Blood test

Last updated
Modern hospital hematology laboratory Hematology .jpg
Modern hospital hematology laboratory

A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a hypodermic needle, or via fingerprick. Multiple tests for specific blood components, such as a glucose test or a cholesterol test, are often grouped together into one test panel called a blood panel or blood work. Blood tests are often used in health care to determine physiological and biochemical states, such as disease, mineral content, pharmaceutical drug effectiveness, and organ function. Typical clinical blood panels include a basic metabolic panel or a complete blood count. Blood tests are also used in drug tests to detect drug abuse.

Contents

Extraction

A venipuncture performed using a vacutainer Blooddraw.jpg
A venipuncture performed using a vacutainer

A venipuncture is useful as it is a minimally invasive way to obtain cells and extracellular fluid (plasma) from the body for analysis. Blood flows throughout the body, acting as a medium that provides oxygen and nutrients to tissues and carries waste products back to the excretory systems for disposal. Consequently, the state of the bloodstream affects or is affected by, many medical conditions. For these reasons, blood tests are the most commonly performed medical tests. [1]

If only a few drops of blood are needed, a fingerstick is performed instead of a venipuncture. [2]

In dwelling arterial, central venous and peripheral venous lines can also be used to draw blood. [3]

Phlebotomists, laboratory practitioners and nurses are those in charge of extracting blood from a patient. However, in special circumstances, and/or emergency situations, paramedics and physicians extract the blood. Also, respiratory therapists are trained to extract arterial blood to examine arterial blood gases. [4] [5]

Types of tests

Vacutainer tubes used in the collection of blood. During venipuncture, pressure differences between the vein and the vacuum in the Vacutainer forces blood into the tube. Vacutainer blood bottles.jpg
Vacutainer tubes used in the collection of blood. During venipuncture, pressure differences between the vein and the vacuum in the Vacutainer forces blood into the tube.

Biochemical analysis

A basic metabolic panel measures sodium, potassium, chloride, bicarbonate, blood urea nitrogen (BUN), magnesium, creatinine, glucose, and sometimes calcium. Tests that focus on cholesterol levels can determine LDL and HDL cholesterol levels, as well as triglyceride levels. [6]

Some tests, such as those that measure glucose or a lipid profile, require fasting (or no food consumption) eight to twelve hours prior to the drawing of the blood sample. [7]

For the majority of tests, blood is usually obtained from the patient's vein. Other specialized tests, such as the arterial blood gas test, require blood extracted from an artery. Blood gas analysis of arterial blood is primarily used to monitor carbon dioxide and oxygen levels related to pulmonary function, but is also used to measure blood pH and bicarbonate levels for certain metabolic conditions. [8]

While the regular glucose test is taken at a certain point in time, the glucose tolerance test involves repeated testing to determine the rate at which glucose is processed by the body. [9]

Blood tests are also used to identify autoimmune diseases and Immunoglobulin E-mediated food allergies (see also Radioallergosorbent test). [10] :1118

Normal ranges

Blood tests results should always be interpreted using the ranges provided by the laboratory that performed the test. Example ranges are shown below.

Test [11] [12] LowHighUnitComments
Sodium (Na)134145mmol/L
Potassium (K)3.55.0mmol/L
Urea 2.56.4mmol/L Blood urea nitrogen (BUN)
Urea1540mg/dL
Creatinine - male62115μmol/L
Creatinine - female5397μmol/L
Creatinine - male0.71.3mg/dL
Creatinine - female0.61.2 mg/dL
Glucose (fasting)3.95.8mmol/LSee also glycated hemoglobin
Glucose (fasting)70120mg/dL

Common abbreviations

Upon completion of a blood test analysis, patients may receive a report with blood test abbreviations. Examples of common blood test abbreviations are shown below.

Abbreviation [13] [14] Stands forDescription
HDL High Density Lipoprotein Level of "good cholesterol" in the blood (ratio of HDL:LDL is usually more significant than actual values)
LDL Low Density Lipoprotein Level of "bad cholesterol" in the blood (ratio of HDL:LDL is usually more significant than actual values)
PV Plasma Viscosity Plasma Viscometry (PV) is the measurement of the viscosity of blood plasma. The result is a number given in milliPascal seconds (m.Pas.s) – known as the PV, or plasma viscosity.
CRP C-Reactive Protein Level of inflammation with the body. If the immune system is fighting an infection or illness, CRP will be higher.
CBC

(UK: FBC)

Complete Blood Count

(UK: Full Blood Count)

