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Clinical Chemistry 20: 1513-1519, 1974;
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Clinical Chemistry, Vol 20, 1513-1519, Copyright © 1974 by the American Association for Clinical Chemistry

Factors Contributing to Intra-Individual Variation of Serum Constituents: 4. Effects of Posture and Tourniquet Application on Variation of Serum Constituents in Healthy Subjects

Bernard E. Statland 1, Henning Bokelund 2, and Per Winkel 3

1 Department of Laboratory Medicine, University of Minnesota, Minneapolis, Minn. 55455.
2 Department of Clinical Chemistry, Odense University Hospital, Odense, Denmark.
3 Department of Clinical Chemistry, Finsensinstitute, Copenhagen, Denmark.

We studied the effects on 18 serum constituents of posture and prolonged tourniquet application. The subjects were 11 healthy men, ages 20-25 years. The assays were performed on the AutoChemist Multi-Channel Analyzer (AutoChem Instrument AB, Lidingö, Sweden). To compensate for the within-hour variation in these constituents, we drew blood samples at 1100 h and 1130 h on several days. The 1100-h sample was taken after the subjects had been sitting erect for 60 min. The 1130-h sample followed different posture regimens: Control day: sitting for 15 min; experimental days: after (a) being supine for 30 min, (b) standing for 30 min, and (c) sitting erect for 30 min. The 1130-h/ 1100-h ratios for the three experimental days were compared with those for the control day. Significant differences (P <.05) were found for serum potassium, calcium, total protein, albumin, aspartate aminotransferase, and acid phosphatase under condition a; for phosphate ion, total protein, total lipid, cholesterol, and alkaline phosphatase under condition b; and for aspartate aminotransferase under condition c. The effect of a 3-minute tourniquet application was similarly studied. The ratio of the "prolonged tourniquet application day" differed significantly from the control day with regard to serum potassium, total protein, iron, total lipid, cholesterol, aspartate aminotransferase, and bilirubin. Significance of posture and tourniquet time in blood-sampling and their effect on total intra-individual variation are discussed.


Key Words: variation, source of • statistics • analytical vs. sampling error • instrumental and pre-instrumental error

Submitted on May 13, 1974




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