What is the white stuff in my blood tube?

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    Have you ever drawn labs from a line and had some buoyant white goop in the tube? I was thinking it might be propofol, but on this particular pt I had been drawing labs on her for a number of days in a row and she hasn't been on propofol for a long time... What is it???
  2. 24 Comments so far...

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    Is pt on heparin? You will also sometimes see these "white" clumps in pts with Hypertriglyceridemia. We see it alot in dialysis in the chambers of our dialysis tubing and dialyzers. Check her lipid profiles and probably high. I have one pt when we draw for her monthly labs there is so much it sometimes literally slows our draw. Her labs were running in the 800's for her triglycerides!!!
    Another thing we see in draws are called "White Thrombus". Has to do with platelet and fibrin aggregations.
    Last edit by Lacie on Dec 13, '09
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    bd vacutainer blood and urine collection- faqs

    what coatings layer the walls of bd vacutainer® plus serum and sst™ tubes?
    bd vacutainer® plus plastic serum and sst™ tubes are coated with silicone and micronized silica particles to accelerate clotting. a silicone coating reduces adherence of red cells to tube walls. the silica coating can sometimes cause the inner tube wall to appear cloudy and/or filmy. this cloudy appearance does not make the tubes unacceptable for use.


    don't forget the tube inversion!


    what are the proper number of inversions for the various bd vacutainer® blood collection tubes?
    an inversion is one complete turn of the wrist, 180 degrees, and back. tubes should be inverted according to the following recommendations:
    • sst and serum tubes – 5 inversions
    • additive tubes (edta, heparin, etc) – 8-10 inversions
    • sodium citrate tubes (blue top) – 3-4 inversions
    jrwest, jrw03282009, and Ayvah like this.
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    I concur with respondent Lacie, in that the buoyant while substance you saw in the blood sampling tube is likely the result of hyperlipidemia. I'm not so sure about White Thrombus formation however, as that seems to occur more so with specific types of hemodialysis tubing (and is also observed with banked blood), in addition to being proportionately dependent upon hematocrit levels (see here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2390940/ ).

    Additionally, as PROPOFOL (DIPRIVAN) enters the blood stream, it is dissolved and rapidly absorbed by peripheral tissues. I'm certainly no pharmacist, but IMHO, I honestly question if there is enough remaining within circulating blood to separate out of solution like your description.

    Hence, my vote is for excess blood lipids.
    Acosmo27 likes this.
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    Quote from stephenfnielsen
    Have you ever drawn labs from a line and had some buoyant white goop in the tube? I was thinking it might be propofol, but on this particular pt I had been drawing labs on her for a number of days in a row and she hasn't been on propofol for a long time... What is it???
    In-N-Out Burger/Jack in the Box/Taco Bell....ask the patient what their poison is. There is a 'ton' of fatty Americans out there exploring the landscape in their motorized wheelchairs. Often they will find their way into the hospitals as well.

    I see it quite often in the dirty south.
    mamamerlee, Meredith09, Acosmo27, and 1 other like this.
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    I agree with the respondants who guess it's fatty matter. When I've drawn bloods on some patients with profound liver disease or pancreatitis and histories of obesity, hyperlipidemia and crappy diets, the fat could be seen rising to the top. Couldn't believe it the first time I saw it, and when they told me what it was I thought they were turning my crank!
    mamamerlee likes this.
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    Quote from RedCell
    I see it quite often in the dirty south.
    That's interesting. I see it more often in the "nasty north"

    Where, pray tell, is the "dirty south"?
    mamamerlee, canigraduate, Lacie, and 2 others like this.
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    Quote from caroladybelle
    That's interesting. I see it more often in the "nasty north"

    Where, pray tell, is the "dirty south"?
    Eastern Texas, North Florida (really all of Florida can be included), Alabama...and a few others. These are just the states that I have experience with. While one can easily observe the motorized wheelchair fans' love of In-N-Out Burger.... it remains a phenomenon of the Western US. I would not consider CA, AZ, UT and NV to be members of this elite group.
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    Very interesting that you can see fat in the blood. It's not the tube because I pulled it with a 10ml syringe
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    I had my blood drawn once after eating fried chicken for lunch and it was full of those little fat globules. I freaked out. The lab person told me that it came from my lunch. Went to the doc right after that and went on a low fat diet and it dissappeared. But my triglcerides were sky high.


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