Tabung Pengumpul Darah, Zat

Aditif dan Penggunaan

Laboratorium
• Sistem tabung evakuasi untuk pengumpulan
darah yang digunakan untuk berbagai tes
laboratorium terdiri dari tabung dengan
berbagai ukuran, dengan kode warna tutup
tabung yang menunjukkan isi tabung.
• Sebagian besar tabung pengumpul darah
– mengandung aditif yang bisa mempercepat
pembekuan darah (clot activator) atau
– mencegah pembekuan darah (antikoagulan).
 Anti Koagulan
•  suatu zat yang mencegah agar darah tidak
membeku
• Pembekuan dihambat melalui beberapa
proses seperti:
– Kelasi
– Pengikatan Kalsium
– Menghambat pembentukan trombin
 Red
The red bottle is less common – it is used for
biochemistry tests requiring serum which might
be adversely affected by the separator gel used
in the yellow bottle.
• Additive: None or contains silica particles which act as clot
activators.
• What additive does: Clot activator promotes blood
clotting with glass or silica particles.
• Laboratory Uses: Serum testing (glucose, cholesterol,
triglycerides, HDL, potassium, amylase, alkaline
phosphatase, BUN, CK, liver enzymes), blood bank,
serology (RH Typing, Antibody screening, Red Cell
Phototyping, DAT, RPR, monospot, rheumatoid factor,
ANA).
 Natrium Sitrat (Biru Muda)
• Garam 0,109 M (3,2%)
• Garam 0,129 M (3,8%)
• Guna:
– LED  sitrat:darah = 1:4
– Koagulasi (mengandung buffer untuk meningkatkan
stabilitas Fc v dan VIII sitrat:darah = 1:9
• Kerja: Pengikatan ion Kalsium
• Plasma sitrat harus dipisahkan segera dari darah
sitrat
 Light Blue
The blue bottle is used for haematology tests
involving the clotting system, which require
inactivated whole blood for analysis.
• Additive: Sodium Citrate
• What additive does: Binds and remove calcium to prevent
blood from clotting
• Laboratory uses: Coagulation (clotting process-P.T)
PT (Prothrombin Time – evaluates the extrinsic system of the
coagulation cascade & monitors coumadin therapy)
APTT/ PTT (Activated Partial Thromboplastin Time – evaluates
the intrinsic system of the coagulation cascade & monitors
heparin therapy)
FDP (Fibrinogen Degradation Products)
TT (Thrombin Time)
Factor assays
 Heparin (Hijau)
• Kerja: anti trombin
 menghambat pembentukan trombin
sehingga perubahan fibrinogen menjadi fibrin
terganggu
• Tidak merubah ukuran eritrosit
• Menyebabkan clumping leukosit dan
trombosit
 Green
This less commonly used bottle is for
biochemistry tests which require
heparinised plasma or whole blood for
analysis.
• Additive: Heparin (Sodium/Lithium/Ammonium)
• What additive does: Inhibits thrombin formation
to prevent clotting
• Laboratory uses: Chemistry Testing (Plasma
determinations in chemistry) : ammonia,
carboxyhemoglobin & STAT electrolytes,
chromosome screening, insulin, renin and
aldosterone.
 Garam EDTA (Ungu)
• Yang sering dipakai K3EDTA
• Dibolak-balik segera min 8x
 menghindari terjadinya gumpalan trombosit dan
pembentukan mikroclot
• K2EDTA  lebih mudah larut dari Na2EDTA
• K3EDTA
– Cair  mempengaruhi kadar Hb, Leukosit, eritrosit, trombosit,
Ht
– Spray-dried  mudah larut, direkomendasikan
• Prinsip
– Merubah ion Kalsium menjadi bentuk bukan ion
– Menghambat agregasi trombosit
 Lavender
These bottles are generally used for
haematology tests where whole blood is
required for analysis.
• Additive: EDTA (Ethylenediaminetetraacetic Acid)
• What additive does: Removes calcium preventing
clotting of blood
• Laboratory uses: Hematology testing (ESR, CBC
w/diff., HgBA1c) blood film for abnormal cells or
malaria parasites, reticulocytes, red cell folate,
Monospot test for EBV, parathyroid hormone
(PTH)
 Sodium Fluorida + Kalium Oksalat
(Abu-Abu)
Sodium Fluorida
• Sifat: menghambat glikolisis
• Guna: pemeriksaan gula darah
• Bila tanpa antikoagulan, gula darah menurun 10 mg/dLtiap
1 jam
Kalium Oksalat
• Kerja:
– Mengikat ion kalsium
– Sifat antiglikolisis
Sodium Fluorida +Kalium Oksalat:
– Menurunkan aktifitas fosfatase asam
– Meningkatkan aktivitas amilase
 Grey
Additive: Potassium oxalate and Sodium
fluoride
What additive does: Sodium fluoride acts
as an antiglycolytic agent to ensure that no
further glucose breakdown occurs within
the sample after it is taken. Potassium
oxalate removes calcium and acts as an
anticoagulant.
Laboratory uses: Chemistry testing,
especially glucose(sugar) and lactate,
Glucose tolerance test (GTT)
 Royal Blue
Additive: Sodium Heparin also
Sodium EDTA
What additive does: Inhibits
Thrombin formation to prevent
Laboratory uses: Chemistry trace
elements (such as Zinc, Copper,
Lead and Mercury), toxicology,
and nutritional chemistry testing.
 Black

Additive: Sodium Citrate

What additive does:
Forms calcium salts to
remove calcium
Laboratory uses:
paediatric ESR