Analysis of 15 different blood test readings to provide information about overall health.
TSH Thyroid-stimulating hormone Thyroid regulates the function of metabolism. Low levels can lead to weight loss, while high levels lead to weight gain.
PTH Parathyroid hormone Regulates serum calcium
ESR Erythrocyte Sedimentation Rate Indicates the time it takes for red blood cells to move down a tube. This shows signs of inflammation within a body.
INR International Normalized Ratio This is a blood clotting test.
LFTLiver Function TestThis test reveals the levels of waste products, enzymes and proteins that are processed by the liver.
U+EUrea and ElectrolytesThis test is performed to measure the function of kidney.
CMP Comprehensive Metabolic Panel This analysis provides an overall picture of the metabolism and chemical balance of the body.
WBC White Blood Cell CountThe level of white blood cells.
RBC Red Blood Cell CountThe level of red blood cells.
HBC Hemoglobin Level of hemoglobin molecules.
HCT Hematocrit Similar to RBC but in percentage.
PLT Platelets Platelets levels in the blood.

Molecular profiles

Cellular evaluation

Future alternatives

Saliva tests

In 2008, scientists announced that the more cost effective saliva testing could eventually replace some blood tests, as saliva contains 20% of the proteins found in blood. [15] Saliva testing may not be appropriate or available for all markers. For example, lipid levels cannot be measured with saliva testing.

Microemulsion

In February 2011, Canadian researchers at the University of Calgary's Schulich School of Engineering announced a microchip for blood tests. Dubbed a microemulsion, a droplet of blood captured inside a layer of another substance. It can control the exact size and spacing of the droplets. The new test could improve the efficiency, accuracy, and speed of laboratory tests while also doing it cheaply. [16] The microchip costs $25, whereas the robotic dispensers currently in use cost around $10,000.[ citation needed ]

SIMBAS

In March 2011, a team of researchers from UC Berkeley, DCU and University of Valparaíso have developed lab-on-a-chip that can diagnose diseases within 10 minutes without the use of external tubing and extra components. It is called Self-powered Integrated Microfluidic Blood Analysis System (SIMBAS). It uses tiny trenches to separate blood cells from plasma (99 percent of blood cells were captured during experiments). Researchers used plastic components, to reduce manufacturing costs. [17] [18]

See also

Related Research Articles

<span class="mw-page-title-main">Blood</span> Organic fluid which transports nutrients throughout the organism

Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the circulatory system is also known as peripheral blood, and the blood cells it carries, peripheral blood cells.

<span class="mw-page-title-main">Cholesterol</span> Sterol biosynthesized by all animal cells

Cholesterol is the principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils.

<span class="mw-page-title-main">Glucose</span> Naturally produced monosaccharide

Glucose is a sugar with the molecular formula C6H12O6. Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using energy from sunlight, where it is used to make cellulose in cell walls, the most abundant carbohydrate in the world.

High-density lipoprotein (HDL) is one of the five major groups of lipoproteins. Lipoproteins are complex particles composed of multiple proteins which transport all fat molecules (lipids) around the body within the water outside cells. They are typically composed of 80–100 proteins per particle. HDL particles enlarge while circulating in the blood, aggregating more fat molecules and transporting up to hundreds of fat molecules per particle.

In biology, homeostasis is the state of steady internal, physical, chemical, and social conditions maintained by living systems. This is the condition of optimal functioning for the organism and includes many variables, such as body temperature and fluid balance, being kept within certain pre-set limits. Other variables include the pH of extracellular fluid, the concentrations of sodium, potassium, and calcium ions, as well as the blood sugar level, and these need to be regulated despite changes in the environment, diet, or level of activity. Each of these variables is controlled by one or more regulators or homeostatic mechanisms, which together maintain life.

<span class="mw-page-title-main">Glucose tolerance test</span> Medical test of how quickly glucose is cleared from the blood

The glucose tolerance test is a medical test in which glucose is given and blood samples taken afterward to determine how quickly it is cleared from the blood. The test is usually used to test for diabetes, insulin resistance, impaired beta cell function, and sometimes reactive hypoglycemia and acromegaly, or rarer disorders of carbohydrate metabolism. In the most commonly performed version of the test, an oral glucose tolerance test (OGTT), a standard dose of glucose is ingested by mouth and blood levels are checked two hours later. Many variations of the GTT have been devised over the years for various purposes, with different standard doses of glucose, different routes of administration, different intervals and durations of sampling, and various substances measured in addition to blood glucose.

<span class="mw-page-title-main">Clinical chemistry</span> Area of clinical pathology that is generally concerned with analysis of bodily fluids

Clinical chemistry is a division in medical laboratory sciences focusing on qualitative tests of important compounds, referred to as analytes or markers, in bodily fluids and tissues using analytical techniques and specialized instruments. This interdisciplinary field includes knowledge from medicine, biology, chemistry, biomedical engineering, informatics, and an applied form of biochemistry.

Reference ranges for blood tests are sets of values used by a health professional to interpret a set of medical test results from blood samples. Reference ranges for blood tests are studied within the field of clinical chemistry, the area of pathology that is generally concerned with analysis of bodily fluids.

<span class="mw-page-title-main">Venipuncture</span> Process of obtaining intravenous access

In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of venous blood sampling or intravenous therapy. In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. In veterinary medicine, the procedure is performed by veterinarians and veterinary technicians.

<span class="mw-page-title-main">Blood sugar level</span> Concentration of glucose present in the blood (Glycaemia)

The blood sugar level, blood sugar concentration, blood glucose level, or glycemia, is the measure of glucose concentrated in the blood. The body tightly regulates blood glucose levels as a part of metabolic homeostasis.

<span class="mw-page-title-main">Arterial blood gas test</span> A test of blood taken from an artery that measures the amounts of certain dissolved gases

An arterial blood gas (ABG) test, or arterial blood gas analysis (ABGA) measures the amounts of arterial gases, such as oxygen and carbon dioxide. An ABG test requires that a small volume of blood be drawn from the radial artery with a syringe and a thin needle, but sometimes the femoral artery in the groin or another site is used. The blood can also be drawn from an arterial catheter.

A blood gas test or blood gas analysis tests blood to measure blood gas tension values, it also measures blood pH, and the level and base excess of bicarbonate. The source of the blood is reflected in the name of each test; arterial blood gases come from arteries, venous blood gases come from veins and capillary blood gases come from capillaries. The blood gas tension levels of partial pressures can be used as indicators of ventilation, respiration and oxygenation. Analysis of paired arterial and venous specimens can give insights into the aetiology of acidosis in the newborn.

<span class="mw-page-title-main">Body fluid</span> Liquids inside of the human body, sometimes excreted or secreted

Body fluids, bodily fluids, or biofluids, sometimes body liquids, are liquids within the human body. In lean healthy adult men, the total body water is about 60% (60–67%) of the total body weight; it is usually slightly lower in women (52–55%). The exact percentage of fluid relative to body weight is inversely proportional to the percentage of body fat. A lean 70 kg (150 lb) man, for example, has about 42 (42–47) liters of water in his body.

<span class="mw-page-title-main">Ischemia</span> Restriction in blood supply to tissues

Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism. Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue i.e. hypoxia and microvascular dysfunction. It also implies local hypoxia in a part of a body resulting from constriction. Ischemia causes not only insufficiency of oxygen, but also reduced availability of nutrients and inadequate removal of metabolic wastes. Ischemia can be partial or total blockage. The inadequate delivery of oxygenated blood to the organs must be resolved either by treating the cause of the inadequate delivery or reducing the oxygen demand of the system that needs it. For example, patients with myocardial ischemia have a decreased blood flow to the heart and are prescribed with medications that reduce chronotrophy and ionotrophy to meet the new level of blood delivery supplied by the stenosed vasculature so that it is adequate.

<span class="mw-page-title-main">Hypercholesterolemia</span> High levels of cholesterol in the blood

Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. It is a form of hyperlipidemia, hyperlipoproteinemia, and dyslipidemia.

<span class="mw-page-title-main">Venous blood</span> Deoxygenated blood

Venous blood is deoxygenated blood which travels from the peripheral blood vessels, through the venous system into the right atrium of the heart. Deoxygenated blood is then pumped by the right ventricle to the lungs via the pulmonary artery which is divided in two branches, left and right to the left and right lungs respectively. Blood is oxygenated in the lungs and returns to the left atrium through the pulmonary veins.

An embolus, is described as a free-floating mass, located inside blood vessels that can travel from one site in the blood stream to another. An embolus can be made up of solid, liquid, or gas. Once these masses get "stuck" in a different blood vessel, it is then known as an "embolism." An embolism can cause ischemia—damage to an organ from lack of oxygen. A paradoxical embolism is a specific type of embolism in which the embolus travels from the right side of the heart to the left side of the heart and lodges itself in a blood vessel known as an artery. Thus, it is termed "paradoxical" because the embolus lands in an artery, rather than a vein.

<span class="mw-page-title-main">Vascular disease</span> Medical condition

Vascular disease is a class of diseases of the vessels of the circulatory system in the body, including blood vessels – the arteries and veins, and the lymphatic vessels. Vascular disease is a subgroup of cardiovascular disease. Disorders in this vast network of blood and lymph vessels can cause a range of health problems that can sometimes become severe, and fatal. Coronary heart disease for example, is the leading cause of death for men and women in the United States.

