Effect of heparin and citrate on measured concentrations of various analytes in plasma.

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Abstract
Frequently it is assumed that concentrations of biochemical analytes are similar for serum and plasma, without regard to the anticoagulant. Recently it has been hypothesized that use of certain anticoagulants results in an osmotic redistribution of fluid between blood cells and plasma, causing some dilution of the plasma. We sought to determine the effect of two commonly used anticoagulants, heparin and citrate, on the measured concentrations of 13 clinical-chemical analytes, including selected trace elements, vitamins, lipids, and proteins. The data demonstrate that hyperosmolar citrate causes a significant dilution of all indices measured. In contrast, heparin had no osmotic effect; concentrations of most of the analytes measured in the heparinized plasma were statistically no different from those measured in the corresponding serum. Therefore, anticoagulants must be chosen carefully, especially if concentrations in plasma and serum are to be compared.