K₂EDTA Versus K₃EDTA Stability in Yemeni Laboratories: Toward Climate-Adapted Protocols for Resource-Limited Settings
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ID: 311562
2025
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Abstract
Background: Preanalytical variability due to anticoagulant choice remains inadequately characterized in resource-limited tropical settings like Yemen, where environmental stressors exacerbate challenges. This study aimed to compare the stability and cost-effectiveness of K₂EDTA and K₃EDTA anticoagulants for complete blood count testing under simulated Yemeni conditions.
Methods: Prospective study of 100 healthy adult male volunteers in Ad’Dla Governorate, Yemen (January–March 2025). Paired samples in K₂EDTA/K₃EDTA tubes were analyzed at baseline (T0) and after 6-hour storage at 22 ± 2°C (T6). Statistical analysis included Bonferroni-corrected repeated-measures ANOVA and paired t-tests.
Results: Fresh samples showed high inter-anticoagulant concordance (ICC > 0.90). After 6-hour storage, K₂EDTA exhibited significant Mean Corpuscular Volume (MCV) reduction (Δ = −2.33 fL, p < 0.001; Cohen’s d = 0.42), while K₃EDTA showed greater Red Blood Cell (RBC) instability (Δ = −0.16 × 10¹²/L, p = 0.008). An observed bidirectional Red Cell Distribution Width – Standard Deviation (RDW-SD) pattern emerged: K₂EDTA increased values (+1.71%) while K₃EDTA decreased them (−2.20%, both p < 0.01). K₃EDTA offered 4.7% direct cost savings per test but incurred higher slide-review costs due to 8% platelet clumping.
Conclusions: K₂EDTA demonstrates superior stability for delayed processing (> 2 hours), while K₃EDTA is preferable for immediate analysis. These findings provide preliminary guidance for hematology testing in Yemeni laboratories and similar tropical settings, pending validation in diverse populations and extreme conditions.
| Reference Key |
ali2025kedta
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|---|---|
| Authors | Naif Taleb Ali |
| Journal | Yemen Journal of Medicine |
| Year | 2025 |
| DOI |
10.63475/yjm.v4i2.0150
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| URL | |
| Keywords | Keywords not found |
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