<span class="mw-page-title-main">Oxygen saturation (medicine)</span> Medical measurement

Oxygen saturation is the fraction of oxygen-saturated hemoglobin relative to total hemoglobin in the blood. The human body requires and regulates a very precise and specific balance of oxygen in the blood. Normal arterial blood oxygen saturation levels in humans are 97–100 percent. If the level is below 90 percent, it is considered low and called hypoxemia. Arterial blood oxygen levels below 80 percent may compromise organ function, such as the brain and heart, and should be promptly addressed. Continued low oxygen levels may lead to respiratory or cardiac arrest. Oxygen therapy may be used to assist in raising blood oxygen levels. Oxygenation occurs when oxygen molecules enter the tissues of the body. For example, blood is oxygenated in the lungs, where oxygen molecules travel from the air and into the blood. Oxygenation is commonly used to refer to medical oxygen saturation.

<span class="mw-page-title-main">Sampling (medicine)</span> Collection of bodily substances for medical assessment

In medicine, sampling is gathering of matter from the body to aid in the process of a medical diagnosis and/or evaluation of an indication for treatment, further medical tests or other procedures. In this sense, the sample is the gathered matter, and the sampling tool or sampler is the person or material to collect the sample.

References

  1. "Venipuncture - the extraction of blood using a needle and syringe". Archived from the original on June 21, 2012. Retrieved June 21, 2012.
  2. MacLennan CA, van Oosterhout JJ, White SA, Drayson MT, Zijlstra EE, Molyneux ME (July 2007). "Finger-prick blood samples can be used interchangeably with venous samples for CD4 cell counting indicating their potential for use in CD4 rapid tests". AIDS. 21 (12): 1643–5. doi:10.1097/QAD.0b013e32823bcb03. PMC   2408852 . PMID   17630562.
  3. Lesser, Finnian D; Lanham, David A; Davis, Daniel (6 May 2020). "Blood sampled from existing peripheral IV cannulae yields results equivalent to venepuncture: a systematic review". JRSM Open. 11 (5): 205427041989481. doi: 10.1177/2054270419894817 . PMC   7236571 . PMID   32523703.
  4. Aaron SD, Vandemheen KL, Naftel SA, Lewis MJ, Rodger MA (2003). "Topical tetracaine prior to arterial puncture: a randomized, placebo-controlled clinical trial". Respir. Med. 97 (11): 1195–1199. doi: 10.1016/S0954-6111(03)00226-9 . PMID   14635973.
  5. "Michigan careers". Michigan.gov. 2010-01-05. Archived from the original on June 29, 2011. Retrieved 2011-08-09.
  6. Belargo, Kevin. "Cholesterol Levels". Manic EP. Archived from the original on 18 January 2012. Retrieved 17 January 2012.
  7. "Fasting blood samples". NHS UK. Archived from the original on June 21, 2012. Retrieved June 21, 2012.
  8. "Blood gases". NHS UK. Archived from the original on May 6, 2012. Retrieved June 21, 2012.
  9. "Glucose tolerance test". Medline. Archived from the original on June 9, 2012. Retrieved June 21, 2012.
  10. Handbook of nutrition and food. Carolyn D. Berdanier, Johanna T. Dwyer, Elaine B. Feldman (2 ed.). Boca Raton: Taylor & Francis. 2008. ISBN   978-0-8493-9218-4. OCLC   77830546.{{cite book}}: CS1 maint: others (link)
  11. C. A. Burtis and E. R. Ashwood, Tietz Textbook of Clinical Chemistry (1994) 2nd edition, ISBN   0-7216-4472-4
  12. "Blood tests normal ranges". Monthly Prescribing Reference. Archived from the original on June 21, 2018. Retrieved June 21, 2012.
  13. "Appendix B: Some Common Abbreviations". MedlinePlus. U.S. National Library of Medicine. Archived from the original on 2016-04-25. Retrieved 2016-04-16.
  14. "Understanding Blood Tests Online". Lab Tests Portal. Archived from the original on 2016-04-09. Retrieved 2016-04-16.
  15. Denny P, Hagen FK, Hardt M, et al. (May 2008). "The proteomes of human parotid and submandibular/sublingual gland salivas collected as the ductal secretions". J. Proteome Res. 7 (5): 1994–2006. doi:10.1021/pr700764j. PMC   2839126 . PMID   18361515.
  16. "Microchip offers faster and cheaper way to test blood". CTV News. Bell Media. 2 February 2011. Archived from the original on 3 October 2016. Retrieved 2 October 2016.
  17. Taylor, Kate (2011-03-18). "Blood analysis chip detects diseases in minutes". Archived from the original on 2011-03-25. Retrieved 2011-03-26.
  18. Dailey, Jessica (2011-03-22). "New SIMBAS Blood Analysis Biochip Can Diagnose Diseases In Minutes". Inhabitat.com. Archived from the original on 2011-03-26. Retrieved 2011-03-26.