What is the white stuff in my blood tube?

Lacie, BSN, RN · Dec 13, 2009

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.

Home Health Columnist / Guide · Dec 13, 2009

bd vacutainer blood and urine collection- faqs

Quote
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!

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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

Emergency RN · Dec 13, 2009

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.

RedCell · Dec 13, 2009

stephenfnielsen said:
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.

pennyaline · Dec 13, 2009

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!

caroladybelle, BSN, RN · Dec 13, 2009

RedCell said:
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"?

RedCell · Dec 13, 2009

caroladybelle said:
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.

stephenfnielsen · Dec 13, 2009

Very interesting that you can see fat in the blood. It's not the tube because I pulled it with a 10ml syringe

Dalzac, LPN, LVN, RN · Dec 14, 2009

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.

jrw03282009 · Dec 14, 2009

When those tubes are spun down, the plasma is a pinkish white b/c of all the fat in the blood. It is AMAZING what our bodies can put up with!

Lacie, BSN, RN · Dec 14, 2009

jrw03282009 said:
When those tubes are spun down, the plasma is a pinkish white b/c of all the fat in the blood. It is AMAZING what our bodies can put up with!

I believe the poster is referring to "prior" to spinning. I have many times drawn for labs and there is large clumps of "white" material in the blood itself. Generally as I previous stated check thier triglycerides, lipid profile, liver enzyme. Bet triglycerides significantly elevated.

:cry: