Adequacies of skin puncture for evaluating biochemical and hematological blood parameters in athletes

Maximizing Microsampling: Measurement of Comprehensive Metabolic and Lipid Panels Using a Novel Capillary Blood Collection Device

BACKGROUND

Demand continues to grow for patient-centric sampling solutions that enable collection of small volumes of blood outside of healthcare facilities. Various technologies have been developed to facilitate sample collection but gaps in knowledge remain, preventing these technologies from replacing standard venipuncture.

METHODS

A novel blood collection device, Touch Activated Phlebotomy (TAP) II® from YourBio Health, and standard fingerstick collection using a BD Microtainer® were utilized to collect capillary serum samples. Measurements of a comprehensive metabolic and lipid panels were measured on these samples and compared to results from venous serum samples that were collected in parallel. Hemolysis was used to assess sample quality. Sample volumes obtained from self-collected TAP II samples were also determined.

RESULTS

Correlation of capillary serum with respect to venous serum was demonstrated (R > 0.9) for professionally collected TAP II samples, self-collected TAP II samples, and professionally collected fingerstick samples for alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, cholesterol, high-density lipoprotein, total bilirubin, and triglycerides. Results for creatinine demonstrated acceptable correlation, however, a consistent negative bias was observed. Biases (with unacceptable correlations) were also observed for measurements of carbon dioxide and potassium. Correlative results for albumin were not consistently acceptable across the collection techniques utilized while the remaining analytes tested did not demonstrate acceptable correlations under any condition. Correlation results, however, would improve with a wider distribution of analyte concentrations.

CONCLUSIONS

Collections of small volumes of liquid blood continue to show potential as a patient-centric solution.

Venous versus capillary sampling for total creatine kinase assay: Effects of a simulated football match

Background

Capillary rather than venipuncture may be a simpler and less invasive blood collection protocol that would increase the number of potential sampling tests. However, if capillary sampling can be used as an alternative to venipuncture to determine changes in plasma, total creatine kinase (CK) activity in response to a football training session is poorly known.

Objective

This study aims to determine whether capillary blood sampling would provide representative measures of total CK activity compared to venipuncture in response to a football training session-induced elevated CK plasma levels.

Methods

Twenty-two players from an under-19 football team performed a simulated football match with 11 players on each team for 90 minutes total duration (two halves of 45 minutes with 15 minutes rest between). Venous and ear lobe capillary blood samples were collected before and after (24h and 48h) the training session. Athletes retested for three consecutive days after exercise during the recovery week.

Results

The simulated match significantly increased (P< 0.05) total CK activity as determined in both venous (1.7-fold) and capillary (1.9-fold) blood sampling. Total CK activity determined using capillary samples demonstrated significant correlation (r = 0.85; P < 0.01) and an elevated concordance Lin index (pc = 0.80) when compared to venous sampling total CK. The Bland–Altman plot showed capillary sampling CK overestimated venous CK levels by 130 U/L (61%), with moderated variance and low bias.

Conclusions

Our results demonstrated that capillary sampling for total CK activity assay may be considered a reliable alternative to venipuncture to determine changes in plasma total CK activity in response to a football training session.

Effect of Compression Garments on Physiological Responses After Uphill Running

Limited practical recommendations related to wearing compression garments for athletes can be drawn from the literature at the present time. We aimed to identify the effects of compression garments on physiological and perceptual measures of performance and recovery after uphill running with different pressure and distributions of applied compression. In a random, double blinded study, 10 trained male runners undertook three 8 km treadmill runs at a 6% elevation rate, with the intensity of 75% VO2max while wearing low, medium grade compression garments and high reverse grade compression. In all the trials, compression garments were worn during 4 hours post run. Creatine kinase, measurements of muscle soreness, ankle strength of plantar/dorsal flexors and mean performance time were then measured. The best mean performance time was observed in the medium grade compression garments with the time difference being: medium grade compression garments vs. high reverse grade compression garments. A positive trend in increasing peak torque of plantar flexion (60º·s-1, 120º·s-1) was found in the medium grade compression garments: a difference between 24 and 48 hours post run. The highest pain tolerance shift in the gastrocnemius muscle was the medium grade compression garments, 24 hour post run, with the shift being +11.37% for the lateral head and 6.63% for the medial head. In conclusion, a beneficial trend in the promotion of running performance and decreasing muscle soreness within 24 hour post exercise was apparent in medium grade compression garments.

Biological variation of plasma osmolality obtained with capillary versus venous blood

BACKGROUND

Plasma osmolality (POsm) is a gold standard to assess hydration status but requires venipuncture. POsm obtained by lancing a digit, a source of capillary puncture blood (CAP), has not been validated. This study compared POsm from CAP versus venous blood (VEN) and validated its sensitivity to detect dehydration.

