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Improper design or use of blood collection devices can adversely affect the accuracy of laboratory test results.

Vascular access devices, such as catheters and needles, exert shear forces during blood flow, which creates a predisposition to cell lysis. Components from blood collection tubes, such as stoppers, lubricants, surfactants, and separator gels, can leach into specimens and/or adsorb analytes from a specimen; special tube additives may also alter analyte stability.

Because of these interactions with blood specimens, blood collection devices are a potential source of pre-analytical error in laboratory testing. Accurate laboratory testing requires an understanding of the complex interactions between collection devices and blood specimens.

Manufacturers, vendors, and clinical laboratorians must consider the pre-analytical challenges in laboratory testing.

Although other authors have described the effects of endogenous substances on clinical assay results, the effects/impact of blood collection tube additives and components have not been well systematically described or explained. This review aims to identify and describe additives and their components and the strategies used to minimize their effects on clinical chemistry assays.