective means for reducing spurious hemolysis, especially when drawing blood from catheters.