METHODS

Healthy young adults (Study A: n=20 men, 22 women; Study B: n=23 men, 23 women) participated. In Study A, CAP and VEN were compared under controlled euhydration meeting dietary reference intakes for water (3.7 L men, 2.7 L women). In Study B, CAP was assessed for sensitivity to detect dehydration with receiver operating characteristic analysis over two 24 h periods: euhydration for 24 h followed by water restriction over 24 h. POsm was measured using freezing point depression.

RESULTS

For all subjects, CAP POsm (283.0±3.9 mOsm/kg) was not significantly different (p=0.07) from VEN (284.2±3.5) during euhydration and met analytical goals for individuality and heterogeneity. When outliers (n=3) were eliminated, mean difference was -1.6 (±3.2) lower (p<0.01) with CAP. Fluid restriction increased (p<0.001) CAP POsm (284.0±4.4 to 292.8±5.2 mOsm/kg), achieving excellent accuracy (0.92) and sensitivity (89.1%) to predict mild dehydration (2% body mass loss).

CONCLUSIONS

POsm via CAP exhibited similar coefficients of variation and analytical goals compared to VEN combined with excellent accuracy and sensitivity to detect dehydration. Although CAP values were approximately 2 mOsm/kg lower than VEN, CAP appears an adequate substitute for tracking changes in non-clinical settings.

Isokinetic eccentric resistance training prevents loss in mechanical muscle function after running

The aim of the study was to verify whether 8 weeks of resistance training employing maximal isokinetic eccentric (IERT) knee extensor actions would reduce the acute force loss observed after high-intensity treadmill running exercise. It was hypothesized that specific IERT would induce protective effects against muscle fatigue and ultrastructural damages, preventing or reducing the loss in mechanical muscle function after running. Subjects were tested before and after IERT protocol for maximal isometric, concentric and eccentric isokinetic knee extensor strength (60° and 180° s(-1)). In a second session, subjects performed treadmill running (~35 min) and the previously mentioned measurements were repeated immediately after running. Subsequently, subjects were randomized to training (n = 12) consisting of 24 sessions of maximal IERT knee extensors actions at 180° s(-1), or served as controls (n = 8). The effects of acute running-induced fatigue and training on isokinetic and isometric peak torque, and rate of force development (RFD) were investigated. Before IERT, running-induced eccentric torque loss at 180° s(-1) was -8 %, and RFD loss was -11 %. Longitudinal IERT led to reduced or absent acute running-induced losses in maximal IERT torque at 180° s(-1) (+2 %), being significantly reduced compared to before IERT (p < 0.05), however, RFD loss remained at -11 % (p > 0.05). In conclusion, IERT yields a reduced strength loss after high-intensity running workouts, which may suggest a protective effect against fatigue and/or morphological damages. However, IERT may not avoid reductions in explosive muscle actions. In turn, this may allow more intense training sessions to be performed, facilitating the adaptive response to running training.

Seven weeks of instability and traditional resistance training effects on strength, balance and functional performance

The objective of the study was to compare the effect of a 7-week unstable and stable resistance training program on measures of strength, balance, and functional performance. Forty participants were divided into unstable or stable resistance training groups. Training was conducted twice a week for 7 weeks. Pre- and post-testing measures included leg extension strength, static and dynamic balance, sit-ups, long jump, hopping test for time, shuttle run, and sprint. Results showed that there was no overall difference between unstable and stable resistance training and the training effects were independent of gender. All measures except sprint time improved with training. Interaction effects demonstrated that unstable resistance training did provide an advantage for number of sit-ups performed (p = 0.03; 8.9%) and the right leg hopping test (6.2%; p = 0.0001). This study has demonstrated that instability resistance training may be considered as effective as traditional stable resistance training for inexperienced resistance trainers. Based on the present study and the literature, instability resistance training should be incorporated in conjunction with traditional stable training to provide a greater variety of training experiences without sacrificing training benefits.

Comparison of a New Blood Sampling Device With the Vacuum Tube System for Plasma and Hematological Analyses in Healthy Dogs

Pediatric devices based on a capillary system may provide an alternative to vacuum tubes for canine blood sampling. The potential advantages are absence of vein collapse, limited blood volume sampled, and improved safety. The aim of this study was to compare routine plasma and hematological variables in seven healthy dogs using both techniques. Five biochemical analytes were measured, and a complete hematological examination and plasma exogenous creatinine clearance test were performed. No clinically relevant difference between the two techniques was observed for any variable or functional test assessed.