Article

Letter to the Editor

Ann Lab Med 2021; 41(5): 504-505

Published online September 1, 2021 https://doi.org/10.3343/alm.2021.41.5.504

Copyright © Korean Society for Laboratory Medicine.

Reply to the Letter “The Stability of Blood Gas Parameters Depends on Leukocyte Count”

Ariadna Arbiol-Roca , Ph.D. and Claudia Elizabeth Imperiali , Ph.D.

Laboratori Clínic Territorial Metropolitana Sud–Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain

Correspondence to: Ariadna Arbiol-Roca, Ph.D.
Laboratori Clínic Territorial Metropolitana Sud–Hospital Universitari de Bellvitge, 08907 Hospitalet de Llobregat, Barcelona, Spain
Tel: +34932607500, E-mail: ariadna.arbiol@bellvitgehospital.cat

Received: January 29, 2021; Revised: February 16, 2021; Accepted: March 23, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dear Editor,

We would like to thank Vaudran, et al. [1] for their letter in response to our article “Stability of pH, blood gas partial pressure, hemoglobin oxygen saturation fraction, and lactate concentration” [2]. We agree with the issues raised by the authors.

In our study, we had acquired complete blood count data of each sample and had preliminarily analyzed whether leukocyte count affected the stability of pH, partial pressure of carbon dioxide (pCO2) and oxygen (pO2), hemoglobin oxygen saturation (sO2), and lactate concentration through a logistic regression model [2].

We observed that leukocytosis impairs the stability of pH and pCO2 in blood samples at room temperature (25°C). The logistic regression model revealed an association of decreased pH (P=0.041) and increased pCO2 (P=0.034) with increased leukocyte count because leukocyte metabolism promotes acidosis (Table 1). However, in samples stored under our recommended condition (45 minutes at 0–3.9°C), we found no association of pH and pCO2 with leukocyte count (P>0.05). Therefore, it is likely that storage at low temperatures (0–3.9°C) reduces leukocyte metabolism in samples and thus, leukocyte count would not affect the stability of blood gas parameters.

Table 1 . Logistic regression model of the effect of leukocyte count (×109/L) on the stability of pH, pCO2, pO2, sO2, and lactate concentration at room temperature (25°C)

POR95% CI
pH0.0410.9810.963–0.999
pCO2 (mm Hg)0.0341.0191.001–1.037
pO2 (mm Hg)0.157--
sO2 (%)0.314--
Lactate (mmol/L)0.173--

Abbreviations: CI, confidence interval; OR, odds ratio; pCO2, partial pressure of carbon dioxide; pO2, partial pressure of oxygen; sO2, hemoglobin oxygen saturation.



The flow chart proposed by the Vaudran, et al. [1] seems very consistent and useful in daily clinical practice. Nevertheless, when leukocyte count cannot be determined, we still recommend storing samples at 0–3.9°C for a maximum of 45 minutes.

We thank all laboratory staff who were involved in the study.


Arbiol-Roca A and Imperiali CE were involved in the study conception, design, data acquisition, analysis, and interpretation as well as drafting, reviewing, and editing of the manuscript. Both the authors read and approved the final manuscript.


The authors declare no conflicts of interest.


This study was supported by a grant from Fundación JL Castaño– SEQC “María Rosa Concustell 2013”.

  1. Vaudran L, Pekar JD, Grzych G, Maboudou P. The stability of blood gas parameters depends on leukocyte Count. Ann Lab Med 2021;41:5:530-1.
    Pubmed CrossRef
  2. Arbiol-Roca A, Imperiali CE, Dot-Bach D, Valero-Politi J, Dastis-Arias M. Stability of pH, blood gas partial pressure, hemoglobin oxygen saturation fraction, and lactate concentration. Ann Lab Med 2020;40:448-56.
    Pubmed KoreaMed CrossRef